Pathophysiology of vitreous and new therapeutic modality

玻璃体中的病理过程将反映在视网膜功能中。探讨玻璃体切割术与视网膜形态和功能的关系。首先，探讨黄斑部疾病玻璃体质量异常与结构异常的关系。我们发现无晶状体型/人工晶状体型黄斑囊样水肿降低了全视野视网膜功能，这可能是由含有各种化学介质的玻璃体病变引起的(AJO2003)。在特发性黄斑裂孔患者中，黄斑裂孔的进展可能取决于黄斑中心凹粘连和玻璃体之间的平衡(AJO2003)。其次，研究玻璃体手术治疗视网膜前膜、脉络膜新生血管、糖尿病黄斑水肿(IOVS2002、2003、2003)和假性黄斑裂孔(AJO2003)的疗效、手术损伤和局限性。在内界膜去除和黄斑移位中，功能恢复延迟(眼科2003，IOVS 2004)。第三，我们研究了纤溶酶对视网膜功能和形态的影响。糖尿病黄斑水肿眼内界膜的组织学标本证实了纤溶酶在玻璃体-视网膜界面分离中的作用。这是纤溶酶在活体人眼中有效的第一个证据(眼科，2004年)。最后，探讨了包括视网膜色素上皮移植在内的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.