Br J Ophthalmol 1998;82:438-443 ( April )
Vitreous intercellular adhesion molecule 1 in uveitis complicated
by retinal detachment
Lynne Webster,
Ros M Stanbury,
Anthony H Chignell,
G Astrid Limb
Department of Ophthalmology, The Rayne
Institute, UMDS, St Thomas's Hospital, London
Correspondence to: Dr G A Limb, Retinal
Inflammation Laboratory, Department of Ophthalmology, Rayne Institute,
St Thomas's Hospital, London SE1 7EH.
Accepted for publication 6 November 1997
AIMS
The vitreous levels of soluble intercellular
adhesion molecule 1 (sICAM-1) were investigated in uveitic eyes
undergoing vitrectomy for retinal detachment (RD) or other
complications, and the presence of this molecule was related to disease
activity and vitreous levels of the cytokine tumour necrosis factor 
(TNF), known to upregulate ICAM-1 expression on various cells.
METHODSVitreous and serum samples from 23 patients with either active or quiescent uveitis undergoing retinal
surgery were examined for the levels of immunoreactive sICAM-1 and
TNF by ELISA methods, and for the presence of biologically active
TNF. Vitreous from non-uveitic eyes with rhegmatogenous retinal
detachment (RRD), macular holes or cadaveric eyes were used as controls.
RESULTSAs a whole, vitreous from uveitic eyes
complicated or uncomplicated by RRD contained significantly higher
levels of sICAM-1 than vitreous from non-uveitic eyes with RRD alone (p < 0.0005), eyes with macular holes (p< 0.0001), or normal cadaveric
vitreous (p < 0.0001). The proportion of vitreous containing >20
ng/ml sICAM-1 (> four times the normal values) was significantly
higher in eyes with uveitis complicated by RRD than in those eyes
without RRD (Fisher's test, p= 0.02), and although levels of sICAM-1
were higher in eyes with active uveitis than in those with quiet
disease (p < 0.02), this could not be dissociated from the increase
caused by RRD. There was a relation between the vitreous levels of
sICAM-1 and those of immunoreactive TNF (Spearman's correlation
coefficient; r = 0.601, p = 0.006), but not between the
vitreous levels of sICAM-1 and those of biologically active TNF.
CONCLUSIONIncreased vitreous sICAM-1 levels
and the association of this molecule with the presence of
immunoreactive TNF in uveitic eyes confirm the operation of cytokine
mediated vascular reactions at the blood-retinal barrier during the
development of this condition. The persistence of high vitreous levels
of sICAM-1 in eyes with uveitis complicated by RRD despite previous
immunosuppression may indicate a low rate of clearance of inflammatory
molecules from the vitreous cavity and an exacerbation of the existing
inflammatory process by the retinal detachment itself.
Keywords:
vitreous;
retinal detachment;
ICAM-1;
TNF;
uveitis
© 1998 by British Journal of Ophthalmology
