Experimental studies on application of anti-adhesion therapy for retinal microcirculatory disturbances

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Leukocyte adhesion to the human retinal vascular endothelial cells was studied in vitro. High glucose concentration and insulin in the culture medium increased the adhesion of neutrophils to the retinal vascular endothelial cells. One of the adhesion molecules of the endothelial cells, intercellular adhesion molecule-1 (ICAM-1), was up-regulated by the high glucose and insulin. The leukocyte adhesion was inhibited by anti-ICAM-1 antibody and the inhibitor of protein kinase C. These results suggested that both glucose and insulin increased the expression of ICAM-1 of the retinal vascular endothelial cells through the activation of protein kinase C and that the increased expression of ICAM-1 is the cause for the adhesion of netrophils.The effect of triamcinolone acetonide on the leukocyte adhesion after scatter retinal photocoagulation was studied in rats in vivo. Acridine orange fluorography was used to study leukocyte dynamics in the retina after laser treatment. The rolling of leukocy … More tes along the retinal veins and increased leukocyte entrapment were observed not only in the photocoagulated area but also in the untreated retina. The OCT study showed the development of retinal edema in the untreated area. The temporal increase in the level of VEGF in the retina and choroid was detected. These results suggest that temporal increase in the VEGF in the retina and choroid by scatter photocoagulation enhances retinal leukostasis which leads to development of retinal edema. We also studied the effect of sub-Tenon's injection of triamcinolone acetonide on the enhanced leukocyte-endothelial interaction and retinal edema after scatter retinal photocoagulation in rats. The results suggested that triamcinolne effectively inhibited the rolling and entrapment of leukocytes in the retina and improved the retinal edema after scatter photocoagulation. This supports the use of triamcinolone acetonide for patients with macular edema to prevent the worsening of macular edema after panretinal laser photocoagulation. Less