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N. Stupp, H. Herbst, H. Gerding; Clinical and Immunehistochemical Findings After Heavy Internal Tamponade With Oxane HD® . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5505.
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Purpose: 1. To evaluate the anatomical results, functional outcome, and ocular complications of heavy internal tamponade applying Oxane HD® and 2. to describe and characterize secondary proliferations occurring in reaction to this new substance by immunehistochemical techniques. Methods: Oxane HD® was applied in 24 patients (24 eyes, f =11, m =13, median age 60.5 years, range 40– 84 years) with complicated retinal detachment involving significantly the inferior part of the retina between July 1st 2003 and February 28th, 2004. 13/24 eyes had one or more previous unsuccessful major retinal/vitreoretinal interventions. Basic pathology: PVR 16 (mainly stage C3 – D2), PDVR 4, traumatic PVR 2, others 2. Oxane HD® was removed after 40– 264 days (median 110 days). The prospective protocol included follow–up examinations at 1, 3, 6 months, and 1 year after Oxane HD® application. Newly formed epiretinal tissue excised at reintervention or Oxane HD® removal was stained with HE and following immunehistochemical markers: CD31, CD68, CD45, GFAP, vimentin, MIB1, MNF116 and S–100. Results: Complete retinal attachment was primarily achieved in 20/24 eyes. 7 eyes needed reintervention due to tractive redetachment (6 inferior, 1 superior). At the end of follow up 18/21 eyes showed total retinal attachment, 3/21 partial peripheral detachment. Functional results: improved visual acuity (at least 2 LogMar lines): 16, unchanged 4, deterioration 4. None of the eyes showed significant dispersion in the posterior segment. 6/24 presented relative small dispersion in the anterior chamber. During and after the application of Oxane HD® ocular hypertension (>25mmHg) occurred in 3/20, permanent hypotony in 1/20 (successfully elevated by intravitreal triamcinolone). Profound proliferative reaction in form of membrane development was found in 11/24 eyes. 6 of these membranes included clinically detectable neovascularisation. The majority of excised membranes presented significant staining for CD31 (23/26 specims), GFAP (25/26), vimentin (25/26), and CD45 (25/26). Conclusions: Oxane HD® was uncomplicated concerning secondary effects like dispersion, hypertension and hypotony. During the periode of internal tamponade a relatively high rate of extensive secondary membrane proliferations and tractional redetachments occurred. Immunhistological results indicate that membrane proliferation seems to be significantly accompanied by three main components, namely glial proliferation, angiogenesis and lymphocytic reaction.
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