Authors: Zhou Yanjie, You Caiyun, Wang Tian, Zhang Mingxue, Song Yinting, Liao Mengyu, Han Han, Zhang Zhuhong, Li Jianan, Yan Hua
Clinical work found that triamcinolone acetonide (TA)bleeding during vitrectomy in proliferative diabetic retinopathy (PDR), but its mechanism is not clear.
This study was to explore the anastalsis of TA in vitrectomy for PDR.
A prospective study was performed.Twelve eyes of 12 patients who received vitrectomy combined with the intraocular use of TA for PDR were in cluded in Tianjin Medical University General Hospital from 2011 to 2014 and served as TA group.Thirty-two eyes of 32 patients who underwent vitrectomy for epimacular membrane or macular hole were enrolled as control group.The vitreous specimens of 0.6~0.8 ml was collected during the surgery.The concentrations of urokinase plasminogen activator (u-PA), tissue plasminogen activator (t-PA) and plasminogen activator inhibitors 1 (PAI-1) in vatreous were measured by ELISA.
The mean contents u-PA, t-PA and PAI-1 in the vatreous were 25.45, 127.44 and 0.42 ng/ml respectively in the TA group, and those the mean contents in the control group were 22.94, 142.37 and 0.27 ng/ml respectively, shouwing a significant difference between the TA group and the control group (Z=-2.268, P<0.05). NO significant difference was found in vitreous t-PA and PAI-1 between TA and control groups (Z=-0.092, -1.847, both at P>0.05).
Vitreous u-PA content is increased in PDR eyes, which is more likely to lead bleeding.Anastalsis of TA during vitrectomy for PDR may be relatived to decreasing vitreous t-PA and u-PA contents as well as increasing PAI-1 contents.