RESUMO
PURPOSE: To compare two drainage techniques in macula-off retinal detachment (RD) surgery: perfluorocarbon liquid (PFCL)-assisted drainage and partial subretinal fluid (SRF) drainage without PFCL. We investigated morphological and functional outcomes, focusing on metamorphopsia quantification. METHODS: Eighty eyes with macula-off RD were retrospectively included. All underwent a 25-gauge pars plana vitrectomy. In the PFCL group, SRF drainage was performed using PFCL. In the partial SRF drainage (SRFD) group, SRF was partially drained through a pre-existing retinal break without PFCL. A follow-up at 3 and 6 months evaluated anatomical outcomes using optical coherence tomography (OCT), best corrected visual acuity (BCVA) and metamorphopsia quantified with M-charts. RESULTS: Reattachment rates were comparable in the PFCL group (97.5%) and the SRFD group (95%) (p > 0.05). Mean BCVA (LogMAR) was 0.23 ± 0.32 (PFCL group) and 0.15 ± 0.13 (SRFD group) (p = 0.206). Metamorphopsia were reported by 19 patients (47.5%) in the PFCL group and by 12 patients (30%) in the SRFD group (p = 0.332). The mean metamorphopsia score was similar in both groups (0.27 ± 0.12 in the PFCL group and 0.28 ± 0.11 in the SRFD group, p = 0.866). Morphological OCT findings were comparable in both groups. CONCLUSION: Morphological and functional outcomes were similar in PFCL and SRFD groups. Metamorphopsia quantification scores did not improve with PFCL. While both of these techniques might be effective and could be recommended for primary macula-off RD management, potential PFCL toxicity should be kept in mind and its use dedicated to selected cases.
RESUMO
Purpose: Endophthalmitis models have reported the virulent role of Panton-Valentine leucocidin (PVL) secreted by Staphylococcus aureus on the retina. PVL targets retinal ganglion cells (RGCs), expressing PVL membrane receptor C5aR. Interactions between PVL and retinal cells lead to glial activation, retinal inflammation, and apoptosis. In this study, we explored oxidative stress and retinal neurotransmitters in a rabbit retinal explant model incubated with PVL. Methods: Reactive oxygen species (ROS) production in RGCs has been assessed with fluorescent probes and immunohistochemistry. Nuclear magnetic resonance (NMR) spectroscopy quantified retinal concentrations of antioxidant molecules and neurotransmitters, and concentrations of neurotransmitters released in the culture medium. Quantifying the expression of some pro-inflammatory and anti-inflammatory factors was performed using RT-qPCR. Results: PVL induced a mitochondrial ROS production in RGCs after four hours' incubation with the toxin. Enzymatic sources of ROS, involving nicotinamide adenine dinucleotide phosphate-oxidase and xanthine oxidase, were also activated after four hours in PVL-treated retinal explants. Retinal antioxidants defenses, that is, glutathione, ascorbate and taurine, decreased after two hours' incubation with PVL. Glutamate retinal concentrations and glutamate release in the culture medium remained unaltered in PVL-treated retinas. GABA, glycine, and acetylcholine (Ach) retinal concentrations decreased after PVL treatment. Glycine release in the culture medium decreased, whereas Ach release increased after PVL treatment. Expression of proinflammatory and anti-inflammatory cytokines remained unchanged in PVL-treated explants. Conclusions: PVL activates oxidative pathways and alters neurotransmitter retinal concentrations and release, supporting the hypothesis that PVL could induce a neurogenic inflammation in the retina.