ABSTRACT
Objective The aim of this study is to observe the clinical characteristics and surgical effects of macular hole retinal detachment in high myopia patients with pars plana vitrectomy (PPV)and secondary internal limiting membrane (ILM)peeling.Methods This was a retrospective study.The clinical data of 1 5 patients (1 5 eyes)with macular hole retinal detachment and high myopia,who underwent primary PPV and secondary ILM peeling,were analyzed,including disease history,refraction diopter,ocular axis length,posterior scleral staphyloma,BCVA,macular reattachment and macular hole heeling.There were 3 males (3 eyes)and 12 female (12 eyes),the average age was (60.80 ± 5.85 )years.All patients were examined by best corrected visual acuity (BCVA ), slit lamp microscopy with 90D pre-lens, indirect ophthalmoscopy,A scan and optical coherence tomography (OCT).After the first PPV and silicone oil tamponade,a shallow retinal detachment around the macular hole,especially around the scleral staphyloma was detected by OCT.During the 2nd surgery to remove the silicone oil,ILM peeling and C3 F8 tamponade were performed.Results The average refraction diopter was (- 12.6 ± 1.86)D,the average ocular axial length (29.82±0.993)mm and the average disease duration was (5.20±1.24)months.All eyes had total retinal detachment of all four quadrants,choroid detachment and macular choroidal atrophy,and type ⅡCurtin posterior scleral staphyloma. After the second surgery, all had retina attached by fundus examination.OCT examination indicated that macular hole closure in 7 eye,macular hole attached and retinal attached in 8 eyes.Their BCVA improved after both the first and second surgery (P =0.000),the BCVA after second surgery was better than that after first surgery (P =0.038).Conclusions The clinical characteristic of our series of patients were as follows:long history,with choroidal detachment and type ⅡCurtin posterior scleral staphyloma.All 1 5 eyes showed retinal attached after secondary ILM peeling.The secondary ILM peeling and C3 F8 tamponade may improve the visual outcome and retinal reattachment rate.
ABSTRACT
ObjectiveTo observe the influence of triamcinolone acetonide (TA) on the expression of pigment epithelium-derived factor (PEDF) of human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells (4th - 6th generations) were treated with four different concentrations of TA (40, 400, 4× 103 and 4× 104 μg/L) for three different periods (12 or 24 or 48 hours), the levels of PEDF protein in the cell culture supernatant and cell lysates were determined by Western blot. After the initial experiment, RPE cells were treated with or without tumor necrosis factor-α (TNF-α, 20 ng/ml) for 24 hours, followed by TA (400 μg/L) treatment. The levels of PEDF and phospho-p38 mitogen activated protein kinase (p-p38MAPK) protein expression in cell culture supernatant and cell lysates were measured by Western blot. Results TA-treated RPE cells had higher PEDF expression, and 400 μg/L TA group had the highest effect (F= 16.98, P＜0. 05). 400μg/L TA treatment for one, six or 24 hours, with or without TNF-α pretreatment, could all promote the PEDF expression and inhibit the p-p38MAPK protein expression (F= 16.87, 10.28; P＜0. 01). TNF-α pretreatment alone could inhibit PEDF protein expression and promote p-p38MAPK protein expression (F= 16.87, 10. 28; P＜0. 01). Conclusions TA can up-regulate the expression of PEDF, and down-regulate the expression of p-p38MAPK in the cultured human RPE cells.