TY - JOUR
T1 - Surface Area of Detachment, Proliferative Vitreoretinopathy, and Pulse Pressure, but not AGEs, are Associated With Retinal Redetachment
AU - Fokkens, Bernardina T.
AU - Mulder, Douwe J.
AU - Nugteren, Michiel B.
AU - Schalkwijk, Casper G.
AU - Scheijen, Jean L.
AU - Smit, Andries J.
AU - Los, Leonoor I.
PY - 2016/12
Y1 - 2016/12
N2 - PURPOSE. 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). METHODS. 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 N-epsilon-(carboxymethyl)lysine (CML), N-epsilon-(carboxyethyl) lysine (CEL), 5-hydro-5-methylimidazolone (MG-H1), and pentosidine, and the alpha-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. RESULTS. 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 a-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. CONCLUSIONS. 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.
AB - PURPOSE. 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). METHODS. 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 N-epsilon-(carboxymethyl)lysine (CML), N-epsilon-(carboxyethyl) lysine (CEL), 5-hydro-5-methylimidazolone (MG-H1), and pentosidine, and the alpha-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. RESULTS. 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 a-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. CONCLUSIONS. 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.
KW - skin autofluorescence
KW - advanced glycation endproducts
KW - rhegmatogenous retinal detachment
KW - proliferative vitreoretinopathy
KW - pulse pressure
U2 - 10.1167/iovs.16-20735
DO - 10.1167/iovs.16-20735
M3 - Article
C2 - 27926755
SN - 0146-0404
VL - 57
SP - 6633
EP - 6638
JO - Investigative Ophthalmology & Visual Science
JF - Investigative Ophthalmology & Visual Science
IS - 15
ER -