INTERCELLULAR-ADHESION MOLECULE-1 IN PROLIFERATIVE VITREORETINOPATHY

Purpose. To measure vitreous levels of the soluble intercellular adhes ion molecule (sICAM-1) in eyes with rhegmatogenous retinal detachment (RRD) complicated or uncomplicated by proliferative vitreoretinopathy (PVR) to investigate whether levels of this molecule related to histor y of previous retinal surgery or to the duration and severity of PVR. Methods. The authors measured vitreous sICAM-1 by enzyme-linked immuno sorbent assay in 28 eyes with PVR and 35 eyes with uncomplicated RRD. Vitreous from 10 eyes with macular holes and from 12 cadaveric eye don ors were used as control specimens. Results. Vitreous sICAM-1 levels w ere higher in the group with RRD complicated by PVR as a whole than in the group with RRD alone or in the control groups. In patients with n o previous retinal surgery, there was no difference in vitreous sICAM- 1 levels between the groups with RRD alone and RRD complicated by PVR. However, in patients who had undergone previous external surgery, tho se with PVR showed higher levels of vitreous sICAM-1 than those with R RD alone. In PVR, raised levels of sICAM-1 were associated preferentia lly with a history of previous vitrectomy as well as with a longer dur ation of the condition, although these levels were not related to the grade of PVR. In eyes with RRD alone, the levels of sICAM-1 were not e nhanced with the duration of the detachment. Despite showing high vitr eous levels of sICAM-1, patients with PVR did not exhibit increased se rum levels of this adhesion molecule. Conclusions. The current observa tions suggest that those persons in whom PVR develops may have an impa irment of the mechanisms that control the inflammatory response to ret inal trauma. Persistently raised vitreous levels of sICAM-1 point to t he continued operation of cytokine-mediated vascular reactions at the blood-retinal barrier.