Vitreous Proteome in Combined Rhegmatogenous Retinal and Choroidal Detachment

Purpose: To review the literature on vitreous analysis in eyes with concurrent rhegmatogenous retinal and choroidal detachment (RRD-CD). Methods: A comprehensive literature search was performed from January 2000 through December 2023 for “rhegmatogenous retinal detachment”, “choroidal detachment”, AND “vitreous.” All English language primary literature was reviewed, and seven studies were found to meet inclusion criteria. Vitreous molecules were categorized by upregulated and downregulated states in RRD-CD eyes compared to controls. The cytokines, chemokines, growth-factors, metabolites, transporter molecules, and other plasma proteins/lipids in the vitreous samples were evaluated in a systematic format to identify pathophysiologic processes involved. Results: Mass spectrometry and immunoassays were most commonly employed for evaluation. Notable dysregulation of the complement cascade (C3a and C5a), immunologic response (sICAM-1, IL-1B, and cellular metabolites), and major inflammatory mediators (MIF and IL-6) was identified and may serve as salient targets. Intravitreal and systemic agents have had mixed success in treating RRD-CD. Utilization of existing modalities and targeting novel factors have not been fully evaluated in RRD-CD. Conclusions: Identification of alterations in levels of vitreous proteins in RRD-CD cases compared to controls highlights disease pathophysiology. Clinical targets exist and additional studies are warranted to improve management of this condition.