Efficacy of Glucocorticoids in the Treatment of Retinal Detachment With Choroidal Detachment: Analysis by Proteomics.

Purpose: Glucocorticoids are widely used for their anti-inflammatory properties, but their specific molecular mechanisms in treating rhegmatogenous retinal detachment with choroidal detachment (RRDCD) remain unclear. This study aims to identify key regulatory factors in the vitreous humor of RRDCD patients and analyze protein changes after hormonal intervention.

Methods: Vitreous fluid samples were collected during surgery from patients with rhegmatogenous retinal detachment (RRD, n = 40), non-glucocorticoid treated RRDCD (nT-RRDCD, n = 35), and glucocorticoid-treated RRDCD (T-RRDCD, n = 32). Primary outcomes were retinal reattachment status and best-corrected visual acuity (BCVA) at 6 months postoperatively. Proteomic analysis was performed using data-independent acquisition (DIA), with differentially expressed proteins validated by parallel reaction monitoring (PRM) and ELISA.

Results: Between RRD and nT-RRDCD, 203 differentially expressed proteins were identified, while 295 proteins were differentially expressed between nT-RRDCD and T-RRDCD. These proteins were involved in complement activation, immune response, blood coagulation, and MAPK signaling. Apolipoprotein D (APOD) and vitronectin (VTN) positively correlated with postoperative BCVA. APOD, serum amyloid A-4 (SAA4), and ubiquitin-conjugating enzyme E2 variant emerged as potential diagnostic biomarkers for RRDCD.

Conclusions: RRDCD development involves multiple factors. Glucocorticoids mitigate retinal damage by suppressing inflammation, regulating oxidative stress, and promoting cell repair. APOD and VTN correlate with BCVA, while APOD, SAA4, and ubiquitin-conjugating enzyme E2 show promise as diagnostic biomarkers for RRDCD.