Anatomical findings of vitreoretinal interface in eyes with asteroid hyalosis

Purpose  To investigate the anatomical features of vitreoretinal interface in eyes with asteroid hyalosis (AH) with optical coherence tomography (OCT) and intravitreal triamcinolone acetonide (TA) during vitreous surgery. Methods  This study was an interventional clinical case series. Records relating to ten eyes from ten patients who underwent a TA-assisted vitrectomy for the treatment of diverse vitreoretinal diseases complicated with AH. The posterior vitreoretinal interface was examined by preoperative OCT and by intraoperative visualization of posterior vitreous cortex utilizing TA. Results  In eight of ten AH eyes, preoperative OCT revealed abnormal vitreoretinal adhesions. In four of these eight eyes, posterior vitreoschisis could be seen on OCT. In the other four of these eight eyes, a clear no posterior vitreous detachment (PVD) pattern could be seen on OCT. Although posterior vitreous cortex could not be clearly identified with preoperative OCT in two of ten AH eyes, a complete PVD was refuted by intraoperative visualization of the posterior vitreous cortex with TA identical to the other eight eyes. Conclusion  These results indicate that complete PVD appears to be unlikely to occur in eyes with AH. In addition, spontaneous PVD in eyes with AH might lead to vitreoschisis or residual whole layer or posterior vitreous cortex, possibly due to anomalous vitreoretinal adhesion.     

玻璃体积血的形态结构与玻璃体后脱离的图像特征

目的探讨玻璃体积血的形态结构和治疗特点.方法对74例(79只眼)增生性糖尿病视网膜病变、视网膜血管炎、视网膜静脉阻塞所致玻璃体积血的临床资料进行比较分析.术前超声检查、术中手术显微镜观察患者的玻璃体形态特点,分析玻璃体与视网膜的关系.结果所有患者均有不同程度的玻璃体后脱离,根据图像的形态特征可归纳为完全后脱离和部分后脱离两种.部分后脱离又分为"V"型、"L"型及后部玻璃体劈裂型,劈裂型多见于视网膜缺血性疾病的增生期.结论了解和掌握玻璃体后脱离及玻璃体劈裂的形态特点,可提高手术治疗的成功率并改善其预后.     

复杂玻璃体视网膜疾病的彩色多普勒超声诊断特征

目的探讨彩色多普勒血流成像(CDFI)技术对复杂玻璃体视网膜疾病的超声诊断特征。方法对518例(678只眼)复杂玻璃体视网膜疾病包括玻璃体积血、玻璃体后脱离、玻璃体劈裂、视网膜脱离、脉络膜脱离、糖尿病视网膜病变等,应用眼科专用B超和CDFI诊断仪对同一患者进行检查,分别按照B超和CDFI的诊断标准予以诊断,再经手术证实,最终判断B超及CDFI检查结果的准确性。结果 CDFI检测复杂玻璃体视网膜疾病的阳性眼数高于B超诊断仪。视网膜脱离、玻璃体后脱离组的B超与CDFI检测结果比较、脉络膜脱离和玻璃体机化膜组的B超与CDFI检测结果比较,差异均有统计学意义(均P＜0.05)。结论综合应用CDFI的形态观察和血流特征两种分析方法,可显著提高诊断复杂玻璃体视网膜疾病的准确性,为临床提供可靠的诊断依据。     

Results of vitrectomy for proliferative diabetic retinopathy

The authors treated 1007 eyes with vitrectomy for complications of proliferative diabetic retinopathy. Indications for surgery were: vitreous hemorrhage, 353 eyes (35%); traction retinal detachment, 360 eyes (36%); combined traction-rhegmatogenous retinal detachment, 172 eyes (17%); and other progressive fibrovascular proliferation 122 eyes (12%). During the study period, the frequency of vitreous hemorrhage as an indication for surgery decreased from 42 to 25%, and other progressive fibrovascular proliferation increased from 5 to 22%. The frequency of traction and traction/rhegmatogenous retinal detachments did not change. The results of surgery varied according to the indication. Seventy-nine percent of eyes with vitreous hemorrhage obtained final vision of 5/200 or better. Similar results were obtained in 64% of eyes with traction detachment, 56% of eyes with rhegmatogenous detachment, and 81% of eyes with progressive fibrovascular proliferation. The percentage of eyes achieving final vision of 20/100 or better are as follows: vitreous hemorrhage, 48%; traction detachment, 27%; rhegmatogenous detachment, 24%; and progressive fibrovascular proliferation, 46%. The success rate improved in each anatomic category during the last 3 years of the study.     

Clinicopathologic findings in anterior hyaloidal fibrovascular proliferation after diabetic vitrectomy

Two young patients (27 and 30 years old, respectively) with long-standing diabetes mellitus underwent vitreoretinal surgery for traction retinal detachment and vitreous hemorrhage. The postoperative course in each was characterized by early recurrence of the hemorrhage into the vitreous cavity, hypotony, and severe visual loss. Histopathologic examination of both operated on eyes showed anterior extraretinal fibrovascular proliferation extending along the anterior hyaloid to the posterior lens surface, causing traction detachments of the peripheral retina and ciliary body. The vessels originated from the anterior retina. There was no evidence of excess fibrous tissue at the well-healed sclerotomy wounds.     

手术治疗先天性视网膜劈裂症眼后段并发症

目的评价玻璃体视网膜手术治疗先天性视网膜劈裂症眼后段并发症的效果。方法回顾性分析伴有眼后段并发症的先天性视网膜劈裂症7例（10眼）玻璃体视网膜手术的效果。其中玻璃体积血5眼，玻璃体积血合并牵引性视网膜脱离1眼，原发性（孔源性）视网膜脱离2眼，周边劈裂腔进展累及黄斑2眼。所有病例均有周边视网膜劈裂及黄斑中心凹劈裂。1眼孔源性视网膜脱离行巩膜扣带术，其余9眼行玻璃体手术。结果随访12～51月，平均38月，玻璃体积血者术后屈光间质透明，视网膜脱离者术后视网膜复位良好，所有病例术后视力较术前均有不同程度提高，而且视网膜劈裂无明显进展。无严重并发症出现。结论玻璃体视网膜手术用于治疗先天性视网膜劈裂症眼后段并发症，不仅可以清除浑浊的屈光间质，而且可以解除玻璃体牵引，阻止劈裂腔进一步发展，有助于改善和稳定视功能。     

Experimental traction retinal detachment in the cat

We developed a reproducible model of traction retinal detachment (TRD) in the cat eye by creating a serous retinal detachment and then injecting 2.5 × 10⁵ kitten dermal fibroblasts into the vitreous cavity at the site of a retinal wound. Serous detachments were produced by exposing an area of retina to focused light after intravenous injection of rose bengal (a photosensitizing dye). TRD developed rapidly within the first 2 weeks after fibroblast injection, accompanied by the formation of vitreoretinal strands and, to a lesser degree, epiretinal and/or subretinal proliferation. Histopathology demonstrated fibroblasts within the vitreous or along the posterior hyaloid face. Focal deposits of fibroblasts were occasionally found on the inner surface of the retina and/or in the subretinal space. Fibroblast proliferation was confirmed by uptake of radiolabeled thymidine. Deposition of collagen was noted at as early as 3 days after fibroblast injection. Neovascularization was not observed. Control eyes that did not receive fibroblasts showed resolution of serous detachment without retinal traction. In all eyes, retinal degeneration and thinning were seen in the area of previous photodynamic treatment. In this model of TRD, anteroposterior traction (due to vitreous strands) predominates, as is observed in experimental posterior penetrating ocular injury induced by intravitreal blood injection, which also results in vitreous strand formation. Our model, however, enables clinical assessment of TRD in the cat without the media opacification produced by vitreous blood. Offprint requests to: D.L. HatchellSupported by VA medical research funds, NIH research grant EY02903, core grant EY05722, the Helena Rubinstein Foundation, New York, and Research to Prevent Blindness, Inc., New York. Dr. D.L. Hatchell is a Research to Prevent Blindness, Inc., Senior Scientific Investigator. The authors have no commercial or proprietary interest in the chemicals, drugs, or devices used in this study     

The predictive value of echography in diabetic vitreous hemorrhage

PURPOSE: To identify echographic signs that are predictive for the prognosis of diabetic vitreous hemorrhage (VH). METHODS: Sixty eyes of 58 diabetic patients with VH were divided into two groups: group I contained 32 eyes with nonclearing diabetic VH which underwent pars plana vitrectomies. Group II contained 28 eyes which cleared spontaneously with time. The echographic signs were classified according to blood density, blood location and to the presence of vitreoretinal traction. RESULTS: The two groups showed statistically significant differences (P < 0.01) in the frequencies of the same echographic signs. In group I, a high or moderate density of blood in the vitreous cavity (71.5% of eyes), partial posterior vitreous detachment with one or more vitreoretinal or papillary traction sites (67.8%) and blood located in the vitreous gel (62.5%) were the main echographic signs associated with nonclearing diabetic VH. In group II, a low density of blood in the vitreous cavity (75%), total posterior vitreous detachment without a vitreoretinal or papillary traction site (68.8%) and blood in the subvitreal space (46.5%) were the main echographic signs associated with a diabetic VH that will clear with time. The presence of blood in both the vitreous gel and in the subvitreal space occurred at the same frequency (near 28%). CONCLUSIONS: Ultrasonographic examination of a diabetic VH can be predictive for the ultimate prognosis of the intraocular blood. The echographic signs found to be associated with spontaneous clearing of the hemorrhage are a low density of hemorrhage, complete vitreous detachment and blood in the subvitreal space.     

Late Retinal Complications in Former Preterm Infants with Regressed ROP

BACKGROUND: The purpose of this study is to evaluate late retinal complications in former preterm infants with regressed stages of acute retinopathy of prematurity (ROP). PATIENTS AND METHODS: Between 1995 and 2002 a consecutive series of 15 patients (16 eyes) with loss in visual acuity were examined. Gestational age was < 32 weeks, birth weight < 1500 g. The reason for visual disturbances was: RD (n = 14), vitreous haemorrhage (n = 3) and posterior vitreous detachment (n = 1). RESULTS: Two eyes recovered spontaneously. Surgery was performed in 14/16 eyes, with a pars plana vitrectomy (n = 14), or buckling procedure (n = 2). Four eyes with a severe form of regressed ROP needed multiple procedures for reattachment At last follow-up in 13/14 (93.0 %) eyes the retina was completely attached. Visual acuity ranged from light projection to 20/25. CONCLUSIONS: Former premature patients with vitreoretinal changes due to regressed ROP may develop vitreous traction and subsequent late-onset retinal detachment. Surgery with primary vitrectomy technique in eyes with retinal detachment can remove the vitreoretinal adhesions and is an effective treatment technique. In eyes without retinal detachment the natural course can be awaited.     

Anterior hyaloidal fibrovascular proliferation after diabetic vitrectomy

Vitrectomy was performed to treat 74 consecutive eyes for complications of diabetic retinopathy. Eight (13%) of 61 eyes followed up for an average of 12 months developed anterior hyaloidal fibrovascular proliferation. This was the most common postoperative complication, whose features included recurrent hemorrhages into the vitreous cavity or anterior vitreous, or both; vessels or fibrovascular tissue on the posterior lens capsule; anterior extraretinal vascularization extending toward the lens on the anterior hyaloid; traction detachment of the peripheral retina or ciliary body; and hypotony. Patients who developed this complication tended to be young males with severe retinal neovascularization and extensive retinal ischemia; traction retinal detachment as an indication for surgery; placement of a scleral buckle; postoperative rubeosis iridis, recurrent vitreous hemorrhages, and retinal detachment; and multiple surgeries. Four eyes progressed to atrophia bulbi. Early recognition followed by additional surgery in two patients and extensive additional photocoagulation in two other patients was successful in preserving good visual function.     

进展型增生性糖尿病视网膜病变玻璃体 切割手术的价值与意义

目的了解有不同并发症的进展型增生性糖尿病视网膜病变眼进行玻璃体手术的结果。方法将患有Ⅰ、Ⅱ型糖尿病进展型增生性糖尿病视网膜病变的314只眼分为玻璃体积血合并局限牵拉性视网膜脱离组;广泛纤维血管膜合并牵拉性视网膜脱离组;牵拉孔源混合性视网膜脱离组;玻璃体积血视网膜脱离合并老年性白内障行玻璃体手术联合白内障摘除及人工晶状体植入组,分别进行回顾性分析。结果玻璃体积血合并局限牵拉性视网膜脱离组中Ⅰ、Ⅱ型糖尿病患 者手术后获得0.1以上视力的分别占39.4%和66.7%,广泛纤维血管膜合并牵拉性视网膜脱离组中Ⅰ、Ⅱ型糖尿病患者手术后获得0.1以上视力的分别占31.6%和51.6%,牵拉孔源混合性视网膜脱离组手术后获得0.1以上视力者占31.6%,玻璃体积血视网膜脱离合并老年性白内障行玻璃体手术联合白内障摘除及人工晶状体植入组手术后获得0.1以上视力者占62.5%。首要的术中 并发症是医源性视网膜裂孔,术后视力丧失的主要原因包括新生血管性青光眼、视网膜脱离和视网膜中央动脉阻塞。结论玻璃体切割手术联合全视网膜光凝术,能有效地改善进展性糖尿病视网膜病变患者的视力。(中华眼底病杂志,2001,17:171-174)     

Vitrectomy for rhegmatogenous or tractional retinal detachment with familial exudative vitreoretinopathy.

OBJECTIVE: To examine the anatomic features and surgical indications of familial exudative vitreoretinopathy (FEVR) complicated with rhegmatogenous or tractional retinal detachment. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Twenty-eight eyes of 25 patients who had either clinically suspected or fully diagnosed FEVR. Of these, 25 had rhegmatogenous retinal detachment, 2 had tractional retinal detachment, and 1 had tractional retinal detachment plus vitreous hemorrhage. INTERVENTIONS: The authors carefully observed the vitreoretinal interface during surgery, studied the clinical and anatomic features of FEVR, and then evaluated the surgical results. RESULTS: The vitreoretinal adhesions were so strong in the peripheral avascular area that iatrogenic retinal breaks easily occurred in 22 of 28 eyes. In all cases, the bimanual technique with vitreous scissors and forceps was required to dissect the posterior vitreous membrane from the retinal surface. The retina was reattached in 24 of 28 cases (85.7%), and visual acuity improved in 20 eyes (71.4%). CONCLUSION: Dissection of the vitreous in the peripheral avascular area is very difficult in FEVR, and those patients for whom this procedure was not successfully performed may have a poorer prognosis.     

Criswick-Schepens-Syndrom — Familiäre exsudative Vitreoretinopathie

BACKGROUND: Familial exudative vitreoretinopathy is a hereditary, bilaterally progressive formation of a vitreoretinal membrane. It usually occurs in full-term newborns without previous treatment with hyperbaric oxygen. In this report, we present six cases of this disease with various abnormalities of the posterior segment diagnosed in two Syrian families related by first degree of consanguinity. DESIGN: A retrospective family analysis and presentation of cases. CASE PRESENTATION: Six members of the two consanguineous families, aged between 3.5 and 13 years, who were systemically healthy, presented with a visual acuity ranging between light perception and 0.4 with bilateral fundus changes. The findings included: papillary, macular, and retinal temporal traction in 11 eyes, a retinal fold in 7 eyes, a fibrovascular mass in 11 eyes, vitreoretinal traction in 5 eyes, subretinal exudation in 2 eyes, pigmentary abnormalities in 2 eyes, temporal or total tractional retinal detachment in 2 eyes, and vitreous hemorrhage in 1 eye. SUMMARY: Familial exudative vitreoretinopathy is characterized by fundus changes that resemble retinopathy of prematurity and must be differentiated from other diseases (e.g., Coats' disease, incontinentia pigmenti, persistent hyperplastic primary vitreous, and Norrie's disease).     

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(retinal vein occlusion,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(branch retinal vein occlusion,BRVO)19例20只眼，视网膜中央静脉阻塞(central retinal vein occlusion,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。(中华眼底病杂志,1998,14:3-6)     

The role of scleral buckle in experimental posterior penetrating eye injury.

PURPOSE: Although episcleral buckles are frequently placed as an additional procedure to vitreoretinal surgery, little is known about their independent effect after ocular trauma. The authors created a posterior penetrating ocular injury model to evaluate the isolated role of primary episcleral buckle placement. METHODS: Twenty eyes underwent surgery. The penetrating injury consisted of two 5-mm circumferential incisions placed five clock hours apart and 8 mm behind the limbus. A segmental episcleral buckle was placed over a randomly chosen injury site after wound closure. The degrees of fibrous proliferation, traction, and the presence of retinal detachment were evaluated on follow-up examinations. After enucleation and initial fixation, tissue sectioning was performed, and the greatest dimension of the fibrous proliferation at both wound sites was measured with a caliper. RESULTS: Two eyes were excluded from the study. Three eyes developed a retinal detachment; the remaining 15 eyes showed varying degrees of proliferation and traction on the retina. The greatest dimension of the fibrous proliferation at the buckle site (1.22 +/- 1 mm) was significantly different from that at the nonbuckle site (2 +/- 1.45 mm, P = 0.01). CONCLUSIONS: Primary episcleral buckle placement at the time of surgical repair reduces vitreous traction from the buckle site and decreases the degree of fibrovascular proliferation.     

Vitrectomy for diabetic traction retinal detachment using the multiport illumination system

OBJECTIVE: To examine the visual and anatomic results of bimanual vitrectomy surgery with the multiport illumination system (MIS) in eyes with advanced diabetic traction retinal detachment. DESIGN: Retrospective, noncomparative interventional case series. PARTICIPANTS: Sixty-seven consecutive eyes in 62 patients having vitrectomy with the MIS. METHODS: During surgery, the vitreous, the posterior hyaloid membrane, and fibrovascular proliferative tissue were removed by using bimanual dissection made possible by the MIS. MAIN OUTCOME MEASURES: Retinal reattachment rate, visual function, and postoperative complications were compared with previously published series of vitrectomy for diabetic traction retinal detachment. RESULTS: With a minimum of 6 months of follow-up, complete retinal reattachment was achieved in 62 eyes (93%), and macular attachment was achieved in all 67 eyes. Vision was stabilized or improved in 51 eyes (72%), and 5/200 vision was achieved in 47 eyes (70%). No unique complications, such as incision-related retinal tears, occurred. CONCLUSION: MIS allows bimanual surgery during vitrectomy for diabetic traction retinal detachment, with good visual and anatomic results.     

Combined rhegmatogenous and traction retinal detachment in proliferative diabetic retinopathy: clinical manifestations and surgical outcome

BACKGROUND: Combined rhegmatogenous and traction retinal detachment (combined detachment) is a serious complication in proliferative diabetic retinopathy. The common clinical findings and surgical results of this complication were investigated. METHODS: Forty eyes of 36 consecutive patients with combined detachment undergoing pars plana vitrectomy at a teaching hospital in a 4.5-year period were retrospectively reviewed. All cases had been followed up for at least 6 months. RESULTS: Only 10 of the 40 cases had a preoperative visual acuity better than finger counting vision. Extensive proliferation with multiple, thickened, plaque-like vitreoretinal adhesions and large areas of detachment were noted in 38 cases, 19 cases showing predominantly fibrous tissue and 19 cases presenting with predominantly active fibrovascular proliferation. Two cases had minimal fibrovascular proliferation. Retinal breaks were identified in 7 eyes (17.5%) before surgery and in 33 eyes (82.5%) during surgery. Thirty-seven eyes (92.5%) achieved long-term retinal reattachment. Silicone oil was used in 23 eyes (57.5%). Visual acuity improved in 28 eyes (70%), was unchanged in 6 (15%), and became worse in 6 (15%). In 19 eyes postoperative vision was better than 20/400. Multiple regression analysis showed preoperative visual acuity as the single factor associated with postoperative visual outcome. INTERPRETATION: Combined retinal detachment in proliferative diabetic retinopathy may occur during the stage of active fibrovascular proliferation or as a late complication. It is frequently associated with tightly adherent preretinal tissue and extensive detachment. Preoperative visual acuity best predicts visual prognosis.     

Tomographic features and surgical outcomes of vitreomacular traction syndrome

PURPOSE: To study the relation between preoperative macular changes and surgical outcomes in vitreomacular traction syndrome. DESIGN: Prospective study. METHODS: We prospectively examined 14 eyes of 13 patients (aged 48 to 82 years; mean 66.1) with vitreomacular traction syndrome using optical coherence tomography (OCT) before and after vitreous surgery. RESULTS: OCT demonstrated two types of partial posterior vitreous detachment: incomplete V-shaped detachment in 10 eyes (group 1) and partial detachment temporal to the fovea but attached nasally in 4 eyes (group 2). Preoperative OCT showed foveal retinal detachment in all eyes in group 1; the detached retina was intact in 2 eyes and edematous with (6 eyes) or without (2 eyes) cystic changes. After surgery, these 10 eyes had a normal foveal configuration accompanied by visual improvement. In group 2, 3 of the 4 eyes had prominent cystoid macular edema (CME) without foveal retinal detachment before surgery. After surgery, 2 eyes developed a full-thickness macular hole, 1 had persistent CME, and 1 developed macular atrophy. The visual acuity decreased in 2 eyes and remained the same in 2 eyes. CONCLUSIONS: Two types of vitreous traction develop in vitreomacular traction syndrome: an incomplete V-shaped posterior vitreous detachment that leads to foveal retinal detachment, the surgical outcome of which is favorable, and partial posterior vitreous detachment temporal to the fovea in which prominent CME developed, which may result in a macular hole or macular atrophy postoperatively.     

Ultrastructure of the vitreoretinal interface following plasmin assisted vitrectomy

AIMS: To investigate the ultrastructure of the vitreoretinal interface following plasmin induced posterior vitreous detachment. METHODS: Plasmin (1 or 2 U/0.1 ml) was injected into the vitreous cavity of 24 eyes of freshly slaughtered pigs. The 24 fellow eyes received calcium-free and magnesium-free PBS and served as a control. After incubation at 37 degrees C for 30 and 60 minutes, the globes were placed in fixative and hemisected. Specimens for light, scanning, and transmission electron microscopy were obtained from the posterior pole, the equator, and the vitreous base using a corneal trephine. RESULTS: All plasmin treated eyes showed posterior vitreous detachment. However, the inner limiting membrane (ILM) was covered by remnants of cortical vitreous at the posterior pole and at the equator. There was a direct correlation between the concentration and exposure times of plasmin and the degree of vitreoretinal separation. Eyes exposed to 1 U plasmin for 30 minutes had a dense network of residual collagen fibrils while those exposed to 1 U plasmin for 60 minutes had only sparse collagen fibrils covering the ILM. Eyes treated with 2 U plasmin for 60 minutes had a smooth retinal surface, consistent with a bare ILM. At the vitreous base there was no vitreoretinal separation. In all control eyes the vitreous cortex was completely attached to the retina. There was no evidence of retinal damage in any plasmin treated eye. CONCLUSION: Plasmin induces a cleavage between the vitreous cortex and the ILM without morphological changes to the retina. In contrast with previous reports, plasmin produces a smooth retinal surface and additional surgery is not required in this experimental setting. The degree of vitreoretinal separation depends on the concentration and length of exposure to plasmin.     

Trace elements iron, copper and zinc in vitreous of patients with various vitreoretinal diseases

PURPOSE: To measure the concentrations of iron, copper and zinc in human vitreous and to interpret their levels with various vitreoretinal diseases like proliferative diabetic retinopathy, retinal detachment, intraocular foreign body, Eales' disease and macular hole. METHODS: Undiluted vitreous fluid collected during pars plana vitrectomy was used to measure trace elements using an atomic absorption spectrophotometer. RESULTS: The level of vitreous iron increased threefold in Eales' disease (1.85 +/- 0.36 pg/ml), 2.5-fold in proliferative diabetic retinopathy (1.534 +/- 0.17 pg/ml) and 2.3-fold in eyes with intraocular foreign body (1.341 +/- 0.25 pg/ml) when compared with macular hole (0.588 +/- 0.16 pg/ml). This was statistically significant (P < 0.05). Zinc was found to be low in Eales' disease (0.57 +/- 0.22 pg/ ml) when compared with other groups, though the difference was not statistically significant. CONCLUSION: The increased level of iron with decreased zinc content in Eales' disease confirms the earlier reported oxidative stress mechanism for the disease. In proliferative diabetic retinopathy and intraocular foreign body the level of iron increases. This is undesirable as iron can augment glycoxidation, which can lead to increased susceptibility to oxidative damage, in turn causing vitreous liquefaction, posterior vitreous detachment and ultimately retinal detachment and vision loss.