gms | German Medical Science

Background: Laser-flare-photometry of anterior chamber (AC) fluid allows identification of high-risk patients with primary retinal detachment for proliferative vitreoretinopathy (PVR). Aim of this study was to analyse pro-fibrotic factors in AC fluid in relation to laser-flare-value and PVR incidence.

Methods: 68 patients with primary retinal detachment were prospectively enrolled. All patients received laser-flare analysis (FM-500, Kowa Optimed, Düsseldorf) preoperatively. Standard surgical procedure was 20 Gauge pars plana vitrectomy, encircling band and SF-6 gas endotamponade. IL-6, IL-8, MCP-1, TGF-ß 1, 2, 3, PDGF aa, and VEGF (R&D Systems GmbH, Wiesbaden, Germany) were analysed in intraoperatively obtained AC fluid samples by multiple bead analysis (Luminex, Austin, Texas, USA).

Results: 20 patients had flare values >15 pc/ms. 4 patients developed PVR retinal detachment, 6 patients developed PVR grade C. 8/10 patients (80%) with PVR had flare values of >15 pc/ms. 46/52 patients (79%) without PVR had flare values of <15 pc/ms. The odds for PVR with flare values of >15 pc/ms were 15-fold increased compared to <15 pc/ms (p=0.0005). Levels of IL-6, IL-8, MCP-1, and TGF-ß1 in AC fluid were elevated depending on the flare value (p<0.0001, p=0.0007, p=0.0008 respectively). Levels of VEGF, PDGF aa and TGF-ß2 were not elevated (p=0.263, p=0.926, p=0.444 respectively). TGF-ß3 was not detected.

Conclusion: Laser flare photometry in patients with primary retinal detachment allows risk-estimation for later PVR with high sensitivity and specificity. Pro-fibrotic factors were elevated in AC fluid, dependent on the flare value and constitute promising targets for prophylactic intervention. Anti-fibrotic TGF-ß3 was not detected in AC fluid.