Abstract
Purpose: :
To determine the possible involvement of adipokines in the future development of proliferative vitreoretinopathy (PVR) following reattachment surgery for rhegmatogenous retinal detachment (RRD).
Methods: :
A multiplex immunoassay was used to measure 6 different adipokines in 75 subretinal fluid samples collected during reattachment surgery for primary RRD. Twenty-one patients who developed a redetachment due to postoperative PVR after scleral buckling surgery (PVR group) were compared with age-, sex-, and storage-time-matched RRD samples from 54 patients with an uncomplicated postoperative course (RRD group).
Results: :
Detectable levels of adiponectin, adipisin, cathepsin S, chemerin, and leptin were determined in all 75 samples investigated, whereas for tissue inhibitor of metalloproteinase (TIMP)-1, 2/21 (9.5%) PVR samples and 21/54 (38.9%) RRD samples were above the upper detection limit (P = 0.013). The median levels of adiponectin were significantly elevated in the PVR group (26877 pg/mL; range 7810 - 46132) as compared to the RRD group (17699 pg/mL; range 2300 - 38737) (P = 0.006). A highly significant difference was also noted for cathepsin S with median levels of 6119 pg/mL (range 2326 - 9453) in the PVR group and 4592 pg/mL in the RRD group (range 1230 - 10151) (P = 0.001). Furthermore, we found a 2-fold elevation of median leptin levels in patients who developed postoperative PVR (2357 pg/mL; range 818 - 13067) as compared to RRD patients with an uncomplicated postoperative course (1136 pg/mL; range 694 - 7397) (P = 0.041). There were no significant differences in levels of adipsin (P = 0.915) and chemerin (P = 0.351) between both groups. In contrast, median levels of TIMP-1 were significantly lower in the PVR group (14401 pg/mL; range 8724 - >28000) than in the RRD group (16356 pg/mL; range 8581 - >28000) (P = 0.044). Of all adipokines investigated, logistic regression analysis showed that adiponectin was the exclusive predictor of the development of redetachment due to PVR after scleral buckling surgery (P = 0.003). We found that for each 10000 pg/mL increase in adiponectin content the probability of the occurrence of postoperative PVR increased with an odds ratio of 2.3.
Conclusions: :
Our findings indicate that an increased expression of adiponectin, cathepsin S, and leptin and a decreased expression of TIMP-1 at the time of primary retinal detachment surgery are associated with the future development of PVR.
Keywords: retinal detachment • proliferative vitreoretinopathy • cytokines/chemokines