外伤性增殖性玻璃体视网膜病变发病机理

增殖性玻璃体视网膜病变是眼后段穿破伤视力丧失的主要原因,临床所见轻则为黄斑区视网膜前膜,重则可引起视网膜全脱离,眼球萎缩,为了探讨其发病机理,作者用灵长类为动物模型进行了形态学的观察,并用13只患者摘除的眼球进行粘连蛋白免疫抗体组织化学研究,结果表明,此病变为组织对视网膜损害的过度反应.发生在视网膜内界膜水平的玻璃体后脱离是诱发因素。病变过程中脉络膜粘连蛋白持续升高,这不但是由于血管通透性改变血浆外渗引起,而是脉络膜自身产生细胞型粘连蛋白.粘连蛋白巳知对组织损伤的愈合有促进作用,故此也可能是增殖性玻璃体视网膜病变发病的重要因素.

Pathogenesis of traumatic proliferative vitreoretinopathy]

Proliferative vitreoretinopathy is the main cause of loss of vision following posterior penetrating eye injury. Clinically, it can range from macular epiretinal membrane to total retinal detachment and phthisis bulbi. To gain more knowledge of its pathogenesis, the author performed morphologic studies using a primate model and also studied the distribution of fibronectin in 13 enucleated patient eyes using immunofluorescent histochemical techniques. Results indicate this disease process represents an overstimulated response to retinal injury. Posterior vitreous detachment at the level of internal limiting membrane appears to be a predisposing factor. During the active phase of the disease process, there is selective increase of fibronectin in the choroid. This increase is not merely due to the passive leakage of plasma caused by the injury, but the choroid itself produces cellular fibronectin. Fibronectin is known to enhance wound healing and may be an important factor in the pathogenesis of proliferative vitreoretinopathy.