Pathophysiology of vitreous and new therapeutic modality

玻璃体的病理过程会反映在视网膜的功能上。我们研究了玻璃体切除术与视网膜形态和功能的关系。首先，研究黄斑病变中玻璃体的质量异常与结构异常的关系。我们证明无晶状体/假性晶状体囊样黄斑水肿的眼底功能下降，这可能是由病变玻璃体与各种化学介质引起的（AJO2003）。在患有特发性黄斑孔的眼睛中，黄斑孔的进展可能取决于中央凹粘连和玻璃体之间的平衡（AJO2003）。其次，对视网膜前膜、脉络膜新生血管、糖尿病性黄斑水肿（iovs2002,2003,2003）和假黄斑孔（AJO2003）进行玻璃体手术的疗效、手术损伤和局限性进行了研究。在内限制膜去除和黄斑移位中证实了延迟功能恢复（Ophthalmology2003,IOVS2004）。第三，我们研究了纤溶酶对视网膜功能和形态的影响。糖尿病性黄斑水肿眼内限定膜的组织学标本证实了纤溶蛋白在玻璃体-视网膜界面分离中的作用。这是活体人眼中纤溶酶有效性的第一个证据（眼科学2004）。最后，研究了视网膜色素上皮移植治疗老年性黄斑变性的新方法。

Pathological processes in the vitreous will be reflected in the retinal function. We studied the relationship between the vitrectomy and the morphology and the function of the retina. First, the relationship between the qualitative and structure abnormality of the vitreous in macular diseases was studied. We demonstrated aphakic/pseudophakic cystoid macular edema had decreased full-field retinal function, which may have been caused by the diseased vitreous with various chemical mediators (AJO2003). In eyes with idiopathic macular hole, the progression of the macular hole might depend on a balance between the foveal adhesion and the vitreous (AJO2003). Second, the efficacy, surgical damage and limitation of vitreous surgery were investigated in epiretinal membrane, choroidal neovascularization, diabetic macular edema (IOVS2002,2003,2003) and pseudo-macular hole (AJO2003). Delayed functional recovery was demonstrated in internal limiting membrane removal and macular translocation (Ophthalmology2003,IOVS2004). Third, we studied the effect of plasmin on the retinal function and morphology. The efficacy of plasmin in separation of the vitreo-retinal interface was demonstrated by the histological specimen of the internal limiting membrane removed from the eyes with diabetic macular edema. This was the first evidence of the effectiveness of plasmin in the living human eye (Ophthalmology 2004). Lastly, the new treatment of age-related macular degeneration including transplantation of retinal pigment epithelium has been investigated.