AAV2-PDE6B restores retinal structure and function in the retinal degeneration 10 mouse model of retinitis pigmentosa by promoting phototransduction and inhibiting apoptosis

Retinitis pigmentosa is a group of inherited diseases that lead to retinal degeneration and photoreceptor cell death.However,there is no effective treatment for retinitis pigmentosa caused by PDE6B mutation.Adeno-associated virus(AAV)-mediated gene therapy is a promising strategy for treating retinitis pigmentosa.The aim of this study was to explore the molecular mechanisms by which AAV2-PDE6B rescues retinal function.To do this,we injected retinal degeneration 10(rd10)mice subretinally with AAV2-PDE6B and assessed the therapeutic effects on retinal function and structure using dark-and light-adapted electroretinogram,optical coherence tomography,and immunofluorescence.Data-independent acquisition-mass spectrometry-based proteomic analysis was conducted to investigate protein expression levels and pathway enrichment,and the results from this analysis were verified by real-time polymerase chain reaction and western blotting.AAV2-PDE6B injection significantly upregulated PDE6βexpression,preserved electroretinogram responses,and preserved outer nuclear layer thickness in rd10 mice.Differentially expressed proteins between wild-type and rd10 mice were closely related to visual perception,and treating rd10 mice with AAV2-PDE6B restored differentially expressed protein expression to levels similar to those seen in wild-type mice.Kyoto Encyclopedia of Genes and Genome analysis showed that the differentially expressed proteins whose expression was most significantly altered by AAV2-PDE6B injection were enriched in phototransduction pathways.Furthermore,the phototransductionrelated proteins Pde6α,Rom1,Rho,Aldh1a1,and Rbp1 exhibited opposite expression patterns in rd10 mice with or without AAV2-PDE6B treatment.Finally,Bax/Bcl-2,p-ERK/ERK,and p-c-Fos/c-Fos expression levels decreased in rd10 mice following AAV2-PDE6B treatment.Our data suggest that AAV2-PDE6B-mediated gene therapy promotes phototransduction and inhibits apoptosis by inhibiting the ERK signaling pathway and upregulating Bcl-2/Bax expression in retinitis pigmentosa.

Incidence of rhegmatogenous retinal detachments is increasing in Wenzhou,China

AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.

Pars plana vitrectomy for retinal detachment using perfluoro-n-octane as intraoperative tamponade:a multicenter,randomized,non-inferiority trial

AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade,and both are safe and well-tolerated.

Non-contact wide-field viewing system-assisted scleral buckling surgery for retinal detachment in silicone oilfilled eyes

AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.

Efficacy of scleral buckling for the treatment of rhegmatogenous retinal detachment using a novel foldable capsular buckle

●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.

Rhegmatogenous retinal detachment in highly myopic eyes with implantable collamer lens

AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.

葛根素对遗传性视网膜色素变性rd小鼠的干预作用及其抗凋亡机制研究

目的观察葛根素对视网膜色素变性rd小鼠外核层细胞和视网膜光感受器外段的病理、超微结构、凋亡和Bcl-2表达的影响,探讨葛根素对rd小鼠的干预作用和干预机制。方法rd新生小鼠随机分为2组,实验组和对照组。实验组小鼠从出生时腹腔注射葛根素80mg.kg-1,每天2次,至生后35d,对照组同时注射等量生理盐水。分别在用药后当日和3、7、14、21、28、35d取眼球,固定后,常规病理和电镜观察。用TUNEL方法检测视网膜光感受器细胞的凋亡,用免疫组化方法测定Bcl-2在视网膜的表达。结果病理结果显示,经葛根素治疗后14、21、28、35d,rd小鼠光感受器细胞层数与未用药的对照组相比较明显增加,P<0.01。电镜结果显示,葛根素可减缓rd小鼠光感受器细胞及其外段盘膜部位线粒体的病变,减少盘膜和外界膜的破坏。rd小鼠经葛根素药物治疗后d7、14、21、28、35,光感受器细胞的凋亡率比未用药的对照组明显减少,P<0.01;d3、7、14、21、28、35,Bcl-2在视网膜外核层及光感受器细胞外段的表达明显增强,P<0.05或P<0.01。结论葛根素可延缓rd小鼠视网膜外核层细胞和视网膜光感受器外段损伤。

视网膜色素变性遗传致病基因peripherin/RDS的突变筛选

目的 了解中国视网膜色素变性患者 (RP)中peripherin/RDS基因的突变谱及突变率。方法 应用聚合酶链-异源双链 -单链构象多态性 (PCR SSCP)及DNA序列分析技术对收集的 15个常染色体显性遗传视网膜色素变性家系和 5 5例散发视网膜色素变性患者peripherin/RDS基因的第一、第二外显子进行检测。结果 15个家系及 5 5例散发患者未检测到peripherin/RDS基因突变。结论 本研究所检测的视网膜色素变性患者与RDS基因无关。显示视网膜色素变性的遗传异质性。

遗传性视网膜变性rd小鼠及其感光细胞凋亡研究

目的 研究遗传性视网膜变性rd小鼠感光细胞层的发育变化及细胞凋亡。方法 对出生后 5d到4 0d的rd小鼠及对照小鼠视网膜感光细胞层进行光镜及超微结构观察、TUNEL法检测及形态计量学分析。结果 与同龄对照鼠相比 ,rd小鼠出生后第 10d视网膜开始变性 ,尔后 1周内感光细胞迅速减少 ,第 18d时只残留一层视椎细胞。rd小鼠出生后第 10d感光细胞层开始出现TUNEL染色阳性细胞 ,第 14d及 16d达到高峰。电镜下变性高峰期rd小鼠视网膜感光细胞层可见大量浓缩核、染色质边聚及凋亡小体。结论 rd小鼠视网膜感光细胞在发育过程中变性 ,并通过凋亡的方式死亡。

中药复方制剂对rds小鼠感光细胞凋亡的干预作用研究

目的观察中药复方制剂对先天性视网膜变性小鼠视网膜感光细胞凋亡的影响。方法以黄芪等药组成复方制剂1。对先天性视网膜变性动物模型rds小鼠,采用原位末端转移酶标记(TUNEL)方法及组织病理学技术,观察复方制剂1作用后,小鼠视网膜感光细胞数量及感光细胞凋亡的变化。结果仔鼠2周时,中药组小鼠视网膜感光细胞核数与对照组相比无明显差别,两组感光细胞凋亡率分别为1.6%及6.5%,组间差异有显著性(P<0.01);4周时中药组感光细胞核数目较对照组多,差异有显著统计学意义(P<0.01),两组感光细胞凋亡率分别为3.3%及8.5%,组间差异有显著统计学意义(P<0.01)。结论中药复方制剂1可以延缓rds小鼠视网膜色素变性过程中感光细胞凋亡的发展。

视网膜色素变性中视紫红质与Peripherin/RDS基因的突变筛查

目的:迄今尚未见在国人中经序列分析确定该基因突变的报道。了解国人遗传性视网膜色素变性人群中视紫红质和peripherin/RDS基因的突变情况。方法:对83例遗传性视网膜色素变性先证者视紫红质基因全部编码区和peripherin/RDS部分编码区进行PCR扩增,用异源双链-SSCP法对扩增产物进行分析,寻找有差异电泳带纹的突变样本,序列分析确定突变。结果:83例中3例有视紫红质基因突变(Va1104Phe、Lys311Glu、Pro347Leu),其中两个新突变分别见于散发病例(Va1104Phe,杂合性)和常染色体隐性遗传视网膜色素变性家系(Lys311Glu,纯合性)。在peripherin/RDS基因中未发现突变。结论:在国人视网膜色素变性患者中视紫红质基因突变为常见致病原因。眼科学报1998;

脑苷肌肽对rd小鼠视网膜细胞保护作用的研究

目的观察脑苷肌肽(cattle encephalon glycoside and ignotin,CEGI)对体外分离的rd小鼠视网膜细胞的保护作用,旨在探求CEGI对视网膜以及视神经损伤相关疾病的治疗效果,为临床用药提供客观依据和指导。方法采用体外分离rd小鼠视网膜细胞悬液,用MTT和台盼蓝染料排斥法观察CEGI和神经生长因子(NGF)对细胞活性的影响。结果 MTT实验示CEGI8.00mg·L-1、0.04g·L-1、0.20g·L-1和NGF0.04mg·L-1、0.20mg·L-1对视网膜细胞活性有促进作用,尤其以CEGI0.04g·L-1和NGF0.20mg·L-1最为明显,细胞增殖率分别为130.0%±21.8%和124.0%±13.3%。若将二者组合使用,可使细胞增长率达到132.0%±9.1%,与药物空白对照组100.0%±10.1%相比差异均有统计学意义。台盼蓝染料排斥试验结果显示0.04g·L-1CEGI组活细胞比例在除5min外的各时间点,都明显高于对照组,而0.20mg·L-1NGF组也可保护视网膜细胞,主要以短时间点为主(5min～1d),与对照组相比差异均有统计学意义(均为P<0.05)。结论 CEGI有促进视网膜细胞生长发育作用,对rd小鼠视网膜细胞有一定的保护作用。

ILMP及玻璃体腔注药联合硅油填充治疗高度近视MHRD合并脉络膜脱离

目的:观察内界膜剥除(internal limiting membrane peeling,ILMP)和玻璃体腔注射曲安奈德联合硅油填充治疗高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的临床疗效。方法:高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离患者28例28眼,均行玻璃体切割(pars plana vitrectomy,PPV)吲哚菁绿辅助的ILMP以及硅油填充手术,术中将曲安奈德注射于玻璃体腔,术后随访6~24mo,观察术后视网膜复位率、视力恢复情况和术后并发症。结果:术后随访6~24mo,患者手术后平均LogM AR矫正视力为1.01±0.31,与手术前平均LogM AR矫正视力比较,差异有统计学意义(t=-39.28,P<0.01)。黄斑裂孔闭合19眼(68%),黄斑裂孔未闭合9眼(32%),26眼视网膜复位(93%),6眼出现高眼压。结论:玻璃体切割联合ILMP及硅油填充和玻璃体腔注射曲安奈德治疗高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离,可阻止增生性玻璃体视网膜病变的再生,提高视网膜复位率。

MCP-1在rd小鼠视网膜变性过程中的表达

目的探讨单核细胞趋化因子(MCP-1)在rd小鼠视网膜变性过程中的表达。方法RT-PCR反应测定rd小鼠出生后8、10、12、14、16、18d视网膜MCP-1mRNA的表达。原位杂交及免疫组织化学检测高峰期MCP-1mRNA及蛋白在视网膜的定位表达。结果与正常对照鼠相比,MCP-1mRNA在rd小鼠视网膜的表达水平于出生后第8d开始升高,12d达高峰。MCP-1mRNA及蛋白的表达出现于视网膜内层,尤其在内核层细胞及节细胞核周围。结论趋化因子MCP-1在rd小鼠视网膜变性过程中表达升高,提示MCP-1可能在rd小鼠感光细胞凋亡中发挥作用。

充气性视网膜固定术治疗下方裂孔RRD的疗效观察

目的:评价充气性视网膜固定术联合冷凝治疗下方裂孔的孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)的疗效。方法:选取下方裂RRD 22眼纳入研究。患者术前均行最佳矫正视力(BCVA)、裂隙灯显微镜、间接检眼镜及三面镜检查确诊。所有患者行充气性视网膜固定术联合经结膜冷凝术,手术后随访6～24(平均12)mo。观察BCVA及视网膜复位率。结果:手术后经一次眼内充气性视网膜固定术,视网膜复位17眼(77%),2眼行再次眼内注气术联合视网膜激光光凝术视网膜完全复位,充气性视网膜固定术总的视网膜复位率达86%。3眼需要再次巩膜扣带术获得视网膜复位。所有病例最终复位率达100%。术后视力较术前视力明显提高(P<0.01)。结论:充气性视网膜固定术是治疗下方裂孔RRD的一种有效方法。

玻璃体手术治疗ARD和PPRD(PVRC级以上)

目的探讨玻璃体的手术对复杂无晶状体眼视网膜脱离(Aphakic Retinal Detachment,ARD)和人工晶状体眼视网膜脱离(Pseudophakic Retinal Detachment,PPRD)(PVRC级以上)的治疗效果。方法回顾性分析78例87眼ARD和PPRD,所有病人均行玻璃体切割联合眼内填充物治疗。结果首次手术视网膜复位率为78.16%,最终视网膜复位率90.8%。视力下降11眼(12.7%),不变15眼(17.2%),提高59眼(70.1%)。结论彻底的玻璃体切除加视网膜切开、视网膜前膜剥除,适当应用环扎玻璃体填充物可使复杂PPRD,ARD达到较高的视网膜复位率。但ARD、PPRD一旦发生则病情进展迅速,治疗棘手,视力预后差,应从白内障手术开始加强预防。

NADPH氧化酶在rd小鼠遗传性视网膜变性中的活化作用

目的研究NADPH氧化酶在rd小鼠遗传性视网膜变性早期的活化表达及其氧化产物活性氧的生成,探讨其在遗传性视网膜变性早期的致病作用。方法以出生后8,10,12,14,16,18d的rd小鼠及对照鼠视网膜作为研究对象。Real-time PCR测定在rd小鼠感光细胞凋亡过程中视网膜NADPH氧化酶亚单位P22phox mRNA的定量表达。二氢乙锭(DHE)染色法测定NADPH氧化酶活化产物ROS的生成变化。结果与对照组相比,P22phox mRNA在rd小鼠出生后第12天表达明显升高,第14天达高峰。ROS在rd小鼠出生后第8天于视网膜外核层少量产生,第14天生成量达到高峰。结论在rd小鼠视网膜变性过程中NADPH氧化酶表达明显升高,ROS生成显著增加,皆早于或与感光细胞凋亡平行,提示NADPH氧化酶活化生成ROS可能在视网膜变性早期致病过程中发挥重要作用。

NADPH氧化酶在rd小鼠遗传性视网膜变性中的活化表达

背景研究表明，小胶质细胞中烟酰胺二磷酸腺苷（NADPH）氧化酶的活化在中枢神经系统神经元损伤及神经变性疾病中发挥重要作用。已有研究证实NADPH氧化酶在rd小鼠视锥细胞退行性改变中的作用，但关于其在rd小鼠视网膜变性早期视杆细胞病变过程中的作用研究较少。目的研究NADPH氧化酶在rd小鼠感光细胞凋亡过程中的活化表达，探讨其在遗传性视网膜变性中的致病作用。方法取出生后8、10、12、14、16、18d的rd小鼠各18只，过量麻醉法处死后提取视网膜总RNA和总蛋白，并制备视网膜切片，分别用实时荧光定量PCR及Western blot法测定在rd小鼠感光细胞凋亡过程中视网膜中NADPH氧化酶亚单位gp91phox mRNA及蛋白的定量表达变化；采用免疫组织化学及gp91phox和CD11b免疫荧光双染法确定gp91phox在不同鼠龄rd小鼠视网膜中的表达及定位，并与其近交系C57BL／6N小鼠进行比较。结果实时荧光定量PCR研究证实，C57BL／6N小鼠视网膜中未见gp91phox mRNA的表达，而生后8d的rd小鼠视网膜中即有少量gp91phox mRNA的表达，随着鼠龄的增加，gp91phox mRNA表达量（gp91phox mRNA／β-actin）逐渐增加，生后14d达到高峰。不同鼠龄rd小鼠视网膜中gp91phox mRNA表达量差异有统计学意义（F=17．81，P=0．00）；生后10、12、14、16、18d的Td小鼠视网膜中gp91phox mRNA表达量均明显高于出生后8d小鼠，差异均有统计学意义（均P〈0．05），以出生后14d表达量最高，为1．136±0．370。随着小鼠鼠龄的增加，视网膜中gp91phox蛋白表达量（A值）与其基因表达变化趋势一致，不同鼠龄及C57BL／6N对照小鼠间视网膜中gp91phox蛋白表达的差异有统计学意义（F=354．00，P〈0．01），不同鼠龄rd小鼠出生后视网膜中gp91phox蛋白表达量均明显高于C57BL／6N对照小鼠，差异均有统计学意义（均P〈0．05）。免疫组织化学法检测表明，rd小鼠出生后10d视网膜内层gp91phox阳性细胞开始增多，出生后14d达到高峰，外核层也可见到gp91phox阳性细胞。免疫荧光双染结果显示，gp91phox与小胶质细胞标志物CD11b共表达，呈现橙色荧光。结论NADPH氧化酶在rd小鼠视网膜中的表达随着鼠龄的增长而增多，其表达与小胶质细胞活化及感光细胞的凋亡相平行，提示NADPH氧化酶可能在小胶质细胞活化导致的感光细胞凋亡中发挥致病作用。

Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment

AIM: To report the results of combined vitrectomy, lensectomy and silicone oil (SO) tamponade in treating primary rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD). · METHODS: A retrospective, consecutive and case series study of 21 subjects with concurrent RRD associated with CD was conducted. All subjects underwent a standard three -port 20G pars plana vitrectomy (PPV) with lensectomy and silicone oil tamponade. Mean follow -up time was 8 months (rang from 4 to 19 months). The primary and final anatomic success rate, visual acuity and final intraocular pressure (IOP) were recorded and analyzed. ·RESULTS: Of 21 subjects, 8 were women and 13 were men. Age at presentation ranged from 22 to 75 years (mean 57.4 years). The presenting vision ranged from light perception to 0.15. The initial IOP ranged from 3mmHg to 12mmHg (mean 6.2mmHg). All eyes were phakic except one pseudophakic. No intraocular lens was implanted during the primary surgical intervention. Fifteen of 21 (71.4%) eyes had retina reattached after one operation. Six eyes had recurrent inferior retinal detachment due to proliferation. Five of them were successfully reattached after one or more additional operations. Mean IOP at final follow -up was 15.2mmHg (range from 8mmHg to 20mmHg). One case declined for further operation. The final reattachment rate was 95.2%. Visual acuity improved in 19 (90.5%) eyes, was unchanged in 1 (4.8%) eye and decreased in 1 (4.8%) eye.·CONCLUSION: Combination of vitrectomy, lensectomy and silicone tamponade is an effective method in treating RRD associated with CD, reducing the incidence of postoperative hypotony.

Advances in the treatment of rhegmatogenous retinal detachment

The pathogenesis of rhegmatogenous retinal detachment depends on three factors, namely, retinal rupture, vitreous liquefaction and traction causing the retina to separate from the pigment epithelium, among which retinal rupture is the most important. Retinopathy is caused by a gap between the neurosensory retina and the retinal pigment epithelium, which severely damages the visual function of the patient. Therefore, early clinical discovery, prevention and selection of an appropriate treatment are important. This article reviews progress in the treatment of retinal detachment.