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。目的：探讨玻璃体切除术与视网膜形态和功能的关系。首先，研究了黄斑病变玻璃体结构异常与玻璃体质量异常的关系。我们证明了无晶状体/人工晶状体囊样黄斑水肿的全视野视网膜功能下降，这可能是由各种化学介质的患病玻璃体引起的（AJO 2003）。在患有特发性黄斑裂孔的眼睛中，黄斑裂孔的进展可能取决于中心凹粘连和玻璃体之间的平衡（AJO 2003）。其次，对玻璃体手术治疗视网膜前膜、脉络膜新生血管、糖尿病性黄斑水肿（IOVS 2002，2003，2003）和假性黄斑裂孔（AJO 2003）的疗效、手术损伤和局限性进行了研究。内界膜去除和黄斑移位证实了延迟的功能恢复（Ophthalmology 2003，IOVS 2004）。第三，研究纤溶酶对视网膜功能和形态的影响。纤维蛋白溶酶在分离玻璃体视网膜界面的有效性通过从患有糖尿病性黄斑水肿的眼睛中去除的内界膜的组织学标本来证明。这是纤溶酶在活体人眼中有效性的第一个证据（Ophthalmology 2004）。最后，研究了包括视网膜色素上皮移植在内的老年性黄斑变性的新治疗方法。

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.