Aqueous Composition May Distinguish Patients at Greater Risk for RD Recurrence

Researchers found that patients who experienced recurrent retinal detachment had early alterations of cell adhesiveness pathways detectable at the time of initial repair. Specifically, in the aqueous of these patients, they observed significantly upregulated proteins associated with cell-cell adhesion and extracellular matrix interactions. Photo: Mohammad Rafieetary, OD. Click image to enlarge. Recurrence of rhegmatogenous retinal detachment (RD) is relatively common, occurring in approximately 18% to 22% of patients who undergo primary repair and primarily caused by proliferative vitreoretinopathy. Despite the grim prognosis of many of these patients, to date, there is no established prognostic biomarker or validated therapy. Recently, a pilot study identified a biological marker that may help clinicians predict which RD patients are more likely to develop recurrence during initial repair. Researchers evaluated the proteome—the entire array of synthesized proteins—of aqueous in patients with RD who experienced a recurrence vs. those who did not, finding notable differences in the baseline aqueous composition between the two groups.The study enrolled 24 participants who were undergoing surgical repair for rhegmatogenous RD. Of these, 13 individuals experienced recurrent RD and 11 did not. Participants in each group were matched based on age and sex to control for potential confounding variables, and baseline proliferative vitreoretinopathy grading was similar between groups. Aqueous humor samples were collected from each patient at the onset of their surgical procedures, from which researchers identified more than 800 unique proteins.The results revealed marked differences in the protein profiles between the two patient groups. Specifically, 45 proteins were identified that were exclusive to the recurrent RD group, while 10 were found solely in the no-recurrent RD group. Among the notable findings were proteins associated with cell-cell adhesion and extracellular matrix interactions, which were significantly upregulated in patients who experienced recurrence. For instance, types I and IV collagen, crucial to cell adherence processes, exhibited higher levels in the recurrent group. “The identified proteomic differences represent molecular conditions present at the time of primary detachment and already potentially responsible for the eye's fate,” the researchers explained in their paper. They continued, “This evidence suggests that a concerted and multi-faceted repertoire of proteins responsible for transducing mechanical and structural stimuli to the cell is dysregulated in patients destined to recurrent RD, well before such a re-detachment occurs and even before the (initially successful) primary repair.”While the researchers acknowledge the pilot nature of their study, this data suggests “the unprecedented possibility of identifying at the time of primary repair the eyes destined, or more prudently at higher risk for recurrent RD, which, potentially, would allow a selective targeted treatment to minimize such occurrence,” they concluded.Click here for the journal source. Zingale GA, Giammaria S, Pandino I, et al. Can aqueous proteomics predict the recurrence of rhegmatogenous retinal detachment? Retina. January 26, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.