[Clinical and experimental results in the treatment of massive periretinal proliferation (MPP), a retinal detachment with a most unfavorable prognosis]. 1982

S Binder

Today eyes with massive periretinal proliferation which are often seen after uncured retinal detachments or after perforating injuries can be cured at least in 25 to 35% of the cases, even with modern surgical techniques. This is due to proliferation of cells, which enter through different pathways--retinal tears, perforating wounds of sclera and chorioidea, damaged retina or retinal vessels--into the vitreous and form membranes, which prevent the retina to attach. In the vitreous gel these cells of different origin can transform into fibroblast-like or myofibroblast-like cells. They also behave in the same way like fibroblasts or myofibroblasts and cause a kind of excessive wound healing and scar formation in the vitreous cavity. With the use of modern vitreous techniques we could cure nearly 43% of 14 patients with MPP after uncured retinal detachments or after perforating injuries. Because mechanical removal of intravitreal and periretinal membranes alone turned out to be unsuccessful in nearly 60%, methods of medical therapy to suppress this cell-activity seemed to be rather needed. By animal experiment we tried to produce retinal detachments by transplantation of homologue fibroblasts into the vitreous cavity of rabbit eyes, and observed traction detachments in 55% of the eyes. Histologic examination showed a rapid change of loose, round fibroblasts into elongated cells with long nuclei, which formed strands and caused vasoproliferation, especially where the strand reached the rabbit retina. By means of autoradiography the peak of cell activity turned out to be in the 3rd week after cell-transplantation and further examinations of the optic disc showed, that the vascular endothelium cell might be one source of the proliferation. There was no difference between the number of eyes which developed retinal detachment in the aphakic eyes and in the lentectomized and vitrectomized eyes, but we observed the clinical appearance of MPP earlier and more pronounced in the lentectomized and vitrectomized eyes. In the last experiment we tried to inhibit intraocular proliferation with intravitreal dexamethasone alcohol. This leaded to a significant reduce of the number of experimental detachments and vasoproliferations.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011817 Rabbits A burrowing plant-eating mammal with hind limbs that are longer than its fore limbs. It belongs to the family Leporidae of the order Lagomorpha, and in contrast to hares, possesses 22 instead of 24 pairs of chromosomes. Belgian Hare,New Zealand Rabbit,New Zealand Rabbits,New Zealand White Rabbit,Rabbit,Rabbit, Domestic,Chinchilla Rabbits,NZW Rabbits,New Zealand White Rabbits,Oryctolagus cuniculus,Chinchilla Rabbit,Domestic Rabbit,Domestic Rabbits,Hare, Belgian,NZW Rabbit,Rabbit, Chinchilla,Rabbit, NZW,Rabbit, New Zealand,Rabbits, Chinchilla,Rabbits, Domestic,Rabbits, NZW,Rabbits, New Zealand,Zealand Rabbit, New,Zealand Rabbits, New,cuniculus, Oryctolagus
D012163 Retinal Detachment Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003348 Cortisone A naturally occurring glucocorticoid that has been used in replacement therapy for ADRENAL INSUFFICIENCY and as an anti-inflammatory agent. Cortisone itself is inactive; it is converted in the liver to the active metabolite HYDROCORTISONE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p726) 17-Hydroxy-3,11,20-trioxopregn-4-en-21-yl acetate,Adreson,Cortisone Acetate,Cortone Acetate
D005131 Eye Injuries Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries. Injuries, Eye,Eye Injury,Injury, Eye
D005260 Female Females
D005347 Fibroblasts Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. Fibroblast

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