Retinal detachment:: visual acuity and subretinal immunoreactive endothelin-1

Purpose. To analyze whether subretinal (SRF) endothelin-1 (ET-1) - a vasoactive, mitogenic, and pro-apoptotic peptide - levels are related to visual acuity (VA) in rhegmatogenous retinal detachment (RD). Patients and methods. Sixty-six healthy patients between 42 and 70 years of age with unilateral RD, all candidates for scleral buckling surgery (PVR < C3) as a first and single surgical procedure, were prospectively selected. Using radioimmunoassay, immunoreactive ET-1 (IR-ET-1) was tested in both plasma and subretinal fluid (SRF) of these retinal detachment (RD) patients. Best-corrected Snellen VA was considered before surgery (preoperative) and 8 months after surgery (postoperative). Pearson correlations were made between IR-ET-1 levels (in plasma and SRF) and VA (preoperative, postoperative, and postoperative minus preoperative difference). Results. Mean IR-ET-1 values were plasma, 2.91 +/- 0.44 pg/ml, and SRF, 10.71 +/- 7.95 pg/ml. Mean VA values were preoperative VA, 0.31 +/- 0.16; postoperative VA, 0.66 +/- 0.29; and VA difference, 0.35 +/- 0.18. Plasma IR-ET-1 showed significant (p < 0.0001) negative linear correlations with preoperative VA (r=-0.52), postoperative VA (r=-0.69), and VA difference (r=-0.65). SRF IR-ET-1 showed significant (p < 0.0001) negative linear correlations with preoperative VA (r=-0.48), postoperative VA (r=-0.61), and VA difference (r=-0.54). When proliferative vitreoretinopathy (PVR) was associated with RD, correlations between SRF IR ET-1 and postoperative VA (r=-0.70) and VA difference (r=-0.75) showed the highest negative values Conclusions. Correlations between SRF IR-ET-1 and VA were negative and higher for postoperative VA and these correlations showed the highest values when RD was associated with PVR. These findings support the idea of doing primary vitrectomy and perhaps using coadjutant pharmacologic therapy in these cases.