Clinical Trial Summary
Retinal detachment is a condition with an estimated incidence of between 9.5 and 18.2 cases
per 100,000 individuals.
It is an ophthalmological emergency that threatens visual acuity and requires surgery.
However, despite satisfactory post-operative anatomical results, vitreoretinal proliferation
and photoreceptor death can still have a negative impact on visual prognosis. These
complications are still not fully understood.
A previous study carried out by the Eye, Nutrition and Cell Signalling team at the CSGA,
comparing mouse models of retinal detachment with healthy control retinas, revealed an
increase in pro-inflammatory cytokines and a change in retinal lipid abundance in detached
retinas.
However, these results have yet to be confirmed in humans. Our main hypothesis is that the
vitreous content of omega-3 PUFAs and proteins is altered during the onset of retinal
detachment, since it reflects both intraocular inflammation and photoreceptor apoptosis.
We therefore wish to demonstrate that the protein and PUFA contents of the vitreous humour
are different between eyes with retinal detachment and eyes not affected by retinal
detachment after macular surgery (epiretinal membrane or macular hole). We would like to show
that the vitreous PUFA content is lower in the macular surgery group due to the absence of
photoreceptor apoptosis and the absence of dehiscence causing communication between the
subretinal space (photoreceptors whose membranes are very rich in PUFAs) and the vitreous
space. We also hope to identify changes in the protein composition of vitreous fluid in
patients with retinal detachment, with overexpression of proteins involved in inflammation
pathways.
In addition, we hypothesise that retinal omega-3 PUFA content is a factor influencing
retino-vitreal proliferation and functional and anatomical recovery from retinal detachment.
To this end, we will study the correlation between retinal PUFA-3 content and the clinical
presentation and postoperative course of retinal detachment.
Finally, with the aim of identifying a serum marker for the prognostic evaluation of retinal
detachment, we will use as a candidate a biomarker of retinal omega-3 PUFA content that we
have developed in an Age-Related Macular Degeneration (AMD) model. We will analyse the
correlation between this biomarker and levels of omega-3 PUFAs measured directly in the
retina.
To do this, we will analyse intraoperative samples of vitreous humour, sub-retinal fluid and
retinal fluid from patients undergoing vitrectomy for retinal detachment in the Ophthalmology
Department of the Dijon University Hospital. A group of control patients will consist of
patients operated on by vitrectomy for macular surgery (epiretinal membrane or macular hole)
for whom a vitreous humour sample will also be taken.
Clinical information on the characteristics of the retinal detachment will be collected.
During the consultation, the patient will be questioned about any history of dyslipidaemia
and any current treatment, including the use of lipid-enriched food supplements.
Post-operative follow-up with prospective collection of clinical and paraclinical data on
anatomical and functional evolution will be carried out up to 6 months after the occurrence
of retinal detachment.
A blood sample will be taken to establish a lipid profile in all patients. We will thus gain
a better understanding of the changes in lipid and protein content in the vitreous humour,
sub-retinal fluid and retina, and the demonstration of a link between the initial
presentation and the postoperative anatomical and functional evolution of retinal detachment.
This will provide a better understanding of the lipid-dependent mechanisms linked to
inflammation and photoreceptor degeneration during retinal detachment, and will ultimately
make it possible to develop new therapeutic strategies to improve visual prognosis.
