title: Surface Area of Detachment, Proliferative Vitreoretinopathy, and Pulse Pressure, but not AGEs, are Associated With Retinal Redetachment.
abstract: Advanced glycation endproducts (AGEs) have been suggested to play a role in retinal redetachment by promoting proliferative vitreoretinopathy (PVR). The purpose of this study was to investigate whether AGEs, in combination with other clinical characteristics, were able to identify patients at high risk for redetachment after vitrectomy for rhegmatogenous retinal detachment (RRD).
  
  
  
  In this prospective cohort study, 410 RRD patients were included. Skin autofluorescence (SAF), as a reflection of tissue AGE accumulation, was measured by the AGE Reader. In a subgroup of 90 patients, the well characterised AGEs Nε-(carboxymethyl)lysine (CML), Nε-(carboxyethyl)lysine (CEL), 5-hydro-5-methylimidazolone (MG-H1), and pentosidine, and the α-dicarbonyls methylglyoxal, glyoxal, and 3-deoxyglucosone were measured in vitreous biopsies using ultra- or high-performance liquid chromatography. The main outcome was retinal redetachment within 3 months after surgery.
  
  
  
  Fifty-three patients developed a redetachment (aged 64 ± 9.6, 64% male) and were compared with 352 patients without a redetachment (aged 61 ± 9.4, 69% male); five patients were excluded for various reasons. Univariable analysis revealed that SAF, vitreous AGEs, and vitreous α-dicarbonyls were not significantly elevated in patients with a redetachment. Multivariable logistic regression analysis showed that surface area of detachment greater than 50% (odds ratio [OR] 2.74, confidence interval [CI] 1.45-5.17), PVR grade C (OR 4.57, CI 1.68-12.42), and pulse pressure (OR 1.37, CI 1.03-1.83 per SD) were independently associated with the occurrence of redetachment.
  
  
  
  Skin autofluorescence and vitreous AGEs are not suitable to identify patients at high risk for redetachment after vitrectomy surgery. Surface area of detachment greater than 50%, PVR grade C, and pulse pressure were associated with redetachment.
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands 2Research Institute GUIDE, Graduate School of Medical Sciences, University of Groningen, Groningen, The Netherlands 3Department of Ophthalmology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
authors.forename: Bernardina T
authors.initials: BT
authors.lastname: Fokkens
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
authors.forename: Douwe J
authors.initials: DJ
authors.lastname: Mulder
authors.affiliation: Department of Ophthalmology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
authors.forename: Michiel B
authors.initials: MB
authors.lastname: Nugteren
authors.affiliation: Laboratory for Metabolism and Vascular Medicine, Experimental Internal Medicine, Maastricht University, Maastricht, The Netherlands.
authors.forename: Casper G
authors.initials: CG
authors.lastname: Schalkwijk
authors.affiliation: Laboratory for Metabolism and Vascular Medicine, Experimental Internal Medicine, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Scheijen
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands 2Research Institute GUIDE, Graduate School of Medical Sciences, University of Groningen, Groningen, The Netherlands.
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Smit
authors.affiliation: Department of Ophthalmology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands 5W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, The Netherlands.
authors.forename: Leonoor I
authors.initials: LI
authors.lastname: Los
mesh_terms: D001706:Biopsy; D001794:Blood Pressure / Q000502:physiology*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D005500:Follow-Up Studies; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012163:Retinal Detachment / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D014822:Vitreous Body / Q000378:metabolism / Q000473:pathology*
chemical_list: D017127:Glycation End Products, Advanced