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1.
外伤性增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)是视网膜脱离手术失败的主要原因,治疗棘手.玻璃体视网膜手术中内界膜的剥除、松解性视网膜切开术、玻璃体腔填充使用的全氟化碳液体、联合重轻型硅油填充等成为外伤性PVR手术治疗的新方向;药物治疗包括抗代谢药物、糖皮质激素、抑制纤维素生成药物等.新的药物治疗进展有基因治疗、免疫抑制剂、磷酸化糖蛋白等.可通过缓释微粒治疗等新疗法降低PVR发病率和严重程度.  相似文献   

2.
增生性玻璃体视网膜病变(PVR)是一种复杂性眼科疾病,与视网膜脱离等多种疾病的预后密切相关,引起众多学的关注和研究。玻璃体是PVR发生和发展的主要场所,在PVR进程中玻璃体的生化性质发生很大改变。本就这方面研究的最新进展和相应的药物应用作一综述。  相似文献   

3.
增生性玻璃体视网膜病变(PVR)是一种复杂性眼科疾病,与视网膜脱离等多种疾病的预后密切相关,引起众多学者的关注和研究。玻璃体是PVR发生和发展的主要场所,在PVR进程中玻璃体的生化性质发生很大改变。本文就这方面研究的最新进展和相应的药物应用作一综述。  相似文献   

4.
增生性玻璃体视网膜病变发病机制的研究进展   总被引:1,自引:0,他引:1  
胡小军 《眼科》2003,12(2):121-122
增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)是在孔源性视网膜脱离或视网膜脱离复位术后,由于视网膜色素上皮细胞(RPE)及神经胶质细胞的增生和收缩,造成牵拉性视网膜脱离的病变。PVR的病理特征是细胞增生,RPE一旦开始增殖,就产生细胞生长因子,而这些细胞生长因子反过来又刺激细胞增殖。PVR的过程有多种细胞及因子的参与,参与PVR增生的细胞主要是RPE和视网膜神经胶质细胞;涉及PVR的生长因子有:PDGF、EGF、VEGF、TGF、FGF、IGF、HGF等。  相似文献   

5.
增生性玻璃体视网膜病变( proliferative vitreoretinopathy,PVR)为视网膜表面发生无血管的纤维细胞性膜的增生,是引起视网膜脱离的主要原因.公认的PVR发病机制是一个细胞介导的病理过程,即生长因子或细胞因子假说.目前研究较多的细胞因子有血小板衍生生长因子、肝细胞生长因子和结缔组织生长因子等...  相似文献   

6.
转化生长因子-β在增生性玻璃体视网膜病变中的作用   总被引:1,自引:0,他引:1  
吴宏  王桂云 《眼科研究》2001,19(3):283-286
增生性玻璃体视网膜病变(PVR)是孔源性视网膜脱离手术失败的主要原因,其发病机制尚未完全明了。综述了转化生长因子13.(TGF—β1)的生物学特性以及它在PVR发展中的作用。探讨TGF—β1与PVR形成的关系。TGF—β在PVR的形成过程中参与了细胞的增殖、膜的收缩。TGF—β是加速PVR形成的重要生长因子之一。将来也许可以用TGF—β的拮抗剂来预防和治疗PVR。  相似文献   

7.
增生性玻璃体视网膜病变(PVR)是视网膜脱离手术失败的主要原因.近年来发现结 缔组织生长因子在PVR的发展过程中起着重要的作用,并可由此探索出一条新的防治PVR的途径.本文就结缔组织生长因子与增生性玻璃体视网膜病变的研究进展作一简要概述.  相似文献   

8.
目的 观察增生性玻璃体视网膜疾病患者眼内液(房水、玻璃体)中血管内皮生长因子(VEGF)含量的变化规律,探讨VEGF在增生性玻璃体视网膜疾病发展变化中的作用。 方法 采用双抗体夹心酶联免疫吸附试验(ELISA)定量检测增生性玻璃体视网膜病变(PVR)、视网膜静脉阻塞(RVO)、增生性糖尿病视网膜病变(PDR)、新生血管性青光眼(NVG)患者组及正常对照组房水、玻璃体VEGF含量。 结果 PVR、RVO、PDR、NVG患者组房水及玻璃体VEGF含量均高于正常对照组,其差异均有统计学意义(P<0.05);NVG、PDR、RVO、PVR患者组房水及玻璃体VEGF含量依次降低 ,其差异有统计学意义(P<0.05);PVR、RVO、PDR、NVG患者组和正常对照组玻璃体VEGF含量均高于房水VEGF含量,其差异有统计学意义(P<0.05);PVR患者病史与房水、玻璃体VEGF含量呈负相关(r分别为-0.819、-0.823,P<0.05);RVO患者病史与房水、玻璃体VEGF含量呈正相关(r分别为0.913、0.929,P<0.05);PDR患者玻璃体积血时间与房水、玻璃体VEGF含量呈正相关(r分别为0.905、0.920,P<0.05)。 结论 增生性玻璃体视网膜疾病患者房水及玻璃体VEGF含量明显增高,VEGF可能在增生性玻璃体视网膜疾病发展变化中起着重要的作用。 (中华眼底病杂志, 2006, 22:313-316)  相似文献   

9.
硅油取出术36例临床分析   总被引:3,自引:0,他引:3  
自1962年Paul Cibis首次将硅油作为玻璃体替代品注入眼内治疗一些用常规手术没有希望治愈的严重增生性玻璃体视网膜病变(PVR)患者获得成功。硅油已在治疗复杂玻璃体、视网膜病变中得到了广泛的应用,使PVR、巨大裂孔视网膜脱离、外伤性PVR、增生性糖尿病视网膜病变(PDR)及其他复杂视网膜脱离等手术成功率大为提高。但硅油能引致青光眼、白内障、角膜病变、  相似文献   

10.
目的 研究血管内皮生长因子 (VEGF)在增殖性玻璃体视网膜病变 (PVR)玻璃体中的表达 ,分析VEGF在 PVR中的作用。方法 增殖性玻璃体视网膜病变 37例 ,其中视网膜脱离 PVR2 2例 2 2眼 ,外伤性 PVR15例。以 12例猝死无眼疾的成年人作为正常对照。检测病例组、对照组玻璃体 VEGF水平。VEGF的测定采用对抗夹心法 (EL ISA)。结果  37例增殖性玻璃体视网膜病变玻璃体 VEGF平均 2 2 0 .5 2± 10 1.97pg/ m l,其中 2 2例网脱PVR玻璃体 VEGF2 38.90± 6 1.2 4pg/ ml,外伤性 PVR玻璃体 VEGF193.5 8± 5 8.17pg/ ml。正常对照组玻璃体VEGF89.90± 36 .36 pg/ ml。PVR玻璃体 VEGF水平明显高于正常对照组 (P <0 .0 5 )。VEGF在 PVRA级、B级水平较高 ,且随 PVR程度增加而降低。有危险因素 PVR,VEGF水平高于无危险因素 PVR(P <0 .0 5 )。结论 作为细胞间的传导信号 ,VEGF参与 PVR的发生发展。VEGF在 PVR中呈上调性表达。VEGF不仅在缺血性眼部疾病中呈高表达 ,而且在某些非缺血性眼部疾病中表达升高。 VEGF主要在 PVR早期发挥作用 ,PVR危险因素可以刺激玻璃体 VEGF上行性表达。  相似文献   

11.
目的观察单核细胞趋化蛋白-1(monocyte chemotac ticprotein-1,MCP-1)和基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)在增生性玻璃体视网膜病变(PVR)增生膜中的表达。方法 玻璃体手术取出的PVR增生膜24例,其中C级膜11例,D级膜13例,用免疫组织化学方法检测MCP-1和MMP-2的表达。结果在全部24例增生膜中,MCP-1和MMP-2均有表达,MCP-1阳性表达8例,强阳性表达16例;MMP-2阳性表达7例,强阳性表达17例。结论MCP-1和MMP-2均存在于PVR增生膜中,提示2者在PVR增生膜的形成和PVR发生发展过程中起重要作用。  相似文献   

12.
Proliferative vitreoretinopathy (PVR) is characterized by the periretinal proliferation of nonneoplastic cells complicated by traction retinal detachment. In this study, we report the demonstration of macrophages, which are thought to be involved in the etiology of this intraocular disease, in human periretinal membranes by an immunochemical staining procedure using a monoclonal anti-human macrophage antibody. Fibronectin, a high-molecular protein of plasma and extracellular matrix, may be visualized accordingly and could act concomitantly with macrophages as an important factor in PVR. Fibronectin is shown to be present in high quantities (Elisa) in vitreous aspirates from patients with PVR. We hypothesize that the interaction of macrophages and fibronectin may be a crucial step in the development of PVR.  相似文献   

13.
PURPOSE: To determine the histologic features of granulomatous reactions in persilicone periretinal proliferation. PATIENTS AND METHODS: This retrospective study included 12 patients with recurrent retinal detachment and persilicone granulomatous proliferation after vitrectomy for proliferative vitreoretinopathy (PVR). All patients underwent reoperation for membrane surgery. Immunohistochemical study of the excised periretinal membranes was performed with cytokeratins, GFAP, vimentin, CD68, CD45, and lysozyme antibodies. RESULTS: The cellular characteristics of periretinal granulomas allow differentiation of two types of tissue. Spongy tissue (nine cases) showed an accumulation of mature vacuolated macrophages that contained silicone without multinucleated giant cells (MGC). The second type (three cases) consisted of an accumulation of sparsely vacuolated macrophages, epithelioid cells, and MGC. The MGC corresponded to transition forms of foreign body giant cells (FBGC). Spongy tissue was associated with anatomic success (58.3% of cases) and with stabilized PVR (66.7% of cases) at the time of the membrane surgery. MGC were associated with prolonged silicone oil tamponade, recurrent retinal detachment, and progressive PVR. CONCLUSIONS: Intraocular silicone oil can lead to periretinal foreign body granulomas. FBGC are occasionally observed and were associated with progressive PVR.  相似文献   

14.
目的 观察表皮生长因子受体(epidermalgrowthfactor receptor,EGFR)在增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)增生膜中的表达及其与病程的关系。方法 玻璃体手术中取出的PVR增生膜43例,按病程分为早期膜(<2个月),中期膜(2—6个月)和晚期膜(>6个月),用免疫组织化学及原位杂交技术从蛋白质及mR—NA水平检测EGFR的表达。结果 EGFR蛋白分子在早期膜中呈强阳性表达,中期膜中呈弱表达,晚期膜中呈阴性。EGFR基因仅在早期膜中呈阳性表达。结论 EGFR主要存在于PVR的早期膜中,可能介导有丝分裂信号对PVR的发生发展所起的重要调控作用。  相似文献   

15.
Several cell types participate in the formation of vitreoretinal traction membranes in proliferative intraocular disorders. The communication between these cells involves hormones, growth factors, and the interaction with extracellular matrix molecules. We have previously demonstrated a partial colocalisation of two potent mediators of cell attachment, fibronectin and vitronectin, in periretinal membranes from patients with proliferative vitreoretinopathy (PVR). We found a similar pattern of vitronectin and fibronectin deposition in proliferative diabetic retinopathy (PDR) (n = 6). Now we show the expression of the corresponding cell surface receptors, integrins, for fibronectin and vitronectin by proliferating cells in 22 periretinal membranes, including traumatic (n = 8) and idiopathic (n = 8) PVR as well as PDR membranes (n = 6). Integrins are membrane receptors for extracellular matrix macromolecules which are involved in such basic biological phenomena as embryogenesis and metastasis. Future studies on the pathogenesis of vitreoretinal proliferation will have to focus on the initiation, maintenance, and regulation of this intercellular communication network involving attachment proteins and integrins.  相似文献   

16.
Mononuclear phagocytes have been a focus of attention in the cellular biology of proliferative vitreoretinopathy (PVR) for more than ten years. The pattern of phagocyte participation in periretinal traction membrane formation in PVR depends on the etiology, i.e. trauma, rhegmatogenous retinal detachment, previous therapy, i.e. multiple surgical interventions, and the clinical stage of the disease. We have recently identified microglial cells as a distinct cellular population, in membranes from patients with non-traumatic PVR. Current evidence of mononuclear phagocyte function in PVR suggests a role for resident phagocytes of the vitreous and retina in PVR subsequent to rhegmatogenous detachment, and a role for blood-derived monocytes in post-traumatic PVR. The cellular biology of PVR may be much more heterogeneous than previously assumed.  相似文献   

17.
From 1983 to 1986, silicone oil injections were used to treat 31 patients with retinal detachment (RD) and advanced proliferative vitreoretinopathy (PVR). In 19 eyes (61%), perisilicone proliferation (PSP) developed causing recurrent RDs in 15 eyes (49%). At an average of 5 weeks after surgery, PSP occurred and was characterized by extensive transparent preretinal membranes with denser focal areas. Microscopic examination of five preretinal membranes showed droplets of silicone oil and necrotic cells on the silicone side and glial or retinal pigment epithelial cells, or both, on the retinal side, often in layers separated by extracellular matrix. Silicone oil was present in periretinal membranes removed several months after the intraocular silicone had been evacuated indicating that silicone within cells may persist despite the removal of silicone. The use of silicone oil to provide tamponade in eyes with recurrent PVR is associated with a high incidence of periretinal proliferation that frequently leads to recurrent RD and visual failure.  相似文献   

18.
Epiretinal and subretinal membranes are fibrocellular proliferations which form on the surfaces of the neuroretina as a sequel to a variety of ocular diseases. When these proliferations complicate rhegmatogenous retinal detachment (a condition known as proliferative vitreoretinopathy or PVR), the membranes often contain numerous retinal pigment epithelial (RPE) cells and a variety of extracellular proteins. The extracellular proteins include adhesive proteins like collagen, laminin and fibronectin. In addition, several matricellular proteins with potential counter-adhesive functions are present in the membranes. Two such matricellular proteins, thrombospondin 1 and osteonectin (or SPARC: Secreted Protein Acidic and Rich in Cysteine), tend to be co-distributed with the RPE cells in PVR membranes. By virtue of their counter-adhesive properties, thrombospondin 1 and SPARC may reduce RPE cell-matrix adhesion and so permit key RPE cellular activities (for example, migration or shape change) in periretinal membrane development. Furthermore, within a 'cocktail' containing other proteins such as the metalloproteinases and growth factors like the scatter factor/hepatocyte growth factor family, matricellular proteins may play a role in the RPE cell dissociation from Bruch's membrane, which characterises early PVR.  相似文献   

19.
The presence of a scaffold for cellular spreading and proliferation is a precondition for the development of traction membranes in proliferative vitreoretinopathy (PVR). This study shows the presence of the serum spreading factor, vitronectin, in the extracellular matrix of periretinal membranes removed during vitreoretinal surgery. By means of a double label immunofluorescence protocol, a partial colocalisation of vitronectin with fibronectin at the magnification of light microscopy can be detected. Fibronectin is a high-molecular glycoprotein with multiple biological functions including the mediation of cell attachment and migration. Both proteins share a special cell recognition site which could be a target for experimental pharmacological approaches to PVR. Preliminary studies of vitreous aspirates using electrophoresis and Western blotting indicate that vitronectin may play a more important role in post-traumatic PVR as compared to PVR following rhegmatogenous retinal detachment.  相似文献   

20.
Cytotoxic effects of daunomycin on retinal pigment epithelium in vitro   总被引:1,自引:0,他引:1  
Proliferative vitreoretinopathy (PVR), the most severe complication of retinal detachment surgery and posterior segment ocular trauma, is characterized by the intraocular proliferation of non-neoplastic cells with formation of vitreal and periretinal membranes resulting in renewed traction retinal detachment. As retinal pigment epithelial (RPE) cells have been shown to play an essential role in the development of PVR, we investigated the acute and chronic effects of daunomycin on the morphology and viability of porcine RPE cells in vitro. The intense and complete inhibition of cell proliferation reported in this study adds to previous evidence that daunomycin may be useful for pharmacological treatment of human PVR.This study was supported by the Retinovit Foundation and the Forschungsförderung NRW  相似文献   

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