INVESTIGATIONS INTO HYALURONIC ACID AND HYALURONIDASE IN THE SUBRETINAL FLUID IN RETINAL DETACHMENT, PARTLY DUE TO RUPTURES AND PARTLY SECONDARY TO MALIGNANT CHOROIDAL MELANOMA: Preliminary Report Suggesting a New Hypothesis Concerning the Pathogenesis of Retinal Detachment

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Abstract
The subretinal fluid was examined for hyaluronic acid and hyaluronidase by a viscosimetric technique in 17 cases of retinal detachment. Hyaluronic acid was present in all 12 cases of serous detachment. It was absent in 2 cases of detachment undergoing a 2d operation, in 1 case of detachment due to an exudative retinopathy and in 2 cases of detachment due to malignant melanomata of the choroid. No hyaluronidase was found in any case. It is postulated that in cases of serous retinal detachments with hole formation the initial retinal lesion may be an allergic vascular reaction resulting in (1) an area of ischemia with consequent tissue necrosis and hole formation, and (2) a liberation of hyaluronidase which produces partial depolymerization of the hyaluronic acid in the related vitreous. The attenuated vitreous traverses the retinal rupture and constitutes the subretinal fluid.

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