[Activities of trypsin-like serine proteases and their inhibitors in blood and subretinal fluid of patients with different stages of proliferative vitreoretinopathy in rhegmatogenous retinal detachment]. / Izuchenie aktivnosti serinovykh proteinaz tipa tripsina i ikh ingibitorov v krovi i subretinal'noi zhidkosti u bol'nykh s razlichnymi stadiiami proliferativnoi vitreoretinopatii pri regmatogennoi otsloike setchatoi obolochki.

Concentrations of protein, trypsin-like and antitryptic activities, and the level of alpha 2-macroglobulin were measured in the subretinal fluid (SRF) and blood of patients with different stages of proliferative vitreoretinopathy (PVR). The content of protein in SRF of patients with retinal detachment with PVR was by an order of magnitude higher than in the vitreous body and increased from stage B to stage D1, which indicates increased permeability of the blood-eye barrier. Trypsin-like proteolytic enzymes and their main inhibitors are present in the SRF, and changes in their activity indicate augmentation of the inflammatory component of PVR from stage B to stage C3 and transition to a process similar to tissue cicatrization during stage D1. Changes in the proteinase-inhibitor balance in the peripheral blood in PVR are characteristic of a sluggish inflammatory process which activates from stage B to stage C and eventuates in stage D1. Increase in the blood level of alpha 2-macroglobulin during stages C3 and D1 seems to indicate the development of total autoimmune reaction. Antiinflammatory steroid therapy before surgery had a favorable impact on the course of the postoperative period.

Electroretinographic characteristics of proliferative vitreoretinopathy in rhegmatogenous detachment of retina. / Elektroretinograficheskaia kharakteristika proliferativnoi vitreoretinopatii pri regmatogennoi otsloike setchatki.

Thirty-five patients with types A, B, C2, C3, and D1 proliferative vitreoretinopathy (PVR) were followed up for 8-14 months after surgical treatment of rhegmatogenic amotio retinae. Hanz-Feld electroretinogram (ERG), rhythmic ERG to low and high-frequency stimulation, and macular ERG were recorded. Before surgery all patients presented with specific signs of changes in the retinal electrogenesis, characteristic of rhegmatogenic amotio retinae with PVR of different types. Comparative analysis of ERG and rhythmic ERG alteration showed a more expressed reaction of Mueller's glial cells in patients with types A-C2 PVR and of second order neurons in the internal nuclear layer of the retina in those with types C3 and D1 PVR. Characteristic changes in the retinal functional activity were detected, possessing a prognostic significance. According to electrophysiological studies, the decisive factor for predicting the course of recovery after surgical treatment of retinal detachment is the preoperative function of retinal neurons. A drastic depression of low-frequency rhythmic ERG is the most unfavorable sign in prognosis of the postoperative time course of visual functions. The least favorable course of recovery after the operation is typical of amotio retinae with type C3 PVR. Recovery of amplitudes of different biopotentials and functional horizontal bonds at different levels of the retinal structure is different.