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The causes of retinal hypoxia are many and varied. Under hypoxic conditions, a variety of soluble factors are secreted into the vitreous cavity including growth factors, cytokines, and chemokines. Cytokines, which usually serve as signals between neighboring cells, are involved in essentially every important biological process, including cell proliferation, inflammation, immunity, migration, fibrosis, tissue repair, and angiogenesis. Cytokines and chemokines are multifunctional mediators that can direct the recruitment of leukocytes to sites of inflammation, promote the process, enhance immune responses, and promote stem cell survival, development, and homeostasis. The modern particle-based flow cytometric analysis is more direct, stable and sensitive than the colorimetric readout of the conventional ELISA but, similar to ELISA, is influenced by vitreous hemorrhage, disruption of the blood-retina barrier, and high serum levels of a specific protein. Finding patterns in the expression of inflammatory cytokines specific to a particular disease can substantially contribute to the understanding of its basic mechanism and to the development of a targeted therapy.

Purpose To describe cases of reabsorption of subretinal acquired vitelliform material (acquired vitelliform lesion [AVL]) associated with vitreomacular disorders after 25-gauge pars plana vitrectomy and peeling of internal limiting membrane. Methods Data of consecutive patients who underwent 25-gauge transconjunctival pars plana vitrectomy for vitreomacular disorders at the Department of Ophthalmology of the University Hospital of Brussels (Belgium) were collected. Patients featuring AVL on fundus examination or on spectral domain optical coherence tomography were recruited. Patients were followed up for 12 months after surgery. Results Four eyes of three consecutive white patients presenting AVL were included. Three cases were affected by macular pucker, whereas one case featured vitreomacular traction syndrome. Progressive flattening of the AVL after surgery was observed in three eyes of three patients. One eye did not show any resorption of the submacular accumulation. In two eyes, atrophy of the retinal pigment epithelium and the outer retinal layers was observed along with resolution of the AVL, with significant worsening of visual acuity postoperatively. Conclusion The outcome of surgery in cases of submacular AVL associated with vitreomacular interface syndromes could be heterogeneous and may depend on the duration of the disease and baseline optical coherence tomography characteristics of the lipofuscin accumulation.