Correlation between high myopia paravascular abnormalities and myopic traction maculopathy / 中华眼底病杂志

Objective:To observe the morphological characteristics of high myopia (HM) paravalvular abnormalities (PVA), and the correlation between different manifestations of PVA and myopic traction maculopathy (MTM) was analyzed.Methods:A cross-sectional clinical study. A total of 42 middle-aged and elderly patients with HM and PVA diagnosed by ophthalmology examination in Department of Ophthalmology, The Second Hospital of Hebei Medical University from June to December 2021 were included in the study. There were 24 eyes in 16 males and 48 eyes in 26 females. Age was (56.71±8.10) years old. Diopter was (-13.05±3.10) D. Axial length (AL) was (28.22±1.04) mm. According to the characteristics of ultra-wide-angle optical coherence tomography images, PVA morphology was divided into paravascular microfolds (PM), paravascular cysts (PC) and paravascular lamellar holes (PLH). MTM was divided into T0-T5 grades, of which MTM≥T3 was defined as severe MTM. The state of vitreoretinal junction was observed and the state of posterior vitreous detachment (PVD) was recorded, which divided into complete PVD and partial PVD. Partial PVD was divided into macular fovea adhesions and paravascular adhesions according to the vitreoretinal adhesions. Posterior scleral staphyloma (PS) was divided into 6 types by ultra-wide-angle fundus photography. Logistic regression model was used to analyze the factors related to MTM.Results:In 72 eyes, PM, PC and PLH were 72 (100.0%, 72/72), 62 (86.1%, 62/72) and 29 (40.3%, 29/72) eyes, respectively. Among them, there were 10 (13.9%, 10/72) eyes with PM alone, 33 (45.8%, 33/72) eyes with PM and PC, and 29 (40.3%, 29/72) eyes with PM, PC and PLH, respectively. There were 42 eyes with partial PVD (58.3%, 42/72), among which the macular fovea and paravascular adhesion were 22 (52.4%, 22/42) and 24 (57.1%, 24/42) eyes, respectively. PS was present in 50 eyes (69.4%, 50/72), among which 27 (54.0%, 27/50), 21 (42.0%, 21/50), 1 (2.0%, 1/50), and 1 (2.0%, 1/50) eyes were types Ⅰ to Ⅳ, respectively. Multivariate logistic regression analysis showed that AL[odds ratio ( OR)=16.139, 95% confidence interval ( CI) 4.062-64.120, P<0.001], PS ( OR=4.212, 95% CI 1.234-14.378, P=0.022), paravascular vitreoretinal adhesion (OR=3.478, 95% CI 11.124, P=0.036) were risk factors for PM, PC and PLH. MTM was present in 58 eyes (80.6%, 58/72), among which T1 was the most common type in 19 eyes (26.4%, 19/72). Univariate logistic regression analysis showed that the occurrence of MTM was significantly correlated to PS ( OR=4.190, 95% CI 1.240-14.157, P=0.021), coexistence of PM, PC and PLH ( OR=11.323, 95% CI 1.389-92.311, P=0.023), and PS were significantly correlated. There was no correlation with PVD ( OR=1.889, 95% CI 0.580-6.150, P=0.291) or PS ( OR=2.778, 1.786; 95% CI 0.700-11.023; 0.445-7.167; P=0.146, 0.413). There was significant difference in the incidence of severe MTM between PM alone, PM combined with PC and coexistence of PM, PC and PLH ( χ2=20.943, P<0.001). Conclusions:PM is the most common and earliest manifestation of PVA in middle-aged and elderly HM patients. AL, PS and paravascular vitreoretinal adhesion are risk factors for PM, PC and PLH. The coexistence of three PVA forms may be a marker of severe MTM.

Recommendations for management of peripheral retinal degenerations

Some degenerations involving the peripheral retina can result in a rhegmatogenous retinal detachment. Currently, there are no clear guidelines for retinal screening and/or management of these peripheral retinal degenerations in patients with or without recent onset posterior vitreous detachment or in those prior to refractive surgery or intraocular procedures. This article aims to provide a set of recommendations for the screening and management of peripheral retinal degenerations based on a common consensus obtained from an expert panel of retinal specialists.

A novel, versatile cannula for vitreoretinal surgery: Bapaye aspiration scraper – Initial experience

The induction of posterior vitreous detachment (PVD) is an important step in the successful outcome of vitreoretinal surgery for various indications. This may pose a significant challenge intraoperatively in cases of strong adhesion between the posterior hyaloid and retina. Various techniques to achieve intraoperative PVD have been described which involve active aspiration as well as non-aspiration techniques to achieve a plane of separation between the posterior hyaloid and retina. Very frequently, combinations of these techniques might be necessary to achieve successful PVD induction. We describe a novel instrument that combines aspiration as well as non-aspiration techniques for PVD induction, Bapaye aspiration scraper. It is also useful in various vitreoretinal interface procedures due to its design and is compatible with small-gauge vitrectomy systems which are commonly used in modern vitreoretinal surgery.

The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment

Purpose: To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision?related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD). Materials: This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun?doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire?25 (NEI VFQ?25) before, and 1 month after, vitreolysis. Results: Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t?test before and after the first laser (0.29 ± 0.49%W [P ? 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ?25 scores post treatment: general vision (z = ?3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = ?2.788, P = 0.005), and mental health (z = ?2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ? 0.001). No adverse events were recorded 1 month after the laser treatments. Conclusion: Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.

Vitreomacular traction release: Finding the edge

Background: Vitreomacular traction (VMT) is a commonly encountered entity in our routine practice. The key question is whether to observe or operate by clinical and imaging based judgement of the visual prognosis in every case. Purpose: This video encapsulates diagnostics, surgical method, and prognosis in a case of VMT released with vitrectomy. Synopsis: A 56-year-old businessman was diagnosed with VMT in the OPD and was advised surgical release of the same. The patient was extremely keen to know the visual prognosis, where the OCT imaging helped. The surgical method demonstrates the method to find the edge of the PVD to release the traction. Also, a simple ILM peel procedure has been described to reduce recurrences in cases like these. Highlights: 1. Judging the prognosis in VMT cases on basis of imaging. 2.Finding the edge (FTE) method of inducing the PVD. 3. ILM peeling simplified

Using swept-source optical coherence tomography to analysis the morphological characteristics of posterior precortical vitreous pocket / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the morphological characteristics of posterior precortical vitreous pocket(PPVP)using swept-source optical coherence tomography(SS-OCT). <p>METHODS:Prospective study. One hundred and thirty-eight eyes of 91 cases with PPVP observed by SS-OCT in Henan Eye Hospital from March 2019 to June 2019 were included in the study. The average width and height size of PPVP was compared among subjects with different genders, age and equivalent spherical.<p>RESULTS: In 138 eyes, 112 eyes(81.2%)were ship shaped, 19 eyes(13.8%)were oval, and 7 eyes(5.1%)were hook shaped. Ninety-nine eyes(71.7%)had PPVP which connected with Martegiani area. The average width of PPVP was 6248.82±1117.87μm, and the average height of PPVP was 562.12±476.94μm. There was no difference in the width and height of PPVP between different genders(<i>P</i>>0.05), and the PPVP' width was positively correlated with age(<i>r</i>=0.32, <i>P</i><0.01). The PPVP' height in low myopia group were lower than that in non-myopia and moderate myopia group eyes(<i>P</i>=0.01, 0.03). <p>CONCLUSION: PPVP is a boat-shaped fluid cavity in front of the macula, which communicates with the Cloquet canal. Its width is related to the age. The existence of PPVP may play a role in the development of PVD and its progress.

Observation of vitrectomy combined with internal limiting membrane peeling for refractory diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effect of vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling in the treatment of refractory diabetic macular edema.<p>METHODS: The data of 56 eyes(56 patients)with refractory diabetic macular edema accepted PPV combined with ILM peeling were collected and retrospectively analyzed. The patients were divided into Group A(no posterior vitreous detachment): 35 cases(35 eyes)and Group B(with posterior vitreous detachment): 21 cases(21 eyes). The best corrected visual acuity(BCVA)and central macular thickness(CMT)before and 1, 3, 6mo after operation were compared and analyzed.<p>RESULTS: The mean CMT and LogMAR BCVA of Group A at 1, 3 and 6mo after operation were significantly different from those before operation(<i>P</i><0.05); There was no significant difference in BCVA between those before and 1, 3, 6mo after operation in Group B(<i>P</i>>0.05). The mean CMT of 1mo after operation was significantly different from that before operation(<i>P</i><0.05). There was no significant difference in mean CMT between 3 and 6mo after operation and before operation(<i>P</i>>0.05). CMT and BCVA were significantly different between the two groups at 1,3 and 6mo postoperatively(<i>P</i><0.05).<p>CONCLUSION: PPV combined with ILM peeling can effectively treat refractory diabetic macular edema without posterior vitreous detachment, improve the patient's vision; However, PPV combined with ILM peeling was not effective in patients without posterior vitreous detachment.

Perfluoro-n-octane-assisted mega Weiss-ring technique for posterior vitreous detachment induction in retinal detachment

Induction of posterior vitreous detachment (PVD) is one of the most critical steps for the success of retinal detachment (RD) surgery. Failure to completely remove the vitreous can result in re-detachments. We describe a novel technique to induce PVD. After core vitrectomy, perfluorocarbon liquid (PFCL) is injected. The vitreous on the posterior pole is gently stroked, with a diamond-dusted membrane scraper, to create a defect in it. This defect is gradually enlarged to create a ring of rolled out vitreous. The entire vitreous is removed in form of a sheet by lifting the edges of the ring using an internal limiting membrane peeling forceps. PFCL naturally slides into the potential space, gradually extending the vitreous detachment peripherally. With this technique, the vitreous sheet in case of RD can easily, effectively and safely be removed with this technique.

The role of posterior vitreous detachment on the efficacy of anti-vascular endothelial growth factor intravitreal injection for treatment of neovascular age-related macular degeneration

Purpose: A prospective cohort study investigating the effect of posterior vitreous detachment (PVD) on the efficacy of intravitreal bevacizumab for exudative age-related macular degeneration (AMD), in view of evidence that the vitreoretinal interface impacts the severity of the disease. Methods: Treatment-naïve AMD eyes with (+) complete PVD and without (?) PVD on ultrasonography received three monthly and then pro re nata bevacizumab injections. Best-corrected visual acuity (BCVA) on Snellen charts and optical coherence tomography (OCT) findings were recorded for 12 months. Secondary analysis included PVD definition and group allocation according to OCT baseline scan. Results: Forty-one eyes of 34 patients met the inclusion criteria. At 12 months, median BCVA improved by 0.12 logMAR in the PVD+ group [interquartile range (IQR) ?0.52, 0.03, P = 0.140] and remained the same in the PVD? group (IQR ?0.12, 0.15, P = 0.643). Median central retinal thickness improved by 43.5 ?m and 43 ?m in the PVD+ (IQR ?143, 3, P = 0.016) and PVD? group (IQR ?90, ?14, P = 0.008), respectively. All parameters were similar in the two groups at final follow up (P > 0.05). The secondary analysis included 32 eyes of 26 patients and showed no significant differences between the groups at the 12 months endpoint (P > 0.05). Conclusion: Our findings show no significant impact of PVD as assessed by ultrasound or by OCT on visual and anatomical outcomes in exudative AMD treated with bevacizumab.

Intravitreal tissue plasminogen activator for treatment of vitreomacular adhesion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the role of a single intravitreal injection of tissue plasminogen activator ( TPA) alone for treatment of vitreomacular traction and the effect of combined intravitreal TPA and bevacizumab on retinal vascular diseases.? METHODS: In this prospective, interventional case series a total of 24 eyes from 24 patients were studied. There were 5 eyes with symptomatic vitreomacular traction syndrome ( VMT ) and 19 eyes with retinal vascular diseases including diabetic macular edema ( DME ) , diabetic vitreous hemorrhage ( VH ) , central retinal vein occlusion ( CRVO ) and neovascular age related macular degeneration ( AMD ) . Measurement of visual acuity, B-scan and OCT were performed at the baseline and 1mo after injections. Three eyes with VMT received a single intravitreal injection of 50 μg and two eyes received 100 μg TPA. And 19 eyes with retinal vascular diseases received combined intravitreal TPA ( 50μg) and bevacizumab (1. 25 mg).?RESULTS: The mean ages for retinal vascular diseases and VMT patients were 56. 8y and 60. 4y, respectively. Ten patients ( 41. 7％) were male and 14 patients ( 58. 3％) were female. And 22 eyes ( 91. 7％) were phakic and 2 eyes ( 8. 3％) were pseudophakic. The incidence of posterior vitreous detachment (PVD) was 0 (0 of 5) and 57. 8％ (11 of 19) for VMT and retinal vascular diseases, respectively (P= 0. 04). Improvement of best corrected visual acuity ( BCVA ) and decrement of central macular thickness ( CMT ) were significantly greater in PVD positive eyes compared with PVD negative eyes.?CONCLUSION: Intravitreal injection of TPA was not successful to induce complete PVD in VMT patients. Combined intravitreal injection of TPA and bevacizumab can induce PVD and improve BCVA and decrease central macular thickness in eyes with retinal vascular diseases.

Ultra-wide Field Fundus Photography Using Eye Steering Technique in Patients with Symptomatic Posterior Vitreous Detachment

PURPOSE: To evaluate the availability of ultra-wide field fundus photography based on eye steering technique to diagnose retinal breaks in patients with symptomatic posterior vitreous detachment (PVD). METHODS: The medical records of patients with symptomatic PVD were reviewed. Retinal breaks were independently identified using four eye steering capture images of ultra-wide field fundus photographs. The sensitivity and specificity of eye steering capture imaging for diagnosing retinal breaks were calculated. RESULTS: A total of 94 eyes of 94 patients were included. Using fundus examination after pupil dilatation, retinal breaks were diagnosed in 42 (45%) eyes. The sensitivity of the eye steering capture imaging was 98% (95% confidence interval [CI]: 88–100%), and the specificity was 98% (95% CI: 90–100%). Of the 58 retinal tears, 28 (97%) involving the superior quadrant, 10 (100%) involving the inferior quadrant, 6 (100%) involving the nasal quadrant, and 13 (100%) involving the temporal quadrant were identified using eye steering capture images. CONCLUSIONS: Ultra-wide field fundus photography based on eye steering technique was useful for diagnosing retinal breaks in patients with symptomatic PVD. However, eye steering photography could not adequately replace the fundus examination after pupil dilatation in all cases.

Analysis of Ganglion Cell-Inner Plexiform Layer Thickness after Internal Limiting Membrane Peeling

PURPOSE: To evaluate the ganglion cell-inner plexiform layer (GCIPL) thickness after internal limiting membrane (ILM) peeling with or without intravitreal gas injection (IVGI) or surgical induction of posterior vitreous detachment (PVD). METHODS: Eighty patients who were diagnosed with epiretinal membrane (ERM) or macular hole and who received surgical intervention were retrospectively reviewed. Forty patients were treated with ILM peeling and forty patients were treated with ERM removal, but not with ILM peeling. The patients were categorized according to ILM peeling, IVGI, and surgical induction of PVD. The GCIPL thickness was measured using optical coherence tomography, and the average and sectorial thickness of GCIPL were compared. RESULTS: The GCIPL thickness in the ILM peeling group significantly decreased (-13.80 ± 22.63 µm; p < 0.001), but was not significantly different in the ERM removal without ILM peeling group, compared with the preoperative GCIPL thickness (+1.21 ± 22.53 µm; p = 0.546). The difference was statistically significant between the two groups (p = 0.038). In the ILM peeling group, GCIPL thickness was not significantly different in the IVGI group (-17.41 ± 23.92 µm vs. -7.25 ± 19.05 µm; p = 0.109) and was significantly decreased in the surgical induction of the PVD group (-23.06 ± 23.92 µm vs. -7.25 ± 19.05 µm; p = 0.020). On sectorial analysis, reduction of the temporal GCIPL thickness was the largest and was significantly different compared with the nasal GCIPL thickness in ILM peeling group (-19.73 ± 28.55 µm vs. -7.42 ± 19.90 µm; p = 0.005). CONCLUSIONS: ILM peeling and surgical induction of PVD may damage ganglion cells. Therefore, gentle ILM peeling and surgical induction of PVD may be needed to minimize ganglion cell damage, especially when ILM peeling is performed in glaucomatous patients.

Spontaneous Separation of Idiopathic Epiretinal Membrane in an Elderly Patient

PURPOSE: To report a case of spontaneous separation of idiopathic epiretinal membrane in an elderly patient. CASE SUMMARY: A 61-year-old male presented with decreased visual acuity in the right eye. He was diagnosed with idiopathic epiretinal membrane (ERM) in the right eye and posterior vitreous detachment (PVD) in both eyes. The patient underwent pars plana vitrectomy and ERM removal in the right eye. At postoperative 1 year, his vision in the right eye had improved, but idiopathic ERM developed in the left eye and visual acuity in the left eye decreased. Three years later, the ERM in the left eye resolved spontaneously and his vision increased. CONCLUSIONS: Herein we present a rare case of spontaneous separation of idiopathic ERM associated with a pre-existing PVD in an elderly patient and reviewed the available literatures regarding the possible mechanisms for the spontaneous separation of ERM in the presence of a pre-existing PVD.

Research advances on treatment of vitreomacular adhesion with gene recombinant ocriplasmin / 中华实验眼科杂志

Vitreous retinal interface abnormalities are associated with many macular diseases.The main approach of treatment is to release the vitreomacular adhesion with pars plana vitrectomy.Because of its complication and limitation,researches of pharmacologic posterior vitreous detachment (PVD) were undertaken.Gene recombinant ocriplasmin was proved by several experiments and clinical trials by inducing a complete PVD,showing its promising prospect.This article reviewed the literatures of ocriplasmin,including pathobiology in treatment of vitreomacular adhesion,pharmacokinetics,vitreodynamics,experimental studies and clinical trials and adverse events.

Study of early changes at the vitreoretinal interface / 国际眼科杂志(Guoji Yanke Zazhi)

On the anatomy, posterior vitreous cortexneighbors with retina, the relationship of vitreous and retinal is both independent and closely linked. Under pathological condition, changes in the vitreous provides a good environment for occurrence and development of a number of vitreoretinal diseases, which indicates that vitreous plays a crucial role in many vitreoretinal diseases occurrence and growth. Elimination of vitreous change in disease, is an issue of great concern of the ophthalmic industry in recent years. Based on the description of vitreous and vitreoretinal interface structure, changes in the vitreous and retinal adhesion mechanisms and interfaces retinal disease risk factors and the impact on the retinal disease were discussed, And the posterior vitreous detachment impact on the vitreoretinal interface disease, the testing methods and its importance were described in this article.

Clinical Characteristics of Rhegmatogenous Retinal Detachment in Patients under 40 Years of Age

PURPOSE: To investigate the risk factors and the factors affecting surgical and visual outcomes of rhegmatogenous retinal detachment in patients under 40 years of age. METHODS: This retrospective study included 88 patients (96 eyes) diagnosed with rhegmatogenous retinal detachment that were followed up for more than 3 months postoperatively. Patients were categorized into 3 groups according to age. The etiologic risk factors and the primary anatomical and functional success rates were analyzed. Preoperative factors that could affect postoperative visual acuity and primary anatomical outcome, such as subretinal strands and proliferative vitreoretinopathy (grade C or worse), were analyzed. RESULTS: Myopia more severe than -4.0 diopters was the most common predisposing factor in all 3 groups. Anatomical success rates and functional success rates were not significantly different among the groups. Prevalence of macular detachment and proliferative vitreoretinopathy were highest in group 1. The presence of subretinal strands was highest in group 2 and proliferative vitreoretinopathy was highest in group 1. Patients with preoperative subretinal strands showed a lower primary anatomical success rate in group 1 and poor postoperative visual acuity in groups 1 and 2. Patients with proliferative vitreoretinopathy had poor postoperative visual acuity however there was no significant difference in primary anatomical success rate among the groups. CONCLUSIONS: Proliferative vitreoretinopathy did not affect the anatomical success rate but did affect visual outcome in rhegmatogenous retinal detachment in patients under age 40. Subretinal strands contributed to a lower anatomical success rate and poorer visual outcome in such patients that were under age 18.

Clinical Characteristics of Rhegmatogenous Retinal Detachment in Patients under 40 Years of Age

PURPOSE: To investigate the risk factors and the factors affecting surgical and visual outcomes of rhegmatogenous retinal detachment in patients under 40 years of age. METHODS: This retrospective study included 88 patients (96 eyes) diagnosed with rhegmatogenous retinal detachment that were followed up for more than 3 months postoperatively. Patients were categorized into 3 groups according to age. The etiologic risk factors and the primary anatomical and functional success rates were analyzed. Preoperative factors that could affect postoperative visual acuity and primary anatomical outcome, such as subretinal strands and proliferative vitreoretinopathy (grade C or worse), were analyzed. RESULTS: Myopia more severe than -4.0 diopters was the most common predisposing factor in all 3 groups. Anatomical success rates and functional success rates were not significantly different among the groups. Prevalence of macular detachment and proliferative vitreoretinopathy were highest in group 1. The presence of subretinal strands was highest in group 2 and proliferative vitreoretinopathy was highest in group 1. Patients with preoperative subretinal strands showed a lower primary anatomical success rate in group 1 and poor postoperative visual acuity in groups 1 and 2. Patients with proliferative vitreoretinopathy had poor postoperative visual acuity however there was no significant difference in primary anatomical success rate among the groups. CONCLUSIONS: Proliferative vitreoretinopathy did not affect the anatomical success rate but did affect visual outcome in rhegmatogenous retinal detachment in patients under age 40. Subretinal strands contributed to a lower anatomical success rate and poorer visual outcome in such patients that were under age 18.

Spontaneous Resolution of Vitreoretinal-Iinterface Disorders

PURPOSE: To review the mechanisms and clinical patterns of spontaneous resolution of vitreoretinal interface disorders by analyzing cases and available literature on macular hole (MH), vitreoretinal traction (VMT), and epiretinal membrane (ERM). METHODS: Medical records and optical coherence tomography (OCT) images of patients with spontaneous resolution of MH, VMT, and ERM were reviewed. RESULTS: Two eyes with VMT, 3 eyes with idiopathic MH, 3 eyes of traumatic MH (including 1 eye with electrical burn), and 2 eyes with ERM showed spontaneous resolution. All eyes except traumatic MH reached a visual acuity better than 0.5 after resolution. All idiopathic MHs achieved anatomic closure in 6 months, and traumatic MHs in 1 month except for the electrical burn case. Seven out of 10 eyes experienced complete posterior vitreous detachment (PVD) during resolution. CONCLUSIONS: Some cases of vitreoretinal interface disorders can resolve spontaneously with complete PVD or other mechanisms. Indicators predicting spontaneous resolution should be considered in patients with vitreoretinal interface disorder.

Human Vitreous Proteomes in Idiopathic Macular Hole

PURPOSE: To investigate the vitreous proteomic profiles of macular hole (MH) patients compared to donor eyes and epiretinal membrane (ERM) patients. METHODS: Ten donor eyes, 25 MH patients (15 MH without posterior vitreous detachment (PVD) and 10 MH with PVD), 10 ERM patients and 4 patients with vitreomacular traction syndrome (VMTS) were enrolled in the present study. The undiluted vitreous samples were obtained from all eyes. Proteins were identified using the micro-RPLC/MS/MS technique and using mass spectrometric data analysis from the IPI database. Proteins were searched for the function, subcellular location and tissue specificity using the Uniprot database. RESULTS: The mean vitreous protein concentrations were the highest (p < 0.01) in MH patients without PVD. There were no qualitative changes according to the age of donor eyes. However, the authors newly-identified 12 proteins (i.e. vasorin) in donor eyes. Ten out of 136 proteins (7.3%) (i.e. retinoschisin) were exclusively detected in the MH samples. S100A8 was exclusively detected in eyes without PVD, whereas CD59 was exclusively detected in eyes with PVD. CONCLUSIONS: The results suggest there is a small difference in the vitreous proteomic profiles in MH patients compared to donor eyes or ERM patients, and that the expression of vitreous proteins is closely associated with the presence of PVD.

A pilot study on purification of human plasminogen from cord blood plasma and inducing posterior vitreous detachment / 中华实验眼科杂志

Background Many studies and clinical trials of pharmacologic vitreolysis are already under way to try to improve vitreo-retinal surgery and to liquefy and detach the vitreous from the retina ultimately, including chondroitinase,hyaluronidase,dispase and plasmin. However, there has not been any report on purification of human plasminogen from cord blood plasma and inducing posterior vitreous detachment of the animal eye at present.Objective This study was designed to isolate and purify the production of human plasminogen (Plg) from cord blood plasma with ethanol precipitation and evaluate the efficacy of Plg in inducing posterior vitreous detachment (PVD).Methods Human Plg was Separated and purified from cord blood plasma by ethanol precipitation method. The protein band corresponding to Plg with molecular mass of 92 000 was revealed in SDS-PAGE and confirmed by MALDI-TOF and Mascot database. Anion-exchange chromatography and plasminogen activity assay kit were used to obtain purified Plg with biological activity. Twenty-five fresh pig eyes were enucleated and assigned to 5 groups and 5 eyes for each group. The normal eyes were used as control group. Balanced salt solution(BSS)of 0.1 ml was intravitreally group and standard substance group. All of the eyes were then incubatedfor 60 minutes under the 37 ℃. Retinal histopathology and ultrastructure were examined under the light microscopy, scanning electron microscopy ( SEM ) and transmission electron microscopy (TEM). Results The Plg with potential fibrinolytic activity was successfully extracted and purified from cord blood plasma by ethanol precipitation method. No posterior vitreous detachment (PVD) was seen in normal control group, BSS group and r-SK group following the intravitreal injection under the sem. However,PVD was demonstrated in r-SK+ Plg group and standard substance group under the SEM. The inner limiting membrane ( ILM ) and the retina were well preserved in all of the experimental eyes. No retinal morphology and ultrastructural abnormality were found under the light and SEM and TEM. Conclusion Ethanol precipitation is a feasible way to isolate and purify Plg from human cord blood plasma. Extracted Plg shows potential fibrinolytic intravitreal injection of Plg.