Preoperative duration of retinal detachment and subretinal immunoreactive endothelin-1: repercussion on logarithmic visual acuity.
OBJECTIVE
To analyze whether preoperative duration of primary rhegmatogenous retinal detachment (RD) influences endothelin-1 (ET-1)--a vasoactive, mitogenic, and pro-apoptotic peptide- levels with repercussions on logarithmic (LogMAR) visual acuity (VA).


METHODS
Prospective clinical cohort study on 66 healthy patients [33 with proliferative vitreoretinopathy (PVR) and 33 with no PVR] with unilateral RD candidates for scleral buckling (SB) surgery. Using radioimmunoassay, immunoreactive ET-1 (IR-ET-1) was tested in both plasma and subretinal fluid (SRF) of these RD patients. Pearson's correlations were evaluated between preoperative RD duration and each IR-ET-1 level (plasma, SRF and the difference SRF minus plasma) and also between both variables and the LogMAR VAs (preoperative, postoperative 8 months, and the difference: postoperative 8 months minus preoperative).


RESULTS
PVR was associated with higher preoperative RD duration, higher LogMAR VA values (pre- and postoperative 8 months) and higher IR-ET-1 values (plasma, SRF and the difference: SRF minus plasma) than no-PVR IR-ET-1 levels (plasma and SRF) were only correlated (r = 0.462, p = 0.007; r = 0.397, p = 0.022 respectively) with preoperative RD duration in the no-PVR group. IR-ET-1 values (plasma, SRF and the difference:SRF minus plasma) showed statistically significant correlations with pre- and with postoperative 8 months LogMAR VAs in no-PVR and with postoperative 8 months LogMAR VA and LogMAR VA difference in PVR The highest correlation between IR-ET-1 levels and LogMAR VAs was found between SRF IR-ET-1 and postoperative 8 months LogMAR VA in PVR (cases with macula-on) (r = 0.956, p < 0.0001).


CONCLUSIONS
Preoperative RD duration showed statistically significant positive correlations with pre- and with postoperative 8 months LogMAR VAs in both the no-PVR and the PVR groups and with IR-ET-1 measurements (plasma and SRF: lower correlations) only in the no-PVR group. These findings support the idea of doing primary and prompt vitrectomy for RD and perhaps using coadjutant pharmacologic therapy in order to improve visual results.
Department of Ophthalmology, Facultad de Medicina, Universidad Complutense, Rey Francisco 11, 28008 Madrid, Spain. MRPUCMHS@telefonica.net
Manuela
M
Roldán-Pallarès
Abdalla-Sadiq
AS
Musa
Carmen
C
Bravo-Llatas
Raquel
R
Fernández-Durango
D000328:Adult; D000368:Aged; D001826:Body Fluids / Q000378:metabolism; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011863:Radioimmunoassay; D012008:Recurrence; D012163:Retinal Detachment / Q000097:blood* / Q000503:physiopathology* / Q000601:surgery; D012591:Scleral Buckling; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology*; D018630:Vitreoretinopathy, Proliferative / Q000097:blood / Q000503:physiopathology
D019332:Endothelin-1