增生性玻璃体视网膜病变眼玻璃体中白细胞介素、肿瘤坏死因子含量变化及意义

目的探讨白细胞介素-12(interleukin-12,IL-12)、白细胞介素-2(interleukin-2,IL-2)、肿瘤坏死因子(tumor necrosis factor,TNF)在增生性玻璃体视网膜病变(prolifｅrative vitreoretinopathy,PVR)发病中的作用。方法PVR-18只眼于冷冻及玻璃体切割前经睫状体平坦部在显微镜直视下抽取玻璃体,单纯黄斑裂孔性视网膜脱离7只眼于玻璃体内注气前抽取玻璃体,对照眼4只于睫状体平坦部抽取玻璃体。玻璃体取出后－70 ℃冻存。用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测其IL-12、IL-2及TNF,其结果用t检验、线性回归进行比较。结果①PVR眼玻璃体 中IL-12、IL-2、TNF的浓度(分别为73.5±64.4、456.3±347.0、460.7±437.6)与病变程度呈正相关性;②PVR组中IL-12、IL-2、TNF的浓度比单纯黄斑裂孔性视网膜脱离组相应值(分别为19.4±12.9、92.9±71.4、44.2±42.2)高(P<0.01);③单纯黄斑裂孔性视网膜脱离组中IL-12、IL-2、TNF的浓度比对照组相应值（未检测出IL-12、IL-2、TNF,各值为0）高。结论细胞因子IL-12、IL-2、TNF在PVR的发病中有一定的作用。(中华眼底病杂志,1999,15:75-77)     

白细胞介素6与增生性玻璃体视网膜疾病

增生性玻璃体视网膜疾病是眼组织对创伤的过渡愈合反应 ,细胞因子如白细胞介素 6等参与其中 ,在增生性玻璃体视网膜病变病理过程中起着重要的作用。本文主要对于白介素 6对增生性玻璃体视网膜病变的影响及对临床治疗的意义加以综述     

增殖性玻璃体视网膜病变的玻璃体手术治疗

目的 评估玻璃体手术治疗增殖性玻璃体视网膜病变的疗效。方法 Ｃ２级以上ＰＶＲ合并视网膜脱离２１眼,特发性ＰＶＲ１４眼,外伤性ＰＶＲ７组,Ｃ级９眼,Ｄ级１２眼,均作常规玻璃体切除术联合环扎、膜剥离、视网膜切开、气体或硅油填充等附加术式。结果随访２～９个月,视网膜复位１５眼（７８．９％）,视力提高２０眼（９５．２％）。４眼手术失败,均系ＰＶＲ再次复发所致。结论 现代玻璃体手术是治疗严重ＰＶＲ的理想术     

巨噬细胞诱发的增殖性玻璃体视网膜病变视网膜内的炎性细胞因子

目的检测增殖性玻璃体视网膜病变（PVR）发生过程中炎性细胞因子在视网膜内的含量变化。方法用同种巨噬细胞诱发免眼PVR，在不同时间点对全层眼组织切片中的TNF－α、IL－1β、IL－8和IL－6进行间接免疫荧光染色，并对其含量变化进行半定量分析。结果此模型1周时，视网膜色素上皮（RPE）胞浆内见极弱荧光绿色（±）；2周时，RPE胞浆内弥散暗荧光绿（＋）；3周RPE胞浆亮绿荧光染色（＋＋），视网膜杆锥层外1／3亦是阳性反应；4周RPE、视杆视锥外2／3呈明亮绿荧光（＋＋＋）。结论四种炎性细胞因子在PVR模型的视网膜组织内含量随自然病程而改变，提示它们在局部病程可能有调控作用。     

增殖性玻璃体视网膜病变的玻璃体手术治疗

目的 评估玻璃体手术治疗增殖性玻璃体视网膜病变（ＰＶＲ）的疗效。方法 Ｃ２级以上ＰＶＲ合并视网膜脱离２１眼,其中特发性ＰＶＲ１４眼,外伤性ＰＶＲ７眼;Ｃ级９眼,Ｄ级１２眼,均作常规玻璃体切除术联合巩膜环扎、膜剥离、松解性视网膜切开、气体或硅油填充等附加术式。结果 出院时２１眼视网膜全部复位（１００％）,１９眼随访２～９个月,视网膜复位成功率为７８．９％（１５／１９）、术后视力提高９５．２％（２０／     

玻璃体在增殖性视网膜病变中的作用

２０世纪７０年代以来人们对玻璃体及其和视网膜、增殖性视网膜病变的关系有了许多新的认识。本文拟就玻璃体与视网膜界面的作用、玻璃体抑制新生血管形成、玻璃体－视网膜屏障及玻璃体细胞学的变化四个方面，对玻璃体在非糖尿病性增殖性视网膜病变中的作用作一综述。随着对玻璃体更深入的研究，将为进一步提高增殖性玻璃体视网膜病变治疗效果，解决玻璃体替代品带来的各种问题以及玻璃体移植术提供资料。     

糖尿病前部增殖性玻璃体视网膜病变

报告9例糖尿病前部增殖性玻璃体视网膜病变,描述了:其临床表现、治疗方法及手术方式,强调除行晶状体摘除外,尚需选择性采用视网膜切开、眼内电凝、条带剪切等措施。并对此病的分类、病因、病理及手术预后进行了详细讨论。     

增殖性玻璃体视网膜病变玻璃体血管内皮生长因子的表达

我们以裂孔源性视网膜脱离的增殖性玻璃体视网膜病变 (ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ ,ＰＶＲ)、眼外伤ＰＶＲ为研究对象 ,对其玻璃体血管内皮生长因子 (ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ ,ＶＥＧＦ)进行定量测定 ,研究ＶＥＧＦ在ＰＶＲ中的表达情况 ,分析ＶＥＧＦ在ＰＶＲ中的作用。一、研究对象1 患者组 :选择孔源性视网膜脱离、眼外伤合并ＰＶＲ并行玻璃体切除术治疗的患者 37例。其中孔源性视网膜脱离ＰＶＲ 2 2例 ,男 16例 ,女 6例 ;年龄 2 1～ 5 2岁 ,平均 (36 14±…     

增生性玻璃体视网膜病变膜剥离标本的免疫组化研究

目的 探讨不同增生性玻璃体视网膜病变(PVR)的增殖特征。方法采用5种特异性抗体对12例PVR膜样本进行免疫组织化学研究。结果成纤维细胞、神经胶质细胞为参与PVR膜的主要细胞成分,视网膜色素上皮细胞(RPE)、巨噬细胞、纤维连接蛋白和新生血管也参与了PVR的病理过程。结论新生血管主要参与了增生性视网膜血管病变的病理过程。增殖膜中增殖的细胞、细胞外基质和血管成分参与了PVR的病理过程并起着不同的作用。     

Osteopontin expression in vitreous and proliferative retinal membranes of patients with proliferative vitreous retinopathy

AIM: To analyze osteopontin (OPN) expression in vitreous and proliferative retinal membranes of patients with proliferative vitreous retinopathy (PVR). METHODS: A total of 54 vitreous fluid samples were obtained between 2009 and 2010, which contained 45 with PVR (group A) and 9 without PVR (group B). Enzyme-linked immunosorbent assay was applied to quantify the OPN concentrations in vitreous fluid. Four samples of proliferative retinal membrane were also obtained at the time of vitrectomy, and their contents of OPN were measured by Real-time RT-PCR. RESULTS: The OPN levels in the vitreous fluid were 778.48±62.06ng/mL in group A and 452.99±32.52ng/mL in group B. The vitreous OPN levels in group A were significantly higher than those in group B and to rise by time in the early stages of PVR. The average OPN levels in the proliferative retinal membranes (F=0.14) were also higher than those in the retinal pigment cells (F=0) using Real-time RT-PCR. CONCLUSION: The high vitreous and proliferative retinal membrane OPN levels in PVR suggest that OPN might promote the development of PVR. The vitreous OPN concentrations are rising by the time in the early phases of PVR.     

缺血性眼病玻璃體血管内皮生长因子、碱性成纤维细胞生长因子、白细胞介素6的定量测定

目的 定量测定缺血性眼病(糖尿病性視網膜病變、視網膜静脉周圍炎、視網膜中央静脉阻塞)玻璃體血管内皮生長因子(VEGF)、碱性成(?)維细胞生長因子(bFGF)、白細胞介素6(IL-6)水平,分析VEGF、bFGF、IL-6在缺血性眼病中的作用。方法 缺血性眼病47例,其中糖尿病性視網膜病變15例,視網膜静脉周圍炎20例,視網膜中央静脉阻塞12例。以15例無眼疾的正常成年人為正常對照。檢測病例組、對照組玻璃體VEGF、bFGF、IL-6的水平。VEGF、bFGF、IL-6的測定采用雙抗夾心法(ELISA)。結果 47例缺血性眼病玻璃體VEGF水平為689.92±103.12pg/ml,bFGF為520.36±124.18pg/ml,IL-6為360.19±125.34pg/ml。15例增殖型糖尿病性視網膜病變玻璃體VEGF水平為820.19±292.56pg/ml;bFGF為590.18±109.56pg/ml,IL-6為380.13±118.97pg/ml;20例視網膜静脉周圍炎(Eales)玻璃體VEGF為610.53±128.59pg/ml,bFGF為480.95±98.13pm/ml,IL-6為305.34±79.16pg/ml;12例視網膜中央静脉阻塞玻璃體VEGF水平為670.12±110.13pg/ml,bFGF為503.48±52.13pg/ml,IL-6為328.15±90.16pg/ml;正常對照組玻璃體VEGF水平為85.40±35.13pg/ml,bFGF為70.18±25.15pg/ml,IL-6為36.18±21.34pg/ml。病例組與對照組相比,差异有顯著性(P<0.05)相關分析顯示,病例組玻璃     

血清和玻璃体中miR-126和miR-325与增生性玻璃体视网膜病变严重程度的关系

目的：探讨血清和玻璃体中miR-126和miR-325与增生性玻璃体视网膜病变(PVR)严重程度的关系。

方法：回顾性研究。选取2019-10/2022-10在本院治疗的PVR患者100例100眼。按照视网膜病变程度分为轻度组42眼和重度组58眼。选取同期因眼外伤在本院进行玻璃体切除术无视网膜病变的患者30例30眼为对照组。采用荧光定量PCR检测血清和玻璃体中miR-126和miR-325表达水平； ELISA检测血清、玻璃体中转化生长因子-β(TGF-β)、血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)水平； Pearson法分析血清和玻璃体中miR-126和miR-325水平与TGF-β、PDGF、VEGF、TNF-α水平的相关性； 采用Logistic多因素分析影响发生重度PVR的因素。

结果：PVR患者血清和玻璃体中miR-126水平较对照组降低，且重度组低于轻度组(均P<0.05)； miR-325水平较对照组升高，且重度组高于轻度组(均P<0.05)。重度组患者血清和玻璃体中TGF-β、PDGF、VEGF、TNF-α水平较轻度组均上升(均P<0.05)。PVR患者血清和玻璃体中miR-126水平与miR-325、TGF-β、VEGF、TNF-α、PDGF水平均呈负相关(均P<0.05)，miR-325与TGF-β、VEGF、TNF-α、PDGF水平均呈正相关(均P<0.05)。Logistic回归分析显示，血清和玻璃体中miR-325、TGF-β、PDGF、TNF-α均是发生重度PVR的危险因素，miR-126是保护因素(P<0.05)。

结论：随PVR疾病的加重，患者血清和玻璃体中miR-126表达降低，miR-325表达升高，且与TGF-β、TNF-α、VEGF、PDGF具有相关性。     

Interleukin (IL)-6, interleukin (IL)-8 levels and cellular composition of the vitreous humor in proliferative diabetic retinopathy, proliferative vitreoretinopathy, and traumatic proliferative vitreoretinopathy

PURPOSE: To investigate the interleukin (IL)-6 levels, IL-8 levels, and cellular composition of the vitreous humor in patients with proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy (PVR), and traumatic PVR. METHODS: Vitreous samples from 14 patients with PDR, 10 patients with PVR, and 10 patients with traumatic PVR were analyzed. Fifteen cadaver eyes were used as controls. Cytokine levels were measured by ELISA. RESULTS: Elevated IL-6 levels were detected in the vitreous of 12 (85.7%) of the PDR patients, eight (80%) of the PVR patients, and all (100%) of the traumatic PVR patients. None of the control IL-6 results were elevated. Vitreous IL-8 levels were elevated in 12 (85.7%) of the PDR patients, six (60%) of the PVR patients, all (100%) of the traumatic PVR patients, and one (6.7%) of the control eyes. Cytological examination of the vitreous specimens revealed a predominance of macrophages (50%) in the PDR samples and a predominance of retinal pigment epithelial (RPE) cells (60%) in the PVR samples. In contrast, neutrophils predominated (88%) in the traumatic PVR samples. CONCLUSION: The findings suggest that IL-6 and IL-8 may be involved in the pathogenesis of PDR, PVR, and traumatic PVR. High proportions of RPE cells and macrophages are associated with elevated IL-6 and IL-8 levels in the vitreous of PDR and PVR patients; however, the fact that these cells are not predominant in traumatic PVR suggests that different immune response mechanisms may be active in the pathogenesis of these disorders.     

Correlation of matrix metalloproteinase levels with the grade of proliferative vitreoretinopathy in the subretinal fluid and vitreous during rhegmatogenous retinal detachment

Purpose: We investigated the activity of matrix metalloproteinase (MMP)‐2 and ‐9 and their latent pro‐forms (proMMP‐2, ‐9), and protein levels of MMP‐1, ‐3, ‐8 and tissue inhibitor of MMPs (TIMP)‐1 in the subretinal fluid (SRF) and vitreous of patients with rhegmatogenous retinal detachment (RRD). Potential correlations with proliferative vitreoretinopathy (PVR) grade were determined. Methods: Thirty‐seven SRF and 32 vitreous samples from RRD patients and nine vitreous samples from human organ donors (controls), were collected and assayed for MMP‐1, ‐3, ‐8/TIMP‐1 levels using enzyme‐linked immunosorbent assay (ELISA), and for proMMP‐2, ‐9, MMP‐2, ‐9 activity employing gelatine zymography. Results: ProMMP‐2, ‐9, MMP‐1, ‐3, ‐9, TIMP‐1 were significantly higher in the SRF and vitreous of RRD patients compared to the vitreous of organ donors. MMP‐8 levels were higher in RRD patients’ SRF. Regarding PVR grade, MMPs and TIMP‐1 were differentially present in SRF and vitreous. PVR grade correlated significantly with the levels of MMP‐2 in SRF, while proMMP‐2, MMP‐1, ‐2, ‐3, ‐8, ‐9 and TIMP‐1 levels correlated with PVR grade in the vitreous. Conclusion: MMP/TIMP‐1 levels are elevated in SRF and vitreous during RRD. Significant correlations between PVR grade and MMP‐2 in SRF and proMMP‐2, MMP‐1, ‐2, ‐3, ‐8, ‐9 and TIMP‐1 levels in vitreous were revealed. Investigation of MMP activity in vitreous may provide more valid conclusions compared to SRF pertaining to the role of the MMPs during RRD. The observations of the present study suggest a possible role for MMPs and TIMP‐1 in PVR pathophysiology.     

Perfluorooctylbromide (PFOB) as a vitreous substitute in non-human primates

We evaluated the toxicity of perfluorooctylbromide in the primate eye as a short-term postoperative vitreous substitute. Four eyes of 4 African green monkeys underwent complete vitrectomy and vitreous replacement with 1.5–2.0 ml of PFOB. One additional animal received BSS as a control vitreous substitute in one eye. Animals were examined twice weekly for clarity and consistency of the vitreous replacement substance. Anterior segment and lenses remained clear in all eyes, although in the immediate postoperative period one eye became inflamed and had a culture-negative vitritis. The other eyes showed a minimal anticipated postoperative vitreous inflammation. Emulsification of the PFOB began within 3 days of injection and progressed up to 3 weeks, precluding fundus examination and fluorescein angiography after 2 weeks. Eyes were enucleated and light microscopy performed at 2 days, 10 days, 33 days, and 45 days. No toxic effects to the retinal cells were detectable by histological examination, but perivasculitis of retinal vessels was noted at 45 days. Indirect examination was normal up to 10 days; thereafter, the fundus view was obscured by the emulsified PFOB. Because of cellular migration into the vitreous cavity and retinal perivasculitis, observed histologically, PFOB seems most suitable for intraoperative rather than postoperative use.Supported in part by U.S. Public Health Service grants EY07541 and EY02377 and NEI1F32EY06193-03 from the National Eye Institute, National Institutes of Health, Bethesda, MD, USA.     

Increased soluble interleukin-6 receptor in vitreous fluid of proliferative vitreoretinopathy

PURPOSE: To clarify the effect of the interaction between interleukin-6 (IL-6) and its soluble receptor (sIL-6R) on retinal pigment epithelial (RPE) cell proliferation in proliferative vitreoretinopathy (PVR). METHODS: Concentrations of IL-6 and sIL-6R molecules in vitreous fluids were measured in eyes with PVR and idiopathic macular hole (MH), and the localization of IL-6 and IL-6R on the PVR fibrous membrane was studied. Production of IL-6 and sIL-6R by cultured RPE cells and the effect of the IL-6/sIL-6R complex on growth of cultured RPE cells were analyzed. RESULTS: Positive staining of IL-6 and IL-6R was observed in proliferating membranes in all PVR cases. IL-6 and sIL-6R concentrations in vitreous fluid from eyes with PVR were significantly higher than in eyes with MH (p < 0.05). A time-dependent increase in IL-6 molecules was identified in the culture medium of RPE cells, although sIL-6R was not detected. Dose-dependent growth of RPE cells was observed in the three concentrations (50, 100, and 500 ng/ml) of sIL-6R used. CONCLUSION: IL-6 derived from blood during the breakdown of the blood-retinal barrier (BRB) and produced by RPE cells and hematogenous sIL-6R cause RPE proliferation.     

玻璃体替代物在玻璃体视网膜疾病中的应用研究进展

玻璃体替代物是玻璃体-视网膜手术中用于治疗视网膜疾病(如复杂的视网膜脱离、黄斑裂孔、糖尿病视网膜病变的并发症以及后段眼外伤)的玻璃体内填塞剂。在玻璃体切除治疗视网膜脱离的手术中,术者需在玻璃体切除后在玻璃体内填充玻璃体替代物,以使脱离的视网膜重新附着。但目前临床上可用的玻璃体替代物仅能做到短期维持。尽管研究人员进行了多年的深入研究,但仍未找到理想的玻璃体替代物。本综述列举了临床上需要应用玻璃体替代物的眼部疾病,并从临床和科研两个角度总结了现有玻璃体替代物的临床应用和研究进展。其中,聚合物水凝胶由于其具有良好的生物相容性,并且和天然玻璃体具有相似的物理性质,被认为是人工玻璃体替代物的未来,尤其是热敏智能水凝胶,最有可能成为理想的玻璃体替代物。