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. 1998 Apr;82(4):438–443. doi: 10.1136/bjo.82.4.438

Vitreous intercellular adhesion molecule 1 in uveitis complicated by retinal detachment

L Webster 1, R Stanbury 1, A Chignell 1, G Limb 1
PMCID: PMC1722567  PMID: 9640197

Abstract

AIMS—The vitreous levels of soluble intercellular adhesion molecule 1 (sICAM-1) were investigated in uveitic eyes undergoing vitrectomy for retinal detachment (RD) or other complications, and the presence of this molecule was related to disease activity and vitreous levels of the cytokine tumour necrosis factor α (TNFα), known to upregulate ICAM-1 expression on various cells.
METHODS—Vitreous and serum samples from 23 patients with either active or quiescent uveitis undergoing retinal surgery were examined for the levels of immunoreactive sICAM-1 and TNFα by ELISA methods, and for the presence of biologically active TNFα. Vitreous from non-uveitic eyes with rhegmatogenous retinal detachment (RRD), macular holes or cadaveric eyes were used as controls.
RESULTS—As a whole, vitreous from uveitic eyes complicated or uncomplicated by RRD contained significantly higher levels of sICAM-1 than vitreous from non-uveitic eyes with RRD alone (p < 0.0005), eyes with macular holes (p< 0.0001), or normal cadaveric vitreous (p < 0.0001). The proportion of vitreous containing >20 ng/ml sICAM-1 (> four times the normal values) was significantly higher in eyes with uveitis complicated by RRD than in those eyes without RRD (Fisher's test, p= 0.02), and although levels of sICAM-1 were higher in eyes with active uveitis than in those with quiet disease (p < 0.02), this could not be dissociated from the increase caused by RRD. There was a relation between the vitreous levels of sICAM-1 and those of immunoreactive TNFα (Spearman's correlation coefficient; r = 0.601, p = 0.006), but not between the vitreous levels of sICAM-1 and those of biologically active TNFα.
CONCLUSION—Increased vitreous sICAM-1 levels and the association of this molecule with the presence of immunoreactive TNFα in uveitic eyes confirm the operation of cytokine mediated vascular reactions at the blood-retinal barrier during the development of this condition. The persistence of high vitreous levels of sICAM-1 in eyes with uveitis complicated by RRD despite previous immunosuppression may indicate a low rate of clearance of inflammatory molecules from the vitreous cavity and an exacerbation of the existing inflammatory process by the retinal detachment itself.

 Keywords: vitreous; retinal detachment; ICAM-1; TNFα; uveitis

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Figure 1  .

Figure 1  

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Levels of sICAM-1 in vitreous from eyes with uveitis complicated or uncomplicated by RD are significantly higher than in control cadaveric vitreous (Mann-Whitney U test, *p<0.0001) and vitreous from eyes with macular holes (Mann-Whitney U test, *p<0.0001). The bars represent median values.

Figure 2  .

Figure 2  

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(A) Levels of sICAM-1 in vitreous from patients with uveitis complicated by retinal detachment (▪); patients with other uveitis complications but without retinal detachment (▴ ) and patients with rhegmatogenous retinal detachment alone (• ). (Mann-Whitney U test: uveitis with RD v uveitis without RD *p < 0.02; uveitis with RD v RRD alone *p < 0.0001). The bars represent median values. (B) Levels of sICAM-1 in vitreous from eyes with active uveitis compared with vitreous from eyes with quiet disease. (Mann-Whitney U test *p < 0.02). Uveitis patients with RD (▪) and without RD (▴). The dotted line represents 20 ng/ml sICAM-1.

Figure 3  .

Figure 3  

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(A) Serum levels of sICAM-1 in patients with uveitis (at the time of vitrectomy) compared with those of sex and age matched controls. (Mann-Whitney U test, *p< 0.02). The bars represent median values. (B) Relation between sICAM-1 levels in serum and vitreous from uveitis patients (Mann-Whitney U test, p<0.25, r = −0.39). The solid line represents the linear regression curve of best fit.

Figure 4  .

Figure 4  

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Relation between levels of sICAM-1 and immunologically detectable TNFα in vitreous from 19 patients with uveitis. The solid line represents the linear regression curve of best fit.

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