玻璃体手术和眼内光凝治疗伴玻璃体积血和新生血管膜的视网膜静脉阻塞

目的评估玻璃体手术和眼内光凝治疗伴玻璃体积血、新生血管膜或牵拉性视网膜脱离的视网膜静脉阻塞（ｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＲＶＯ）的疗效。方法复习连续的３７例ＲＶＯ患者经玻璃体手术和眼内光凝治疗的３８只眼临床资料。视网膜分支静脉阻塞（ｂｒａｎｃｈｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＢＲＶＯ）１９例２０只眼，视网膜中央静脉阻塞（ｃｅｎｔｒａｌｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＣＲＶＯ）１８例１８只眼。结果手术中确认２７只眼有新生血管膜，２３只眼有牵拉性视网膜脱离。手术后３４只眼视力改善，占８９．５％，其中２２只眼有０．１以上的视力。４只眼视力未变。ＣＲＶＯ组病史较长，手术后视力改善较少。结论玻璃体手术和眼内光凝能改善多数伴有玻璃体积血、新生血管膜和牵拉性视网膜脱离的ＲＶＯ眼预后。     

前部增殖性玻璃体视网膜病变的视网脱离及其手术治疗

目的 探讨前部增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅ ｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ,ＰＶＲ）视网膜脱离的临床特点及其手术治疗效果,方法 分析Ｃ～Ｄ级ＰＶＲ视网膜脱离患者８３例（８３只眼）;并针对其前部和后部病变,采用不同的手术方法进行治疗。结果 ８３例视网膜脱离患者中,前部ＰＶＲ３４只眼,占４１．０％;后部ＰＶＲ４９只眼,占５９．０％,发病年龄前者较轻,平均２８．５岁;后者３８．     

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     

玻璃体切除术治疗人工晶状体眼视网膜脱离

目的 探讨玻璃体切除术治疗人工晶状体眼视网膜脱离（ｔｒｔｉｎａｌ ｄｅｔａｃｈｍｅｎｔ,ＲＤ）的效果。方法 对３２例（３２只眼）植入人工晶状体后ＲＤ患眼行玻璃体除术,其中首次治疗采用玻璃体切除术１１只眼（３４．４％）,巩膜扣带术失败后再行玻璃体切除术２１只眼（６５．６％）,玻璃体切除术中联合硅油充填１０只眼（３１．３％）,玻璃体切除术同时行人工晶状体取出１２只眼（３７．５％）。术后随诊６个月至５年     

视网膜脱离PVR形成与脂质过氧化关系的实验研究

目的 探讨视网膜脱离（ＲＤ）后增生性玻璃体视网膜病变（ＰＶＲ）形成与脂质过氧化反应的关系。方法 建立成年健康家兔ＲＤ模型９只眼，临床观察ＰＶＲ形成情况，同时视网膜脱离前后脱离后５，１５，３０天分别抽取血及玻璃体标本，测量超氧化物歧化酶总活力（ＴＳＯＤ）铜锌超氧化物歧化酶（ＣｕＺｎＳＯＤ）锰超氧化物歧化酶（ＭｎＳＯＤ）及脂质过氧化物（ＬＰＯ）含量。结果 （１）视网膜脱离５天后，血清及玻璃体ＬＰＯ活性     

前部增殖性玻璃体视网膜病变的手术治疗

为探讨前部增殖性玻璃体视网膜病变（ａｎｔｅｒｉｏｒｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ，ａＰＶＲ）的手术效果，对３９例伴有ａＰＶＲ的复杂性视网膜脱离３９只眼进行玻璃体视网膜手术治疗；依手术日期先后顺序将３９只眼分为前期手术组（Ⅰ组，１９只眼）和后期手术组（Ⅱ组，２０只眼），分析不同时期的手术效果。结果：Ⅰ组和Ⅱ组视网膜完全复位分别为４只眼（２１．０５％）和１７只眼（８５％，Ｐ＜０．００５）；合计复位２１只眼（５３．８５％）。手术失败１８只眼中９只眼（５０％）为前部增殖松解不足所致。结论：对ａＰＶＲ的认识和处理能力的提高是后期手术组（Ⅱ组）视网膜复位成功率高的主要原因。     

眼内填充在增生型糖尿病视网膜病变合并玻璃体出血玻璃体切割术中的作用

目的　分析眼内填充在增生型糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ）合并玻璃体出血玻璃体切割术中的作用。方法　回顾性分析２０１３年５月至２０１５年５月西安交通大学第二附属医院眼科收治的ＰＤＲ合并玻璃体出血行玻璃体切割术患者的病例资料。术后随访至少１ａ,记录患者一般资料、术前及术后最佳矫正视力、玻璃体内填充物类型、复发性玻璃体出血和视网膜脱离情况。结果　１３０例（１３０眼）患者分无填充物、空气填充和硅油填充３组分析,其中无填充物组４５例（３４．６％）、空气填充组３５例（２６．９％）和硅油填充组５０例（３８．５％）。三组患者复发性玻璃体出血分别为:１１．１％（５／４５）、８．６％（３／３５）和１０．０％（５／５０）。术后１ａ内,三组分别有９７．８％、９４．３％和９２．０％患者未发生视网膜脱离。结论　ＰＤＲ合并玻璃体出血行玻璃体切割术中应用眼内填充物在减少复发性玻璃体出血和避免视网膜脱离方面并没有优势。术中没有视网膜裂孔时应用眼内填充物是不必要的。     

视网膜脱离兔眼视网膜色素上皮细胞糖代谢的改变

增生性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ,ＰＶＲ）是导致视网膜脱离（ｒｅｔｉｎａｌｄｅｔａｃｈｍｅｎｔ,ＲＤ）手术失败的主要原因,ＰＶＲ的药物防治研究是一项重要课题。我们通过观察ＲＤ兔眼视网膜色素上皮（ｒｅ...     

糖尿病视网膜病变全视网膜光凝术后玻璃体视网膜界面的变化

目的　观察比较不同时期糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＤＲ）患者全视网膜光凝术（ｐａｎｒｅｔｉｎａｌｐｈｏｔｏｃｏａｇｕｌａｔｉｏｎ,ＰＲＰ）前后玻璃体视网膜界面状态的变化。方法　将确诊为２型糖尿病的患者１３２例２１７眼随机分为四组:单纯糖尿病组、轻中度非增生期糖尿病视网膜病变（ｎｏｎ-ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＮＰＤＲ）组、重度ＮＰＤＲ组和增生期糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ）组,另选取正常对照组２６例５２眼。采用裂隙灯显微镜加前置镜、Ｂ超、光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）观察各组患者玻璃体视网膜界面的状态,比较各组玻璃体后脱离（ｐｏｓｔｅｒｉｏｒｖｉｔｒｅｏｕｓｄｅｔａｃｈｍｅｎｔ,ＰＶＤ）的发生率,观察ＮＰＤＲ组、ＰＤＲ组患者行ＰＲＰ前后ＰＶＤ的变化。结果　重度ＮＰＤＲ组（４８．３％）和ＰＤＲ组（５１．７％）ＰＶＤ发生率高于正常对照组（７６％）,差异均有统计学意义（Ｐ＜０．０１）。重度ＮＰＤＲ组（３８．３％）和ＰＤＲ组（３２．８％）ＰＲＰ术后完全性ＰＶＤ发生率（３８．３％、３２．８％）高于治疗前（１６．７％、１２．１％）,差异均有统计学意义（均为Ｐ＜０．０１）。结论　ＤＲ常合并异常玻璃体视网膜界面,ＰＲＰ可以促进增生期ＤＲ患者形成完全性ＰＶＤ,有利于延缓或者阻止ＤＲ病变进展,防止视网膜脱离,有利于提高手术疗效。     

无染色剂辅助的玻璃体联合手术治疗高度近视黄斑裂孔视网膜脱离的临床观察

目的 观察无染色剂辅助下玻璃体切除联合内界膜剥除（ILMP）及硅油填充治疗高度近视黄斑裂孔视网膜脱离的疗效.方法 对2011年7月至2013年7月在我院就诊的一组高度近视黄斑裂孔视网膜脱离病变患者行玻璃体切除联合ILMP及硅油填充术的14例（14只眼）患者的临床资料进行回顾性分析.手术后随访1~6个月,观察手术后视力、视网膜复位情况及裂孔闭合形式.结果 黄斑裂孔闭合、视网膜复位14只眼（100%）（其中1只眼为单纯注入C3F8复发后再次手术的）.术后视力提高11只眼（78.6%）,无变化3只眼.结论 玻璃体切除联合ILMP及硅油填充是治疗高度近视黄斑裂孔视网膜脱离的有效手术方式.术中不使用染色剂辅助,减少了视网膜毒性反应.     

Comparative study of incomplete posterior vitreous detachment as a risk factor for proliferative vitreoretinopathy

· Background: Abnormal vitreoretinal relationships have recently been implicated in many vitreoretinal disorders. Sites of abnormal vitreoretinal adherences are likely to exist in eyes predisposed to rhegmatogenous retinal detachment (RD), causing either retinal tears or incomplete posterior vitreous detachment (PVD). The present study was designed in two parts to identify the risk for preoperative and postoperative proliferative vitreoretinopathy (PVR) due to incomplete PVD. · Methods: We prospectively evaluated the vitreoretinal relationships using high-resolution kinetic echography in 102 consecutive eyes of 100 patients with rhegmatogenous RD. In the first part, a case-control study was conducted to compare the vitreous status in patients with preoperative PVR (cases) with that in patients with non-PVR-complicated RD (controls). During the second part, patients with noncomplicated RD (65 eyes) who were operated on by a simple retinal attachment procedure were followed up for a mean period of 6.6 months to compare the recurrence of RD due to postoperative PVR according to their vitreous status. · Results: Patients with PVR on study entry had a higher prevalence of partial PVD (28 of 32 eyes, 87%) than did controls (25 of 70 eyes, 35%). The statistical significance of this difference was independent of all other variables studied. After a mean follow-up period of 6.6 months, the incidence of recurrence of RD associated with postoperative PVR was 33% in the eyes with incomplete PVD, compared with 4.9% in the eyes without incomplete PVD. · Conclusions: Our results support the notion that the occurrence of incomplete PVD in RD is a significant risk factor for preoperative and postoperative PVR. Received: 18 June 1997 Revised version received: 9 October 1997 Accepted: 15 October 1997     

Posterior vitreous detachment after neodymium:YAG laser posterior capsulotomy

PURPOSE: To determine whether retinal detachment (RD) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy is due to a greater incidence of posterior vitreous detachment (PVD) than in controls and whether vitreous status at the time of capsulotomy is useful in predicting the risk for RD. SETTING: Teaching hospital ophthalmology service. METHODS: Patients having Nd:YAG laser posterior capsulotomy after uneventful cataract surgery (treatment group) were prospectively studied. Fellow eyes that had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation but no Nd:YAG capsulotomy (no-laser group) formed 1 control group, and eyes that had no cataract surgery (phakic group) formed a second control group. The treatment group comprised 322 eyes; the no-laser group, 97; and the phakic group, 142. Dilated fundus and vitreous examinations were performed at baseline (before Nd:YAG capsulotomy) and 12 months postoperatively. RESULTS: At baseline, the prevalence of PVD was similar in the treatment and no-laser groups (61.8% and 63.9%, respectively; P=.2014) but was significantly lower in the phakic group (50.7%; P=.0151). There was no significant difference among the groups in the development of PVD in eyes with attached vitreous at baseline (17.9%, treatment group; 11.4%, no-laser group; 17.1%, phakic group) (P=.6588). CONCLUSIONS: The prevalence of PVD was significantly higher in eyes after ECCE and IOL implantation than in phakic eyes independent of Nd:YAG laser posterior capsulotomy. Capsulotomy was not associated with a significantly higher incidence of new PVD; therefore, the presence or absence of PVD at the time of capsulotomy is not helpful in assessing the risk for RD in the first year after laser treatment.     

复杂性视网膜脱离的多焦视网膜电图研究

目的 探讨多焦视网膜电图（mfERG）对复杂性视网膜脱离（RD）视功能客观评价的意义。方法 应用VERIS ScienceTM 4．2mfERG检测仪对80例复杂性RD患者的双眼进行检测,并与正常对照组比较。结果 复杂性RD患者的对侧眼、患眼在6个环的N1波、P1波振幅密度较正常对照组降低,潜时延长,差异均有统计学意义（P〈0．01）。有严重玻璃体积血组的N1、P1波振幅密度在2～6环高于无严重玻璃体积血组,差异均有统计学意义（P〈0．05）。重度PVR组的N1、P1波振幅密度低于轻度PVR组,在6个环差异均有统计学意义（P〈0．05）。黄斑裂孔组在所有6个环的N1、P1波振幅密度较正常对照组降低,潜时延长,差异均有统计学意义（P〈0．01）。结论 mfERG能客观定量评价复杂性RD患者的视功能。严重的玻璃体积血、黄斑裂孔、PVR对视功能有明显影响。     

药物性玻璃体后脱离对增生性玻璃体视网膜病变影响的实验研究

目的 观察药物性玻璃体后脱离（PVD）对增生性玻璃体视网膜病变（PVR）的影响。方法 24只有色成年家兔,左眼为实验眼。兔自体富含血小板血浆玻璃体腔注射建立兔眼PVR模型,同时随机将实验兔分为A、B组及对照组,每组各8只眼。建模后3 h A组玻璃体腔内注入1 U纤溶酶（0.05 ml）+20 U透明质酸酶（0.05 ml）共0.1 ml、B组玻璃体腔内注入纤溶酶0.1 ml、对照组玻璃体腔内注入等量的平衡盐溶液。给药后1、7、28 d记录实验眼PVR级别,进行各组PVR等级评分,并行闪光视网膜电图（F-ERG）、眼部B型超声检查及视网膜组织病理学检查。结果 PVR模型成功建立,并在注药后7 d,A组发生完全性PVD 5只眼,不完全性PVD3只眼;B组不完全性PVD 5只眼,未见完全性PVD,另3只及对照组无PVD发生。A、B组在注药后28 d PVR等级评分均低于对照组,差异有统计学意义（D=75.6, 98.9;P=0.003,P=0.011）;注药后7、28 d,A、B 两组F-ERG b 波波幅均高于对照组;产生PVD的眼中PVR级别均较无PVD的眼级别低,其中完全性PVD眼中PVR级别仅为0～1级。结论 在兔眼PVR建模后3 h,纤溶酶与透明质酸酶联合玻璃体腔注射诱导的完全性PVD在一定程度上可以阻止兔眼PVR的发生和发展,纤溶酶单独或联合透明质酸酶玻璃体腔注射诱导的不完全 性PVD对PVR的发展有减缓作用。     

Causative factors of retinal detachment in macular holes

Two hundred nine macular holes of both pathologic myopia and idiopathic senile type were statistically analyzed to find out which factors cause retinal detachment in eyes with macular holes. The incidences of retinal detachment were as follows: 97.6% in myopia over -8.25 D, 67.7% in myopia between -8.0 and -3.25 D, and 1.1% in eyes under -3.0 D; 100% in widespread chorioretinal atrophy, 90.6% in spotty or lineal chorioretinal atrophy, 64.3% in myopic tigroid fundus, and 0% in eyes without myopic tigroid or atrophy; 96.0% in eyes with posterior staphyloma and 8.2% in eyes without it; 56.4% in posterior vitreous detachment [PVD] (+) eyes, 53.3% in PVD(+/-) eyes, and 51.9% in PVD(-) eyes. The statistically significant (P less than 0.05) factors that caused retinal detachment were refractive error, myopic chorioretinal change, and posterior staphyloma. There was no statistically significant difference regarding PVD.     

Retinal detachment associated with macular hole in high myopia: using the vitreous anatomy to optimize the surgical approach

PURPOSE: To evaluate the efficacy of different surgical strategies on the postoperative outcomes of retinal detachments (RDs) associated with macular holes (MHs) in high myopia. DESIGN: Prospective, noncomparative case series. PARTICIPANTS: The study included 120 phakic, highly myopic eyes (mean degree of myopia, -22.2+/-4.80 diopters) with RDs and MHs that underwent surgical repair. The patients were divided into 2 groups. Group 1 consisted of 60 eyes with a posterior vitreous detachment (PVD). Mean preoperative visual acuity (VA) was 20/200+/-20/500. Group 2 consisted of 60 eyes with posterior vitreous schisis (PVS). The mean preoperative VA was 20/152+/-20/333. The minimum follow-up was 6 months. INTERVENTION: The surgical approach was chosen on the basis of the clinical characteristics. Twenty-five eyes of group 1 underwent pneumoretinopexy (group 1A), whereas 35 eyes of group 1 were repaired with vitrectomy (group 1B). Forty-nine eyes of group 2 underwent pars plana vitrectomy (group 2A), whereas 11 eyes of group 2 underwent scleral buckling of the macula (group 2B). MAIN OUTCOME MEASURES: Anatomic attachment of the retina and VA. RESULTS: Retinal reattachment at 6 months was achieved in 23 of 25 (92%) eyes of group 1A, 31 of 35 (88.5%) eyes of group 1B, 45 of 49 (91.8%) eyes of group 2A, and 8 of 11 (72.7%) eyes of group 2B. A significant (P<0.01) improvement of postoperative VA with respect to the preoperative values was observed in all groups. The greatest percentage improvement in postoperative VA was observed in groups 1A and 1B eyes. CONCLUSIONS: Different surgical approaches can be used to repair myopic RD associated with an MH. The choice between different surgical techniques may depend on vitreoretinal relationships, the extent of chorioretinal atrophic areas, and presence of posterior staphyloma. In our study, eyes with a PVD had significantly better visual outcomes than detachments in eyes with PVS.     

Treatment of retinal tears and lattice degenerations in fellow eyes in high risk patients suffering retinal detachment: a prospective study

BACKGROUND/AIMS: Fellow eye prophylaxis for retinal detachment (RD) is still a controversial issue since opinions are not unanimous regarding the kind of lesions to be treated or the method of treatment. This prospective clinical study aimed to follow the course of vitreoretinal conditions in 150 high risk fellow eyes. METHODS: 150 consecutive patients with unilateral rhegmatogenous RD were included in this study. Inclusion criteria were good explorability of fellow eye retinal periphery and one of the following conditions in the fellow eye-aphakia, pseudophakia with capsulotomy, high myopia (>-6D), contralateral eye to a giant retinal tear. Prophylactic treatment (photocoagulation or scleral buckling) was performed in the presence of retinal tears and lattice degenerations. The state of the vitreous body was determined at the beginning of the study and at the end, when RD occurred. RESULTS: Follow up ranged from 36 to 132 months. 95 fellow eyes were subjected to laser treatment; five eyes underwent prophylactic surgical treatment. Initially, in the treated group posterior vitreous detachment (PVD) was present in 100 eyes (100% of cases), but as a complete PVD only in 42 of them (42%). 10 eyes in the treated group developed RD during the follow up period. In five of these cases the partial PVD had progressed and a retinal tear in a previously healthy area was the cause of the retinal detachment. In the other five eyes RD apparently developed from previously treated lesions. Progression of PVD was evident in four out of these five eyes. The untreated eyes had no visible degenerative lesions. During follow up eight eyes developed RD. These eyes had no PVD at the beginning of the study, but showed a partial PVD at the time of the diagnosis of RD. CONCLUSION: Fellow eyes with pre-existing retinal tears and PVDs can go on to retinal detachment in spite of laser prophylactic treatment. When PVD is not detectable or a partial PVD is present, the progression of posterior vitreous separation can account for retinal tears and RDs arising in formerly healthy areas.     

玻璃体后脱离与视网膜分支静脉阻塞的预后

目的探讨玻璃体后脱离对视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)预后的影响。方法回顾性分析116例经荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查确诊的BRVO患者116只患眼初诊时玻璃体检查结果与随访(10.7±2.2)个月时形成新生血管、发生黄斑水肿的临床资料,探讨玻璃体条件与眼后节新生血管形成、黄斑水肿的关系。结果FFA检查116只患眼中40只眼为缺血型改变,其中25只无玻璃体后脱离或部分性后脱离眼中,12只眼发现视网膜或(和)视盘新生血管形成,占48.0%;15只完全性玻璃体后脱离眼中只有1只眼产生新生血管,占6.7% (P＜0.05)。116只患眼中45只眼发生弥漫性黄斑水肿,占38.8%。视网膜黄斑粘连者黄斑水肿发生率为51.5%,显著高于视网膜黄斑分离者(22.0％) (P<0.01)。结论完全性玻璃体后脱离对BRVO发生眼后节新生血管和黄斑水肿具有一定阻止效应。(中华眼底病杂志,2001,17:2-4)     

Evaluation of primary surgical procedures for retinal detachment with macular hole in highly myopic eyes: a comparison [corrected] of vitrectomy versus posterior episcleral buckling surgery.

PURPOSE: To evaluate postoperative outcomes between pars plana vitrectomy (PPV) and posterior episcleral buckle procedure (PEBP) in myopic eyes with retinal detachment (RD) and macular hole (MH). DESIGN: Retrospective nonrandomized comparative interventional trial. PARTICIPANTS AND INTERVENTION: The study included 30 phakic, highly myopic eyes (from 19-30 negative diopters) of 30 patients with an RD and MH. The patients were divided into two groups: They were assigned to PPV (15 eyes, group A) or to PEBP (15 eyes, group B). No significant (P > 0.01) differences in preoperative visual acuity (VA) between group A and group B eyes were found. Follow-up was 12 months. MAIN OUTCOME MEASURES: Anatomic attachment of the retina was determined, and VA was measured. RESULTS: Retinal reattachment was obtained on 11 of 15 (73.3%) eyes of group A and on 14 of 15 (93.3%) eyes of group B. In group A eyes the VA was substantially unmodified after surgical treatment, whereas in group B eyes the VA observed after surgical treatment increased significantly (P < 0.001) with respect to the preoperative values. CONCLUSIONS: PEBP resulted in better postoperative anatomic and functional results compared with PPV in eyes with extreme degrees of myopia, pronounced posterior staphyloma, and posterior vitreous schisis affected with RD caused by MH.     

Soluble cellular adhesion molecules in proliferative vitreoretinopathy and proliferative diabetic retinopathy.

PURPOSE. To measure vitreous levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cellular adhesion molecule-1 (sVCAM-1) in the eyes of patients with retinal detachment (RD) due to proliferative diabetic retinopathy (PDR) or proliferative vitreoretinopathy (PVR) and to determine whether the levels of these mediators correlated with clinical parameters of disease. METHODS. Undiluted vitreous specimens were collected from 50 eyes of 48 patients undergoing vitrectomy for traction RD due to PDR (21 specimens) and recurrent RD due to PVR (19 specimens). Control vitreous specimens were obtained from patients undergoing macular hole repair (10 specimens). The levels of sICAM-1 and sVCAM-1 were measured in each sample by specific enzyme-linked immunoadsorbent assays. RESULTS. Vitreous levels of sICAM-1 were significantly increased in vitreous specimens from both PVR (median +/- SD; 12.0 +/- 76.3 ng/ml; P < 0.01) and PDR (8.4 +/- 24.0 ng/ml; P < 0.01) when compared to vitreous from eyes with macular holes (0. 3 +/- 4.2 ng/ml). Vitreous levels of sVCAM-1 were significantly increased in both PVR (36.5 +/- 255.2 ng/ml; P < 0.001) and PDR (26. 2 +/- 93.5 ng/ml; P < 0.01) when compared to control vitreous (17.7 +/- 7.8 ng/ml). The vitreous levels of sICAM-1 were higher in cases of PDR which developed recurrent proliferative disease (P < 0.01) and recurrent RD (P = 0.01), whereas the levels of sICAM-1 in PVR and sVCAM-1 in PDR and PVR did not significantly correlate with these clinical parameters. CONCLUSIONS. Soluble forms of ICAM-1 and VCAM-1 are increased in the vitreous cavity of patients with RD due to PDR or PVR, reflecting the inflammatory nature of these conditions and suggesting a possible role for these mediators in the pathogenesis of proliferative retinal disease. The vitreous levels of these sCAMs at the time of surgery may serve as a marker of inflammation, but their specific levels do not predict the likelihood of recurrent proliferation or surgical anatomic success in most cases of PVR and PDR.