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Laboratory science
Transthyretin levels in the vitreous correlate with change in visual acuity after vitrectomy
  1. E Van Aken1,
  2. E A De Letter2,
  3. M Veckeneer3,
  4. L Derycke4,
  5. T van Enschot5,
  6. I Geers5,
  7. S Delanghe5,
  8. J R Delanghe5
  1. 1
    Department of Ophthalmology, University Hospital Ghent, Ghent, Belgium
  2. 2
    Department of Forensic Medicine, University Hospital Ghent, Ghent, Belgium
  3. 3
    Rotterdam Eye Hospital, Rotterdam, The Netherlands
  4. 4
    Upper Airway Research Laboratory, University Hospital Ghent, Ghent, Belgium
  5. 5
    Department of Clinical Chemistry, University Hospital Ghent, Ghent, Belgium
  1. Correspondence to Dr E Van Aken, Department of Ophthalmology, University Hospital Ghent, De Pintelaan 185, B-9000 Ghent, Belgium; elisabeth.vanaken{at}


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

Methods: TTR was measured 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 to 24 mg/l) comprised 2.2% of reference values for vitreous protein levels (median 538 mg/l; IQR 269 to 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 to 27 mg/l) than in pseudophakic patients (median 12 mg/l; IQR 8 to 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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  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Ethics approval Ethics approval was provided by the Ethics Committee of University Ghent Hospital, Belgium.

  • Patient consent Obtained.

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