Objective To investigate the correlation between the vitreomacular adhesion (VMA) and exudative age-related macular degeneration (AMD). Methods A literature research was performed in PubMed, EMbase, Cochrane Library, CNKI and Wanfang database from January 2000 to December 2016. Case-control studies on the relationship between VMA or posterior vitreous detachment and exudative AMD were included in this analysis. Literature screening and data extraction were performed according to inclusion and exclusion criteria. The qualities of the literatures were evaluated according to the Newcastle-Ottawa Scale (NOS). Seven literatures were selected into meta-analysis. The NOS score was 9 points in 1 article, 8 scores in 4 articles, 7 points in 2 articles. A total of 947 eyes with exudative AMD, 638 eyes with dry AMD, and 618 eyes with controls were included. The correlation between exudative AMD and VMA were analyzed using the software Review manager 5.3. Results The prevalence of VMA in exudative AMD eyes was higher than that in controls [odds ratio (OR)=2.14, 95% confidence interval (CI)=1.19 - 3.84, P=0.010] and dry AMD eyes (OR=2.24, 95%CI=1.24 - 4.03, P=0.007). There was no difference in PVD prevalence among exudative AMD eyes, dry AMD eyes (OR=0.44, 95%CI=0.16 - 1.20, P=0.110) and controls (OR=0.70, 95%CI=0.41 - 1.18, P=0.180). Conclusion There is correlation between VMA and exudative AMD.
Integrins is a family of multi-functional cell-adhesion molecules, heterodimeric receptors that connect extracellular matrix to actin cytoskeleton in the cell cortex, thus regulating various physiological and pathological processes. Risuteganib (Luminate®) is a novel broad-spectrum integrin inhibitor. Based on multiple biological functions of anti-angiogenesis, vitreolysis, and neuroprotection, risuteganib is hopeful in treating several fundus diseases such as diabetic macular edema, vitreomacular traction, and non-exudative age-related macular degeneration. By far, risuteganib has successfully met the endpoints for three phase 2 studies and is preparing to enter the phase 3 of diabetic macular edema clinical trials. Overall the risuteganib is safe with no serious ocular or systemic adverse events. Given the unique mechanism of action and longer duration of efficacy, intravitreal injection of risuteganib has the potential to serve as a primary therapy, or adjunctive therapy to anti-VEGF agents.
Objective To observe the safety and efficacy of posterior vitreous detachment (PVD) induced by combined intravetreal injection of lysineplasminogen and reteplase in rabbits.Methods Fifteen healthy New Zealand rabbits were divided into three groups with five rabbits in each. Take the right eyes as experimental eyes，while the left eyes as the control. The experimental eyes of three groups received combined intravetreal injection of 1250 mu;g/ml lysineplasminogen at 0.1 ml dose and 104U，3times;104U，105U reteplase at 0.05 ml dose recpectively, while the control eyes were injected intravetreally with 0.15 ml balanced salt solution. The conjunctiva, anterior chamber, lens, vitreous body, and retina were examined by slit lamp microscope and +120D preset lens. The retinal function was examined by electroretinogram (ERG).Results All the experimental eyes had PVD. The results of optical microscope showed that no change in retinal structure was found in the control group and 104 U reteplase group, clear retinal hierarchical but decreased ganglion cells and kernel layer cells were found in 3times;104 U reteplase group, only retinal pigment epithelium layer but no normal retinal structure was observed in 105U reteplase group. The results of ERG showed that compared the maximum mixed reaction of a and b wave amplitude in control group and reteplase group respectively, the difference was not statistically siginificant between 104U reteplase group and control group(a wave：t=0.881，-1.773，0.809；b-wave：t=-0.223，-0.441，1.400；P＞0.05),the differences were statistically siginificant between 3times;104 U(a wave：t=-3.20，b-wave：t=-4.182，-4.103),105 U reteplase group(a wave：t=-0.737，b wave：t=-15.150，6.597)and control group(P＜0.05). The control eyes didnprime;t had PVD.Conclusion Combined intravetreal injection of lysine-plasminogen and reteplase can induce complete PVD, and no damage to the retinal structure in rabbits.
Objective To investigate the dosage, efficacy and safety of intrav itreal injection of plasmin in producing posterior vitreous detachment (PVD), an d the possible role of plasmin in degrading adhesion glycoproteins of inner limiting membrane (ILM).Methods Twenty eyes of young human cadavers within 24 hours after death were divided into 4 groups that received 0.1 ml balanced salt solution (group 1) as control, 1 (group 2), 2 (group 3), or 3 (group 4) U of human plasmin. Optical and transmission electron microcopies were performed to examine the ultrastructure of the vitreoretinal interface. Electron-immunocytochemical techniques were carried out on ILM to estimate the content of fibronectin (FN) and laminin (LN). Flow cytometry was used for cell viability analysis of variance (ANOVA) and Tukey-test was employed for statistical analysis. Results Microscopy demonstrated that plasmin especially in group 4 cleaved the attachment of the vitreous collagen fibrils to the ILM with no evident damage to the inner retina. The content of LN, FN in ILM decreased with injection of plasmin (group 3 and 4 had statistical significance from control group for FN,P＜0.05; for LN in group 4, P＜0.05). Retinal cell viability was similar for plasmin-treated and control eyes. Conclusion Human plasmin disrupts the attachment of posterior hyaloid to the ILM with no morphologic changes of the inner retina. PVD is induced mostly with injection of 3 U plasmin. (Chin J Ocul Fundus Dis，2003，19：42-45)