Electrolyte, Nitric Oxide and Oxidative Stress Levels of Aqueous Humor in Patients with Retinal Detachment and Silicone Oil Tamponade

<b>Purpose</b>: To enlighten the pathogenesis of silicone oil (SiO)-related complications via measuring aqueous humor levels of electrolytes, nitric oxide (NO), and oxidative stress in SiO, retinal detachment (RD), and control groups. <b>Materials and Methods</b>: In this prospective study, 56 patients were grouped as SiO (<i>n</i> = 29), RD (<i>n</i> = 12), and control (<i>n</i> = 15). The results of pre- and post-operative ophthalmological examinations, aqueous humor electrolyte and NO levels, total antioxidant and oxidant status (TAS, TOS) and oxidative stress index (OSI) were analyzed. <b>Results</b>: SiO group had a higher mean Na⁺ level compared to controls (144.77 ± 11.48 vs 137.56 ± 6.57 mmol/kg, <i>p</i> = .02). Also, the mean Na⁺ and Cl⁻ levels of RD group were higher than controls (149.04 ± 12.05 vs. 137.56 ± 6.57 mmol/kg, <i>p</i> = .02, 115.2 ± 7.79 vs 106.23 ± 8.99 mmol/kg, <i>p</i> = .031 for Na⁺ and Cl⁻, respectively). The mean NO level of RD group was higher than that of SiO group (51.07 ± 19.56 vs. 34.07 ± 13.84 μM, <i>p</i> = .009). The mean TAS and TOS were lower in SiO group compared to controls (1.92 ± 0.64 vs. 2.49 ± 0.56 μmolTroloxEqv./L, <i>p</i> = .021, 34.98 ± 26.55 vs. 61.46 ± 22.69 μmolH₂O₂Eqv./L, <i>p</i> = .004 for TAS and TOS, respectively). Intraocular retention time of SiO demonstrated positive correlation with post-operative visual acuity (logMAR) and negative correlation with TOS. <b>Conclusions</b>: Elevated aqueous humor Na⁺ and Cl⁻ in RD patients might reflect abolished function of ion channels on detached retina. Increased Na⁺ and lack of NO response to elevated intraocular pressure in SiO-filled eyes might contribute to secondary cataract and glaucoma formation. SiO is associated with low levels of oxidative stress in aqueous humor; however, increased intraocular retention time of SiO is related to a poor visual outcome.

<b>研究目的</b>：本研究旨在通过检测硅油（silicone oil, SiO）组、视网膜脱离（retinal detachment, RD）组与对照组患者房水中的电解质、一氧化氮（nitric oxide, NO）水平以及氧化应激状态，阐明硅油相关并发症的发病机制。<b>材料与方法</b>：本前瞻性研究共纳入56例患者，分为硅油组（<i>n</i> = 29）、视网膜脱离组（<i>n</i> = 12）与对照组（<i>n</i> = 15）。对所有受试者的术前及术后眼科检查结果、房水电解质与一氧化氮水平、总抗氧化能力与总氧化能力（total antioxidant and oxidant status, TAS、TOS）以及氧化应激指数（oxidative stress index, OSI）进行分析。<b>研究结果</b>：硅油组的平均钠离子（Na+）水平高于对照组（144.77 ± 11.48 vs 137.56 ± 6.57 mmol/kg，<i>p</i> = 0.02）。此外，视网膜脱离组的平均钠离子与氯离子（Cl−）水平亦高于对照组（钠离子：149.04 ± 12.05 vs 137.56 ± 6.57 mmol/kg，<i>p</i> = 0.02；氯离子：115.2 ± 7.79 vs 106.23 ± 8.99 mmol/kg，<i>p</i> = 0.031）。视网膜脱离组的平均一氧化氮水平高于硅油组（51.07 ± 19.56 vs 34.07 ± 13.84 μM，<i>p</i> = 0.009）。与对照组相比，硅油组的总抗氧化能力与总氧化能力均更低（总抗氧化能力：1.92 ± 0.64 vs 2.49 ± 0.56 μmolTrolox等效物/L，<i>p</i> = 0.021；总氧化能力：34.98 ± 26.55 vs 61.46 ± 22.69 μmolH₂O₂等效物/L，<i>p</i> = 0.004）。硅油的眼内留存时间与术后最小分辨角对数（logMAR）视力呈正相关，与总氧化能力呈负相关。<b>研究结论</b>：视网膜脱离患者房水中升高的钠离子与氯离子水平，可能反映了脱离视网膜上的离子通道功能丧失。硅油填充眼内升高的钠离子水平以及一氧化氮对眼压升高的应答缺失，可能参与了继发性白内障与青光眼的形成。硅油与房水中较低的氧化应激水平相关，但硅油的眼内留存时间延长与不良视力预后相关。