To evaluate the impact of oxidative stress and the antioxidant defense system in the pathogenesis of proliferative vitreoretinopathy (PVR).
Methods
In this prospective study, three groups of patients undergoing pars plana vitrectomy (PPV) were included: Group 1 included patients with rhegmatogenous retinal detachment (RRD) complicated by grade C PVR; Group 2 included patients with RRD without PVR; and Group 3 (control group) consisted of patients undergoing PPV for macular hole or vitreomacular traction. At the initiation of PPV, approximately 0.2 ml of a vitreous sample was obtained. Samples were analyzed for total oxidant status (TOS, µmol H2O2 equivalent/L), total antioxidant status (TAS, mmol Trolox equivalent/L), and oxidative stress index (OSI, TOS/TAS).
Results
A total of 60 eyes from 60 patients were included (n = 20 per group). The mean TAS levels were 1.23 ± 0.62 in Group 1, 1.41 ± 0.64 in Group 2, and 1.84 ± 0.52 in Group 3 (p = 0.008). The mean TOS levels were 18.62 ± 8.56, 14.32 ± 6.57, and 10.42 ± 5.82 in Groups 1, 2, and 3, respectively (p = 0.005). There was a statistically significant difference in OSI values between the groups (Group 1: 24.4 ± 31.51; Group 2: 13.31 ± 13.79; Group 3: 6.88 ± 6.26) (p = 0.001).
Conclusion
Elevated TOS and OSI levels, along with reduced TAS levels in the vitreous samples of patients with PVR, suggest that oxidative stress and impaired antioxidant defense may play a critical role in the pathogenesis of PVR.
MitryDCharterisDGYorstonD, et al.The epidemiology and socioeconomic associations of retinal detachment in Scotland: a two-year prospective population-based study. Invest Ophthalmol Vis Sci2010; 51: 4963–4968.
2.
PopovicMMMuniRHNichaniP, et al.Pars plana vitrectomy, scleral buckle, and pneumatic retinopexy for the management of rhegmatogenous retinal detachment: a meta-analysis. Surv Ophthalmol2022; 67: 184–196.
WickhamLHo-YenGOBunceC, et al.Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes. Br J Ophthalmol2011; 95: 1234–1238.
5.
IdreesSSridharJKuriyanAE. Proliferative vitreoretinopathy: a review. Int Ophthalmol Clin2019; 59: 221–240.
6.
PastorJCde la RúaERMartínF. Proliferative vitreoretinopathy: risk factors and pathobiology. Prog Retin Eye Res2002; 21: 127–144.
7.
WangWXXingMApteRS. Interventions for proliferative vitreoretinopathy. JAMA Ophthalmol2024; 142: 669–670.
8.
HughesPJBhagatNGonzalez-MartinezOG, et al.Intravitreal methotrexate injection for the treatment and prevention of proliferative vitreoretinopathy. Retina2024; 44: 1748–1757.
9.
ZhengYValikodathNWoodwardR, et al.Oral curcumin to reduce risk of proliferative vitreoretinopathy following rhegmatogenous retinal detachment repair. Retina2024; 44: 1741–1747.
10.
LumiXConfalonieriFRavnik-GlavačM, et al.Inflammation and oxidative stress gene variability in retinal detachment patients with and without proliferative vitreoretinopathy. Genes (Basel)2023; 14: 804.
11.
IribarneMOgawaLTorbidoniV, et al.Blockade of endothelinergic receptors prevents development of proliferative vitreoretinopathy in mice. Am J Pathol2008; 172: 1030–1042.
12.
MachemerRAabergTMFreemanHM, et al.An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol1991; 112: 159–165.
13.
Di LauroSKadhimMRCharterisDG, et al.Classifications for proliferative vitreoretinopathy (PVR): an analysis of their use in publications over the last 15 years. J Ophthalmol.2016; 2016: 7807596.
14.
LangeCFeltgenNJunkerB, et al.Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg visual acuity test (FrACT). Graefes Arch Clin Exp Ophthalmol2009; 247: 137–142.
15.
CarpinetoPLicataAMCiancagliniM. Proliferative vitreoretinopathy: a reappraisal. J Clin Med2023; 12: 5287.
16.
BeattySKohH-HPhilM, et al.The role of oxidative stress in the pathogenesis of age-related macular degeneration. Surv Ophthalmol2000; 45: 115–134.
17.
KaurJ. The oxidative stress in cataract patients. J Clin Diagn Res2012; 6: 1629–1632.
18.
KangQYangC. Oxidative stress and diabetic retinopathy: molecular mechanisms, pathogenetic role and therapeutic implications. Redox Biol2020; 37: 101799.
19.
CederlundMGhoshFArnérK, et al.Vitreous levels of oxidative stress biomarkers and the radical-scavenger α1-microglobulin/A1 M in human rhegmatogenous retinal detachment. Graefe’s Archive for Clinical and Experimental Ophthalmology2013; 251: 725–732.
20.
RohMIMurakamiYThanosA, et al.Edaravone, an ROS scavenger, ameliorates photoreceptor cell death after experimental retinal detachment. Investigative Opthalmology & Visual Science2011; 52: 3825.
21.
MantopoulosDMurakamiYComanderJ, et al.Tauroursodeoxycholic acid (TUDCA) protects photoreceptors from cell death after experimental retinal detachment. PLoS One2011; 6: e24245.
22.
Pietras-BaczewskaANowomiejskaKBrzozowskaA, et al.Antioxidant status in the vitreous of eyes with rhegmatogenous retinal detachment with and without proliferative vitreoretinopathy, macular hole and epiretinal membrane. Life (Basel)2021; 11: 1–11.
23.
BonilhaV. Age and disease-related structural changes in the retinal pigment epithelium. Clinical Ophthalmology2008; 2: 413.
24.
GrossniklausHENickersonJMEdelhauserHF, et al.Anatomic alterations in aging and age-related diseases of the eye. Investigative Opthalmology & Visual Science2013; 54: ORSF23.
25.
ValkoMLeibfritzDMoncolJ, et al.Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol2007; 39: 44–84.
26.
DattaSCanoMEbrahimiK, et al.The impact of oxidative stress and inflammation on RPE degeneration in non-neovascular AMD. Prog Retin Eye Res2017; 60: 201–218.
27.
KoJSotaniYIbrahimDG, et al.Role of macrophage migration inhibitory factor (MIF) in the effects of oxidative stress on human retinal pigment epithelial cells. Cell Biochem Funct2017; 35: 426–432.
28.
LiangYLiXFanJ, et al.The effect of platelet-derived growth factor on the formation of proliferative vitreoretinopathy. Zhonghua Yan Ke Za Zhi2002; 38: 144–147.
29.
LeiHVelezGHovlandP, et al.Growth factors outside the PDGF family drive experimental PVR. Invest Ophthalmol Vis Sci2009; 50: 3394–3403.
30.
Artem’evaOVSamoĭlovANZhernakovSV. Proliferative vitreoretinopathy: modern view on etiology and pathogenesis. Vestn Oftalmol2014; 130: 67–71.
31.
CicikETekinHAkarS, et al.Interleukin-8, nitric oxide and glutathione Status in proliferative vitreoretinopathy and proliferative diabetic retinopathy. Ophthalmic Res2003; 35: 251–255.
32.
El-GhrablyIA. Intravitreal invading cells contribute to vitreal cytokine milieu in proliferative vitreoretinopathy. Br J Ophthalmol2001; 85: 461–470.
33.
HuXWuXZhaoB, et al.Scutellarin protects human retinal pigment epithelial cells against hydrogen peroxide (H2O2)-induced oxidative damage. Cell Biosci2019; 9: 12.
34.
ZhangYZhaoDYangS, et al.Protective effects of fucoidan on epithelial-mesenchymal transition of retinal pigment epithelial cells and progression of proliferative vitreoretinopathy. Cell Physiol Biochem2018; 46: 1704–1715.
35.
HillJANyathiYHorrellS, et al.An ultraviolet-driven rescue pathway for oxidative stress to eye lens protein human gamma-D crystallin. Commun Chem2024; 7: 81.
36.
GarwegJGZandiSPfisterI, et al.Cytokine profiles of phakic and pseudophakic eyes with primary retinal detachment. Acta Ophthalmol2019; 97: e580–e588.
