Histopathologic Study of the Effect of Retinal Detachment Surgery on 49 Eyes Obtained Post Mortem

Wilson, David J.; Green, W. Richard

doi:10.1016/s0002-9394(14)74222-9

Cited by 97 publications

(40 citation statements)

References 28 publications

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“…41 Although it is a rare complication, choroidal blood vessels are known to grow through induced breaks in Bruch's membrane after surgery for retinal detachment. 42,43 However, the frequency and severity of CNV observed in this study was much greater than that reported in surgical cases. In addition, vascular leakage and CNV extended far beyond the initial puncture site, whereas no evidence of CNV was observed in any control virus injections.…”

Section: Discussioncontrasting

confidence: 64%

Overexpression of Vascular Endothelial Growth Factor (VEGF) in the Retinal Pigment Epithelium Leads to the Development of Choroidal Neovascularization

Spilsbury

Garrett

Shen

et al. 2000

The American Journal of Pathology

353

214

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Vascular endothelial growth factor (VEGF) has been strongly implicated in the development of choroidal neovascularization found in age-related macular degeneration. Normally expressed in low levels, this study investigates whether the overexpression of VEGF in the retinal pigment epithelium is sufficient to cause choroidal neovascularization in the rat retina. A recombinant adenovirus vector expressing the rat VEGF 164 cDNA (AdCMV.VEGF) was constructed and injected into the subretinal space. The development of neovascularization was followed by fluorescein angiography, which indicates microvascular hyperpermeability of existing and/or newly forming blood vessels, and histology. VEGF mRNA was found to be overexpressed by retinal pigment epithelial cells and resulted in leaky blood vessels at 10 days postinjection, which was maintained for up to 31 days postinjection. By 80 days postinjection, new blood vessels had originated from the choriocapillaris, grown through the Bruch's membrane to the subretinal space, and disrupted the retinal pigment epithelium. This ultimately led to the formation of choroidal neovascular membranes and the death of overlying photoreceptor cells. By controlling the amount of virus delivered to the subretinal space, we were able to influence the severity and extent of the resulting choroidal neovascularization. These results show that even temporary overexpression of VEGF in retinal pigment epithelial cells is sufficient to induce choroidal neovascularization in the rat eye. Age-related macular degeneration is a significant cause of central vision loss in aging populations. The more severe form of age-related macular degeneration is characterized by choroidal neovascularization (CNV), in which new blood vessels grow from the choroid, through the Bruch's membrane into the subretinal space. This ultimately leads to the formation of choroidal neovascular membranes (CNVMs), from which blood and serum may leak, causing vision loss.

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Section: Discussioncontrasting

confidence: 64%

Overexpression of Vascular Endothelial Growth Factor (VEGF) in the Retinal Pigment Epithelium Leads to the Development of Choroidal Neovascularization

Spilsbury

Garrett

Shen

et al. 2000

The American Journal of Pathology

353

214

View full text Add to dashboard Cite

show abstract

“…[133][134][135][136] The histopathologic features following retinal detachment surgery by scleral buckling have been previously reviewed. [137][138][139] Twenty nine percent of the 204 eyes in an early series studied by Boniuk and Zimmerman 126,139 had clinically unsuspected tumors, 14 eyes (6.9%) had no evidence of tumor though they were enucleated because of the suspicion of an ocular tumor, 23% had anterior segment necrosis, and glaucoma was present in most of the cases. Lensinduced endophthalmitis, granulomatous and sympathetic uveitis, keratitis, reaction to sutures and implants, and infection and internal erosion of buckle elements were other less conspicuous findings.…”

Section: (Vi) Pathologic Changes Following Surgery For Retinal Detachmentioning

confidence: 99%

“…Lensinduced endophthalmitis, granulomatous and sympathetic uveitis, keratitis, reaction to sutures and implants, and infection and internal erosion of buckle elements were other less conspicuous findings. In the study of 49 eyes, following scleral buckling procedure, Wilson and Green 137 found epiretinal membranes in 75.5%, macular pucker secondary to epiretinal membranes in 30.6%, photoreceptor atrophy in 26.5%, element in-erosion in 21.7%, cystoid macular edema and ciliochoroidal effusion each in 10.2%, anterior segment necrosis in only 8.2% compared to 23% in the study of Boniuk and Zimmerman, and choroidal neovessels in 6.1% of the cases. One eye with cystoid macular edema also had an inner lamellar macular hole.…”

Section: (Vi) Pathologic Changes Following Surgery For Retinal Detachmentioning

confidence: 99%

Pathology and pathogenesis of retinal detachment

Ghazi

Green

2002

Eye

221

160

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Retinal detachment, separation of the neurosensory retina from the underlying retinal pigment epithelium, is a sight threatening condition that is considered one of the few ocular emergencies. The literature is enormously rich in studies that focused on different aspects of this disease process. Yet certain aspects remain largely unanswered. We briefly review major aspects of retinal detachment and discuss various important contributions in this field, focussing mainly on the pathogenesis of and predisposing factors to retinal detachment, and on the pathologic changes that occur following its development and following various surgical procedures currently used in its management.

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“…There is a steady decline in the thickness of the outer nuclear layer (ONL) if the retina remains detached. 15,16 Although the actual peak of TUNEL positive cells appears to occur at around day 3 of detachment, 13 they remain in the retina even at a month after the detachment event, indicating that cell death is still occurring.…”

Section: Photoreceptor Cell Deathmentioning

confidence: 99%

Animal models of retinal detachment and reattachment: identifying cellular events that may affect visual recovery

Lewis

Charteris²,

Sethi³

et al. 2002

Eye

120

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Retinal detachment continues to be a significant cause of visual impairment, either through the direct effects of macular detachment or through secondary complications such as subretinal fibrosis or proliferative vitreoretinopathy. Animal models can provide us with an understanding of the cellular mechanisms at work that account for the retinopathy induced by detachment and for the generation of secondary effects. As we understand the mechanisms involved, animal models can also provide us with opportunities to test therapeutic agents that may reduce the damaging effects of detachment or improve the outcome of reattachment surgery. They may also reveal information of use to understanding other causes of blindness rooted in retinal defects or injuries. Understanding the effects of detachment (and reattachment) are likely to become even more important as surgeons gain skills in subretinal surgical techniques and macular translocation, both of which will generate short-lived detachments. Here we discuss the fundamental events that occur after detachment, present changes associated with reattachment, and discuss retinal changes that may affect the return of vision.

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Histopathologic Study of the Effect of Retinal Detachment Surgery on 49 Eyes Obtained Post Mortem

Cited by 97 publications

References 28 publications

Overexpression of Vascular Endothelial Growth Factor (VEGF) in the Retinal Pigment Epithelium Leads to the Development of Choroidal Neovascularization

Overexpression of Vascular Endothelial Growth Factor (VEGF) in the Retinal Pigment Epithelium Leads to the Development of Choroidal Neovascularization

Pathology and pathogenesis of retinal detachment

Animal models of retinal detachment and reattachment: identifying cellular events that may affect visual recovery

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