[Time course of changes in aqueous protein concentration in rhegmatogenous retinal detachment]

Changes in aqueous protein concentration (APC) in unilateral rhegmatogenous retinal detachment (RD) were investigated 1) prospectively in 40 patients who were undergoing scleral buckling surgery with cryotherapy and 2) retrospectively in another 40 patients who had undergone successful retinal reattachment more than 2 years previously. Before the surgery, APC in RD eyes was more than double that in the contralateral normal eyes. The surgical intervention led to a further increase in APC and a peak was observed at 2 weeks postoperatively. Values decreased to a stable level approximately 3 months after surgery, but remained significantly higher than those of the control eyes. Clinical factors which were found to significantly correlate with APC were: 1) before surgery; age, area of RD, balloon-shaped RD, tear rather than hole, and the extent of preoperative hypotony; 2) in the early postoperative period; age, size of retinal breaks, and number of cryoapplication; and 3) in the late postoperative period; age, area of RD, and performance of scleral encircling. It was suggested that different mechanisms are responsible for the increase in APC observed at different periods, including 1) decreased aqueous bulk flow; 2) disruption of the blood-retinal barrier caused by cryotherapy, and/or dispersion of subretinal protein during the surgeries; and 3) decreased aqueous flow rate following buckling procedures, and breakdown of the blood-aqueous barrier induced by changes in anterior uveal blood circulation.