The role of skin autofluorescence as a predictor for post-operative proliferative vitreoretinopathy and surgical failure in patients with retinal detachment

With aging, structural changes develop in the vitreous body. This can be
followed by the development of a posterior vitreous detachment, which can
induce retinal damage such as intravitreal hemorrhage, retinal tear and retinal
detachment.
The importance of collagen fibrils in maintaining the vitreous gel structure
leads to the logical assumption that changes in the gel structure could be
directly related to changes in the collagen fibrils. These changes can be
caused by forming advanced glycation endproducts (AGEs), which involves a
series of non-enzymatic reactions with reducing sugars, oxoaldehydes, oxidized
lipids and reactive carbonyls. AGEs form arbitrarily on any protein, dependent
on the concentration of reactive molecules, and, once settled, they can only be
removed by degradation of the protein.
Recently, it has been suggested that AGEs may be involved in vitreo-retinal
interface diseases. Although these eye conditions remain without (serious)
symptoms in the majority of subjects, they are insidious and can lead to
permanent visual loss and blindness. It is difficult to identify high risk
subjects based on eye examination. Therefore, in order to identify those
subjects at increased risk for severe disease progression, it is of importance
to gain more insight into the relation between general ageing and age-related
disease in the eye.
It was found that skin autofluorescence (skin AF) was independently associated
with the severity of retinal detachment (degree of retinal detachment and
presence of proliferative vitreoretinopathy (PVR)) at the time of surgery.
Since it has been shown that preoperative PVR is the best clinical predictor of
postoperative PVR and hence surgical failure, skin autofluorescence might also
predict postoperative PVR.

The aim of this study is to investigate whether skin autofluorescence (AF) is
predictive of postoperative PVR (and corresponding surgical failure) in
patients being surgically treated for retinal detachment and to investigate
some pathways which may contribute to the explanation of the relation of
systemic skin AF with local eye disease.

The objectives will be tested in a prospective cohort study in patients who
will undergo vitrectomy because of retinal detachment.

The participants will have the burden of a single skin AF measurement, and a
single venipuncture, and will be approached for clinical follow-up assessment;.
Future general benefit may be that a more focused and accurate, rapid
non-invasive and low-cost prediction of risk of proliferative vitreoretinopathy
and/or surgical failure in retinal detachment patients will become available.