Bulbusrekonstruktion bei ausgedehnten Verletzungen des Hinterabschnittes

Severe injuries of the posterior eye segment mostly occur during perforation or rupture of the globe. The first treatment includes primary surgical repair of the ocular wound and prophylactic scleral buckling in case of involvement of the posterior segment. Thereafter, a vitrectomy should be performed to remove vitreous hemorrhage and intraocular foreign bodies and to achieve a stable attachment of the retina. Therefore, temporary perfluorocarbon and permanent silicone oil tamponade are used. A predictor of poor visual outcome is the presence of retinal and choroidal injury. In our patients, the most important prognostic factor was the initial visual acuity after the injury. Vitrectomy can significantly reduce the incidence of enucleation. Currently, better visual outcome is achieved by advances in surgical techniques.

Clinical findings in macular hole surgery with indocyanine green-assisted peeling of the internal limiting membrane

PURPOSE

Indocyanine green (ICG) staining of the internal limiting membrane has facilitated ILM peeling in macular hole surgery. However, it has been reported that ICG-assisted peeling of the ILM may result in retinal damage and unfavorable functional outcome. Therefore, we analyzed our visual and anatomical results of ICG assisted macular hole surgery.

METHODS

In a retrospective study the records of a consecutive series of 37 patients with full-thickness idiopathic macular holes operated with ICG-assisted ILM peeling by a single surgeon were analyzed. All patients underwent a standard three-port vitrectomy with surgically induced posterior vitreous detachment, staining of the ILM with ICG, peeling of the ILM in a circular manner around the fovea, and SF6 20% endotamponade.

RESULTS

A total of 37 patients (37 eyes) were included in the study. The mean age was 69+/-7 years (range 52-81 years), and there were 26 women and 11 men. The follow-up ranged from 6 to 30 months (mean 18+/-6 months). At baseline visual acuity ranged from 20/400 to 20/40. Anatomically, 13 eyes had stage 2 holes, 21 eyes (57%) stage 3 holes, and three eyes stage 4 holes. At the postoperative visit (8-12 weeks after surgery) anatomical closure of the macular hole was achieved in 36 eyes. Visual acuity ranged between 20/400 and 20/20. At the last follow-up after initial surgery the macular hole was closed in all eyes. Visual acuity ranged from 20/200 to 20/20.

CONCLUSION

In our retrospective series anatomical and functional results of macular hole surgery with ICG-assisted peeling of the ILM are satisfactory. Primary hole closure was achieved in 97% of eyes and visual acuity increased in 62% of eyes in our series.

Experimental dispase-induced retinopathy causes up-regulation of P2Y receptor-mediated calcium responses in Müller glial cells

During proliferative vitreoretinopathy (PVR) Müller glial cells show an up-regulation of their responsiveness to extracellular adenosine 5'-triphosphate (ATP). In the present study, we investigated if such a glial cell response is also a feature for other retinopathies besides PVR. To this aim, the proteolytic enzyme, dispase (0.1 U), was injected into the vitreous of rabbit eyes. After 3 weeks, a distinct retinopathy had developed which showed no signs of PVR. The retinopathy was characterized by strong alterations of the retinal vasculature in the medullary rays, by photoreceptor degeneration, retinal atrophy, and activation of microglial cells. Müller cells became reactive, as indicated by up-regulation of glial fibrillary acidic protein immunoreactivity and by hypertrophy involving subretinal fibrosis. Müller cell reactivity was also evidenced electrophysiologically by a down-regulation of their inwardly rectifying potassium currents and by an up-regulation of their responsiveness to extracellular ATP. Significantly more Müller cells from dispase-treated eyes showed ATP-evoked calcium (83%) and current responses (69%) when compared with cells from control eyes (13 and 9%, respectively). The results indicate that increased responsiveness to extracellular ATP may be a more general feature of Müller cell gliosis, and is also observed in retinopathies besides PVR.

Advanced glycation end products induce choroidal endothelial cell proliferation, matrix metalloproteinase-2 and VEGF upregulation in vitro

BACKGROUND

Advanced glycation end products (AGEs) are considered to be important modulators of angiogenesis and accumulate in choroidal neovascularization (CNV). Their effects regarding cells involved in proliferation of CNV [retinal pigment epithelial (RPE) cells, Müller cells and choroidal endothelial cells (CECs)] were investigated. Furthermore, the effects of AGEs on expression of matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) by CECs were explored.

METHODS

RPE cells, CECs and Müller cells were exposed to AGEs (10 microg/ml, 50 microg/ml and 100 microg/ml) for a time course of three days in their desired medium and proliferation was estimated by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. MMP-2 expression of AGE-stimulated CECs was determined by zymography and reverse-transcription polymerase chain reaction (RT-PCR) after 36 h of exposure. Furthermore, VEGF expression of AGE-stimulated CECs (50 microg/ml and 100 microg/ml) was determined by RT-PCR after an exposure time of 36 h.

RESULTS

AGEs in a concentration of 50 microg/ml and 100 microg/ml increased the proliferation of CECs (41% vs 46.1%; P<0.005). No AGE effect on RPE cell and Müller cell proliferation was seen. AGEs in all concentrations used upregulated the VEGF mRNA expression of CECs. Zymography and RT-PCR demonstrated the upregulation of MMP-2 by CECs after AGE exposure.

CONCLUSION

AGEs stimulate CEC proliferation, MMP-2 secretion and VEGF upregulation and may be important promoters of CNV formation in exudative AMD in vivo.

[Progress in somatic gene therapy of retinal degeneration in the animal model]

More than 60 genes responsible for human retinal dystrophies have already been identified. Most of them are either expressed in the photoreceptor or in the retinal pigment epithelium (RPE). Therefore these cells have become the target of new therapeutical strategies on a molecular level. The most promising approach at present is somatic gene therapy, which has been developed over the last years and the principle has now been established in animal models. For gene therapy of inherited retinal degeneration, as for gene therapy in general, gene transfer has to be proven to be not only efficient but also safe. This has recently been achieved using the adeno-associated virus (AAV) as a vector to express a therapeutic gene within the photoreceptor cell. It could be demonstrated in mouse and dog models of retinal degeneration that expression of the therapeutic transgene leads to anatomical and functional restitution of degenerating photoreceptors. A significant immune response to AAV has not been detected so far. In this paper the recent success of gene therapy of retinal degeneration in animal models is reviewed.

Structure of the human histamine H3 receptor gene (HRH3) and identification of naturally occurring variations

Neurotransmitter release is modulated by presynaptic histamine H(3) receptors located on histaminergic, noradrenergic and other nonhistaminergic neurons of the central and peripheral nervous system. Here, we report the determination of the structure of the human histamine H(3) receptor gene (HRH3) and the identification of a missense mutation (Ala280Val) in a patient with Shy-Drager syndrome. The coding region of the gene consists of three exons interrupted by two introns of approximately 1 kb in size. Exon boundaries only partly correspond to transmembrane domain organization. The homozygous Ala280Val variation in the third intracellular loop of the histamine H(3) receptor of a patient with Shy-Drager syndrome may be related to the etiology of the illness due to altered norepinephrine release. Furthermore, knowledge of the gene structure allows the verification of alternative splicing of the receptor. The corresponding histamine H(3) receptor isoforms as reported for the guinea pig and rat histamine H(3) receptor in different brain regions are not found in the human brain.

Hypoxia: modulation of endothelial cell proliferation by soluble factors released by retinal cells

A devastating complication of ischemic retinopathies is retinal neovascularization. We studied the impact on retinal endothelial cell proliferation of soluble factors released from cultured retinal glial (Müller) cells and from retinal explant cultures. Hypoxia strongly stimulated VEGF release by all types of cultures but endothelial cell growth was not further increased by the corresponding conditioned media if compared to supernatants obtained under normoxia. When the final concentration of the hypoxia-conditioned media was adjusted to the VEGF level of normoxia-conditioned media, they even inhibited endothelial cell proliferation. Inhibition may be exerted by TGF-beta 2 but TGF-beta 2 mRNA and protein expression in Müller cells were found to be down-regulated under hypoxia. We conclude that retinal endothelial cell proliferation is controlled by the balance of the amount and/or efficacy of several stimulatory and inhibitory factors.

Minor influence of the immunosuppressive cytokines IL-10 and TGF-beta on the proliferation and apoptosis of human retinal pigment epithelial (RPE) cells in vitro

Undesirable immune reactions such as uveitis or graft rejection after corneal and subretinal transplantations are serious inflammations in the eye. Minimizing this process by means of physiological suppressors, either through systemic or intraocular administration with or without gene therapy, is a future therapeutic possibility. In our study, we used different concentrations of transforming growth factor-beta (TGF-beta; 5, 10, and 50 ng/ml) and interleukin-10 (IL-10; 100, 200, and 500 U/ml), both known as modulators of the suppression process, to treat human retinal pigment epithelium (RPE) cells in vitro. The influence of both cytokines on the viability and proliferation of the RPE cells was measured. Furthermore, the secretion of typical markers of the apoptosis process, such as Fas, soluble Fas ligand, and bcl-2, was investigated. Our results show that the concentrations of TGF-beta and IL-10 used have only a slight influence on RPE cells. Cell proliferation under the influence of TGF-beta was significantly reduced, whereas more Fas protein could be found in the cell lysate of the IL-10 samples. In general, IL-10 seemed to have less effect on the physiology of RPE cells. The discussion of the therapeutic use of an immunosuppressive factor in the eye should therefore be focused more on this cytokine.

Direct measurement of VEGF-induced nitric oxide production by choroidal endothelial cells

Vascular endothelial growth factor (VEGF) and nitric oxide (NO) seem to be involved in the process of angiogenesis, but their interactions are not clearly understood. The aim of this study was to investigate the influence of VEGF on NO production of choroidal endothelial cells (CEC) and its importance in angiogenesis. Experiments were performed using cultured bovine CEC. Basal NO release of unstimulated CEC was measured and compared to NO release of VEGF-stimulated CEC (1, 10, and 100 ng/ml). Further, cells were pretreated with N(omega)-nitro-L-arginine methyl ester (L-NAME, 1 and 2 mM) and incubated with and without VEGF (10 ng/ml) to investigate the effect of blocking NO synthase. NO release into the medium was assessed by an amperometric NO sensor. To show the importance of NO in angiogenesis, proliferation and migration of CEC were measured after VEGF stimulation and in the presence or absence of L-NAME (1 and 2 mM). Unstimulated CEC continuously produced low levels of NO. Stimulation of the cells with VEGF resulted in a dose-dependent increase in NO release. The time course after stimulation with 10 ng/ml VEGF was characterized by a prompt initial rise up to 140% of unstimulated levels and a subsequent sustained increase over 120 min. Pretreatment with L-NAME attenuated the VEGF-induced response. L-NAME incubation alone led to a reduction in basal NO release. L-NAME also significantly diminished the VEGF-enhanced CEC proliferation and migration. The results demonstrate that VEGF enhances the formation of NO in cultured CEC. The blockade of NO production reduces CEC proliferation and migration, an effect which may be important for controlling angiogenesis, especially in reducing neovascularization in age-related macular degeneration in the eye.

Pars plana lentectomy for treatment of congenital cataract

BACKGROUND

Congenital cataract surgery can be performed using a pars plicata/plana or a limbal approach, if placement of an intraocular lens at the time of cataract removal is not a consideration. Because of the high incidence of secondary cataract formation in children the operation should be combined with capsulotomy and anterior vitrectomy.

METHODS

The series consisted of 30 eyes from 20 consecutive children who suffered from congenital cataract and underwent cataract surgery between May 1995 and June 2000. The inclusion criterion was congenital cataract affecting the visual axis. We performed the operations as lens aspiration with anterior and posterior capsulotomy and anterior vitrectomy via the pars plana or plicata. We used contact lenses to rehabilitate vision. All patients received intensive orthoptic and pleoptic treatment.

RESULTS

This surgical technique provided in all eyes a clear visual axis. During follow-up of 3 months to 4.5 years, secondary cataract developed in five eyes. Retinal detachment, glaucoma and endophthalmitis did not occur. One patient developed contact lens intolerance and a secondary intraocular lens was placed in the ciliary sulcus.

DISCUSSION

Lentectomy via a pars plana or pars plicata approach is a suitable and safe method for treating cataract in children. Our chosen method of lentectomy is an alternative to early implantation of an intraocular lens. It is possible to perform uncomplicated secondary implantation of an intraocular lens in the ciliary sulcus.

Histological findings of surgically excised choroidal neovascular membranes after photodynamic therapy

AIM

To investigate effects of photodynamic therapy (PDT) on human choroidal neovascularisation (CNV).

METHODS

Two patients with recurrences after PDT with verteporfin underwent surgical extraction of the CNV. Immediately after surgical excision the subfoveal neovascular membranes were divided for light microscopic and for electron microscopic processing. For light microscopy tissues were embedded in paraffin. Sections were stained with haematoxylin and eosin, and the periodic acid Schiff (PAS) reaction was performed to determine histological diagnosis and to ensure tissue quality. For electron microscopy the specimens were fixed in glutaraldehyde and embedded in epoxy resin. Semithin sections were stained with uranyl acetate and lead citrate and examined with a transmission electron microscope.

RESULTS

Light microscopy showed thick fibrovascular membranes in both cases. On the outer surface remnants of retinal pigment epithelial cells resting on thickened inner aspect of Bruch's membrane were found. On the retinal side some outer segments were found. The membrane showed areas with irregularly shaped vessels. Electron photomicrographs showed occluded vessels within the CNV containing thrombotic masses and/or ultrastructural damage of the neovascular endothelium. Most of the vessels presented regressive changes with vacuolisation and fragmentation of the neovascular endothelium accompanied by disintegration of the endothelial cell layer. Extravasation of red blood cells was observed. Occasionally, vessels with normal endothelium containing intact red blood cells were observed. Some vessels contained immature endothelial cells. At some locations the retinal pigment epithelium cells (RPE) were metaplastic showing highly vacuolised cytoplasm.

CONCLUSIONS

These findings suggest that the evidence of fluorescein leakage from the CNV and enlargement of the neovascular complex following PDT could be related to new vessel growth and recanalisation of occluded vessels. Additionally, RPE disturbances were observed in the specimens. This finding may be related to the original pathology or could indicate that PDT treatment may result in RPE atrophy.

Immunosuppression by IL-10-transfected human retinal pigment epithelial cells in vitro

PURPOSE

Retinal pigment epithelium (RPE) transplantation seems to be a possible therapy for restoring vision in the case of retinal degeneration. As there is a risk of allergic rejection, a gene-transfer of immunosuppressive cytokines into the graft may diminish this reaction. Therefore, we investigated the transfer of interleukin-10 (IL-10) into an immortalised human RPE cell line (hTERT-RPE1) and its effect on the proliferation of allogeneic immune competent cells.

METHODS

The hTERT-RPE1 cells were transiently transfected with the cDNA of human IL-10 using a lipid-based transfection reagent. The expression of IL-10 mRNA was ana-lysed by reverse transcription-polymerase chain reaction and an enzyme-linked immunosorbent assay measured the secretion of the cytokine over 7 days. The effect of the secreted IL-10 on the proliferation of allogeneic T cells with and without homologous macrophages was investigated colorimetrically. To enhance this reaction, RPE cells were pre-activated with interferon-gamma (IFN-gamma). Anti-IL-10 antibodies were used in a neutralising assay.

RESULTS

A transfection efficiency of 23.3 +/- 9.03% was achieved. IL-10 mRNA could only be shown in IL-10-transfected hTERT-RPE1 cells. The same was found for the level of cytokine, with a maximum on day 3 (10.34 +/- 0.09 ng/ml). A significant suppressive effect of the secreted IL-10 on T-cell proliferation was detectable on days 5 and 6. This effect could be significantly abolished with anti-IL-10 antibodies.

CONCLUSIONS

The IL-10-producing hTERT-RPE1 cells had an immunosuppressive action on T-cell proliferation in vitro. A gene-transfer into RPE allografts before transplantation may be able to promote graft survival.

Molecular and cellular evidence for T-cell stimulation by allogeneic retinal pigment epithelium cells in vitro

PURPOSE

The rejection of retinal pigment epithelium (RPE) allografts is a major barrier to long-term success after retinal transplantation. The aim of this study was to investigate the action of RPE cells on allogeneic T cells in coculture with or without macrophages. For the detection of T-cell activation the interleukins IL-1beta and IL-2, typical for this process, were investigated.

METHODS

Human RPE cells (6 x 10(5) cells/flask) were used as stimulator cells. To investigate the influence of MHC class II molecules the RPE cells were pre-incubated with different concentrations of interferon-gamma (IFN-gamma; 0, 50, 100, or 250 U/ml) for 4 days. This was followed by coculture with either 6 x 10(6) T cells or, in a second trial, the T cells plus 6 x 10(5) macrophages. The mRNAs of the cytokines under study were detected using a reverse-transcriptase polymerase chain reaction and were quantified by colorimetry after 6 h. The cytokine protein content in the supernatants was measured after 20 h using specific enzyme-linked immunoabsorbent assays.

RESULTS

Cytokine-specific mRNAs and proteins were found in all samples. After coculture the level of IL-1beta mRNA was higher and that of cytokine-specific protein was significantly increased. Furthermore, the addition of macrophages led to increased cytokine secretion but a general influence of the pre-activation with interferon could not be found. Similar results were detected for IL-2; at the highest dose, IFN-gamma preactivation and, in combination with macrophages, a significant increase in the protein level could be found.

CONCLUSION

These results show that RPE cells are able to activate allogeneic T cells in vitro. Professional antigen-presenting cells may promote this process, as may pre-treatment with IFN-gamma. The circumstances modelled here are involved in the rejection process after RPE transplantation in humans and help to explain this immune response.

Facilitation of artificial retinal detachment for macular translocation surgery tested in rabbit

PURPOSE

For macular translocation surgery, the native attached retina has to be detached either locally or completely. Although different surgical techniques are used, there is a general search for supporting procedures that facilitate and accelerate the retinal detachment.

METHODS

Pars plana vitrectomies were performed in pigmented rabbits. In all experimental groups, a local retinal detachment was created by infusing the test solution with a thin glass micropipette attached to a glass syringe. In control animals a standard balanced salt solution was used at room temperature, in combination with a standard vitrectomy light source. In two test groups, a calcium- and magnesium-free solution was used for the vitrectomy, under illumination by a standard light source in group I (solution at room temperature) and group II (solution heated up to body temperature). In group III the rabbits were dark-adapted for half an hour, and then, during surgery, a red filter was used in front of the light source (standard balanced salt solution at room temperature). After the rabbits were killed at the end of surgery, the adherence of the retinal pigment epithelium (RPE) to the neural retina in the detachment area was quantified microscopically, and the morphologic integrity of the detached retinal tissue was examined by light and electron microscopy. No electrophysiology was performed.

RESULTS

In all four groups, it was possible to detach the retina. The maximum adherence of the RPE cells to the neural retina was observed in the control group. Virtually no decrease in adherence was found in test group II (36 degrees C solution without calcium and magnesium), whereas a significant decrease was seen in both group I (calcium- and magnesium-free solution at room temperature) and group III (dark adaptation-red light technique; standard balanced salt solution at room temperature). In none of the experimental groups was any obvious damage of the retinal structure observed, even after exposure to the test solutions for 60 minutes.

CONCLUSIONS

Both dark adaptation (red illumination) and the use of a calcium chloride- and magnesium chloride-free solution (at room temperature) can facilitate retinal detachment in macular translocation surgery. Both techniques are proposed as a gentle support for the operation, because they protect an intact RPE cell layer and do not cause retinal damage at the ultrastructural level.

Experimental retinal detachment causes widespread and multilayered degeneration in rabbit retina

Retinal detachment remains one of the most frequent causes of visual impairment in humans, even after ophthalmoscopically successful retinal reattachment. This study was aimed at monitoring (ultra-) structural alterations of retinae of rabbits after experimental detachment. A surgical procedure was used to produce local retinal detachments in rabbit eyes similar to the typical lesions in human patients. At various periods after detachment, the detached retinal area as well as neighbouring attached regions were studied by light and electron microscopy. In addition to the well-known degeneration of photoreceptor cells in the detached retina, the following progressive alterations were observed, (i) in both the detached and the attached regions, an incomplete but severe loss of ganglion cell axons occurs; (ii) there is considerable ganglion cell death, particularly in the detached area; (iii) even in the attached retina distant from the detachment, small adherent groups of photoreceptor cells degenerate; (iv) these photoreceptor cells degenerate in an atypical sequence, with severely destructed somata and inner segments but well-maintained outer segments; and (v) the severe loss of retinal neurons is not accompanied by any significant loss of Müller (glial) cells. It is noteworthy that the described progressive (and probably irreparable) retinal destructions occur also in the attached retina, and may account for visual impairment in strikingly large areas of the visual field, even after retinal reattachment.

The influence of pro-inflammatory cytokines on human retinal pigment epithelium cell receptors

PURPOSE

To investigate the mRNA expression of the receptors for tumour necrosis factor alpha (TNFRp55, TNFRp75), interferon gamma (IFN gamma R alpha, IFN gamma R beta), interleukin 10 (IL-10R, CRFB4) and transforming growth factor beta (TGF beta RII) on human retinal pigment epithelium (RPE) cells and to modulate this expression with the pro-inflammatory cytokines TNF-alpha and IFN-gamma as stimulators.

METHODS

The cells were cultured in the presence of TNF-alpha (10 ng/ml), IFN-gamma (1000 U/ml) or a combination of both for 24 h, 48 h and 72 h. The total RNA was prepared, and the receptor mRNA expression was investigated by the reverse-transcription polymerase chain reaction method. The changes in mRNA expression during the modulation were quantified by the ribonuclease protection assay.

RESULTS

The mRNA for TNFRp55, TNFRp75, IFN gamma R alpha, IFN gamma R beta, CRFB4 and TGF beta RII was constitutively expressed in vitro. IL-10R mRNA was detected in neither unstimulated nor stimulated RPE cells. Especially the mRNA of the TNF-Rp75 was up-regulated, mainly by IFN-gamma or the combination of both stimulators.

CONCLUSION

Our results demonstrate that human RPE cells express the mRNA of different cytokine receptors and the expression may be partially modulated by pro-inflammatory cytokines. This may show that RPE cells act as corresponding cells not only in vitro, but also in inflammation and immunological processes in the eye. In this connection it could be hypothesised that activated RPE cells play a stimulating role in addition to the known suppressive one.

Electrophysiology of rabbit Müller (glial) cells in experimental retinal detachment and PVR

PURPOSE

To determine the electrophysiological properties of Müller (glial) cells from experimentally detached rabbit retinas.

METHODS

A stable local retinal detachment was induced by subretinal injection of a sodium hyaluronate solution. Müller cells were acutely dissociated and studied by the whole-cell voltage-clamp technique.

RESULTS

The cell membranes of Müller cells from normal retinas were dominated by a large inwardly rectifying potassium ion (K+) conductance that caused a low-input resistance (<100 M(Omega)) and a high resting membrane potential (-82 +/- 6 mV). During the first week after detachment, the Müller cells became reactive as shown by glial fibrillary acidic protein (GFAP) immunoreactivity, and their inward currents were markedly reduced, accompanied by an increased input resistance (>200 M(Omega)). After 3 weeks of detachment, the input resistance increased further (>300 M(Omega)), and some cells displayed significantly depolarized membrane potentials (mean -69 +/- 18 mV). When PVR developed (in 20% of the cases) the inward K+ currents were virtually completely eliminated. The input resistance increased dramatically (>1000 MOmega), and almost all cells displayed strongly depolarized membrane potentials (-44 +/- 16 mV).

CONCLUSIONS

Reactive Müller cells are characterized by a severe reduction of their K+ inward conductance, accompanied by depolarized membrane potentials. These changes must impair physiological glial functions, such as neurotransmitter recycling and K+ ion clearance. Furthermore, the open probability of certain types of voltage-dependent ion channels (e.g., Ca2+-dependent K+ maxi channels) increases that may be a precondition for Müller cell proliferation, particularly in PVR when a dramatic downregulation of both inward current density and resting membrane potential occurs.

[Retinal degeneration. Apoptosis as pathomechanism and therapy strategy]

Molecular techniques in ophthalmology and related subjects have led in recent years to the identification of many genes expressed in photoreceptor cells and have allowed the characterization of mutations leading to distinct phenotypes of retinal degeneration. Programmed cell death, or apoptosis, has been identified as the final common pathway in this disease group. A cascade of events has evolved, starting with specific stimuli and developing over different mediators and regulators (e.g., Fas ligand, proteins of the Bcl-2 family, p53) to effector enzymes (caspases). The ever increasing data of this pathway serve as a basis for new therapeutic strategies. We review the current knowledge on apoptosis in retinal degeneration.

Retinal pigment epithelium melanin granules are phagocytozed by Müller glial cells in experimental retinal detachment

The ability of retinal Müller glial cells to perform phagocytosis in vivo is studied in a rabbit model of experimental retinal detachment where pigment epithelial cells are occasionally detached together with the neural retina. While macrophages and/or microglial cells phagocytoze most of the cellular debris at the sclerad surface of the detached retinae, some Müller cells accumulate melanin granules. The granules are virtually intact at the ultrastructural level, and are surrounded by a membrane. They are often located close to the sclerad end of the cells, but some are distributed throughout the outer stem process up to the soma. It is concluded that rabbit Müller cells in vivo are capable of phagocytosis and of transporting the phagocytozed material within their cytoplasm.

Alterations of sensory retinal explants exposed to choroidal melanoma cells ex vivo

BACKGROUND

Cultures of retinal explants have been established as a useful tool to investigate effects of pathogenic agents in vitro. We used such cultures as a model to study the effects of choroidal melanoma on retinal organisation and function.

METHODS

Rabbit retinal explants were co-cultured with human choroidal melanoma cells, or exposed to supernatants from choroidal melanoma cell cultures, for various periods from 1 day to 10 days. The retinal explants were then studied by histology and immunocytochemistry for glial fibrillary acidic protein (GFAP) and vimentin. The release of the pro-inflammatory interleukins IL-6 and IL-8 into the media was measured by enzyme-linked immunosorbent assay.

RESULTS

Both in the co-cultures and after treatment with choroidal melanoma cell supernatants for more than 1 week, the layered structure of the retinae became disorganised. Retinal glial (Müller) cells displayed gliosis as indicated by increased GFAP immunoreactivity and decreased immunoreactivity for vimentin. Additionally, the secretion of cytokines, particularly of IL-8, was significantly modulated. The retinal explants produced much less IL-8 than the melanoma cells in separate cultures but increased their IL-8 release significantly after a few days' exposure to melanoma cell-conditioned medium.

CONCLUSION

The results show that in cases of choroidal melanoma, the well-known morphological and inflammatory alterations of the retina are accompanied by glial cell reactivity and up-regulated retinal cytokine secretion, and may be caused by soluble factors secreted and induced by the melanoma.