Kwan-Rong Liu

Intravitreal triamcinolone staining observation of residual undetached cortical vitreous after posterior vitreous detachment.

AimsTo study the pattern of residual undetached cortical vitreous (RCV) after posterior vitreous detachment (PVD) in eyes with rhegmatogenous retinal detachment (RRD) and to examine the relationship between RCV and the development of epiretinal membrane (ERM).MethodsA prospective study was conducted in 33 consecutive patients with clinically evident PVD who underwent pars plana vitrectomy for RRD. During vitrectomy, triamcinolone acetonide (0.2 cm3, 10 mg/cm3) was applied to stain the RCV. The pattern of the staining were recorded. The formation of postoperative ERM was correlated with the staining pattern of RCV. Each case was followed for at least 6 months.ResultsIn all, 23 of the 33 patients had RCV of variable size, with a single stain patch observed in 13 patients and multiple patches in seven patients. Large circumferential areas of staining at the mid-periphery were noted in three patients. A total of 10 cases had staining over the fovea and five patients had staining over the disc. ERM developed in seven patients during follow-up. None corresponded to RCV.ConclusionRCV is common in eyes with PVD and RRD. The macula and disc area are the most frequent locations for these vitreous islands. The relationship between RCV and ERM remains to be investigated.

Treatment of Small-Sized Retinal Hemangioma by Intravitreal Bevacizumab (Avastin) Injection Combined With Laser Photocoagulation

目的：報告一例以玻璃體內注射癌思停(Avastin)藥物合併雷射光凝固療法治療逢希伯•林道症候群併小型視網膜血管瘤案例。 方法：病例報告。 結果：二十歲之逢希伯•林道症候群男性病患患有兩側視網膜血管瘤。病患接受玻璃體內癌思停藥物注射以治療左眼網膜中外緣兩小型血管瘤。第一次注射後兩週，血管瘤體積消退，兩個月後回復到注射前大小。再次注射癌思停藥物，亦觀察到同樣消退後再復發情形。病患於第三次癌思停注射後，合併實施雷射光凝固治療。治療後血管瘤消退並結痂，兩年內病況及視力穩定。 結論：玻璃體內抗血管內皮增生藥物癌思停注射，具有短暫性降低血管瘤血管分佈之作用，搭配雷射光凝固治療，可能是有效長期治療小型視網膜血管瘤的方法。

Integrin-Mediated Matrix Attachment and Vitreous Contraction of Cultured Human Retinal Pigment Epithelial Cells

Background: The pathogenesis of proliferative vitreoretinopathy (PVR) is not fully understood. Integrins, a group of cell surface extracellular matrix (ECM) receptors, are thought to play an active role. Integrin-mediated ECM adhesion and vitreous contraction of human retinal pigment epithelial (RPE) cells were investigated in this study. Methods: Indirect immunofluorescent stain and flow cytometry were used to demonstrate and quantify the expression of integrins on cultured human RPE cells. The functional expression of integrins on RPE cells was evaluated by cell adhesion assay and bovine vitreous contraction assay with specific monoclonal anti-integrin subunit antibodies. Results: Cultured human RPE cells expressed collagen, fibronectin, vitronectin, and laminin receptors on the cell membranes. RPE cells used these integrins to attach to ECM proteins, and the attachment was blocked by integrin-specific monoclonal antibodies. In the vitreous gel model, RPE cells showed divalent-cation dependent vitreous contraction via α2β1 and α3β1 intrgrins. Cytokines enhanced the integrin-mediated vitreous contraction. Conclusion: Human RPE cells express β1 family and α(subscript v)β3 integrins that mediated ECM attachment and vitreous contraction. These integrins on the RPE cells may play an important role in the pathogenesis of PVR.

Indocyanine Green Videoangiography in the Evaluation of Laser Teatment of Choroidal Neovascularization

Laser treatment is the major and most freqently used method in the management of choroidal neovascularization, especialy in age related macular degeneration. However, high recurrent rate limits its effectiveness. Post laser evaluation and long term follow up thus are of great importance. Fluorescein angiography is the conventional method for evaluation of post-laser lesions. In this study, in docyanine green videoangiography is utilized for the immediate post laser evaluation. In our study, laser treated area was noted to be hypofluorescent and laser missed neovascularization was noted to be hyperfluorescent. No profuse dye leakage in the lesion area was present as that in fluorescein angiography. We found that indocyanine green videoangiography was a useful tool for immediate post-laser evaluation of choroidal neovascularization.

Serum Soluble Interleukin-2 Receptor Levels of Normal Subjects and Uveitis Patients

Interleukin-2 receptor (IL-2R) is expressed on the activated T cell after stimulation by interleukin-2 (IL-2), a potent immune growth factor. Meanwhile a soluble form of IL-2R is released into serum. Detection of serum IL-2R levels reflects the immune response of the tissue. We used enzyme-linked immunoabsorbent assay (ELISA) to determine the serum IL-2R levels of endogenous uveitis patients and normal subjects. Seven uveitis patients with active disease had the mean serum IL-2R level of 2100±1085 unit/ml. The mean of IL-2R of eleven patients with inactive disease was 341±71 unit/ml which was not different from that of control group (437±95 unit/ml) significantly. From our preliminary results, we suggested that serum IL-2R levels were associated with the disease activity of uveitis, and measurement of serum IL-2R levels in uveitis patients provided a promising way to monitor the disease activity of uveitis patients.