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Transthyretin levels in the vitreous correlate with change in visual acuity after vitrectomy
  1. Elisabeth H Van Aken1,
  2. Els A De Letter1,
  3. Marc Veckeneer2,
  4. Lara Derycke1,
  5. Tamara Van Enschot1,
  6. Ilona Geers1,
  7. Sigurd Delanghe1,
  8. Joris R Delanghe1
  1. 1 University Hospital Ghent, Belgium;
  2. 2 Oogziekenhuis Rotterdam, Belgium
  1. * Corresponding author; email: elisabeth.vanaken{at}


Background/aim: Little is known about biochemical markers related to change in visual acuity after vitrectomy. We investigated the potential use of transthyretin (TTR), a carrier of the retinol/retinol-binding protein, as a biochemical marker protein.

Methods: We measured TTR using immunonephelometry in a group of patients (n=77) in longstanding (> 1 week) retinal detachment (n=29), fresh (< 1 week) retinal detachment (n=17), macular holes (n=20), or diabetic retinopathy (n=11). Vitreous samples were taken at the start of every vitrectomy procedure. For reference values, cadaver specimens (n=73) were used.

Results: Reference values for vitreous TTR (median 18 mg/l; IQR 4-24 mg/l) comprised 2.2% of reference values for vitreous protein levels (median 538 mg/l; IQR 269-987 mg/l). Vitreous TTR values of patients were comparable in all disorders. Vitreous TTR values were higher in phakic (median 22.5 mg/l; IQR 10-27 mg/l) than in pseudophakic patients (median 12 mg/l; IQR 8-19 mg/l)(p=0.06). Postoperative change in visual acuity correlated well with vitreous TTR values found peroperatively (rs=0.408; p=0.012). Both change in visual acuity and lens status were the only variables which proved to explain the variance of TTR (multiple correlation coefficient: 0.494; phakic status: t=2.767; p=0.0084; and change in visual acuity t=2.924: p=0.0056).

Conclusion: Vitreous fluid concentrations of TTR can be regarded as a biochemical marker for retinal function.

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