My Journey of Retinal Detachment

Taiji SakamotoJapan Speaker My journey of retinal detachmentIn the 1990s, I began studying retinal detachment (RD) as a model for neuronal degeneration, particularly apoptosis. I discovered that necrotic retinal cells release highly toxic substances, but the vitreous body neutralizes them. Taking advantage of this, we developed a vitreous surgery method using hyaluronic acid. Subsequently, I worked as a surgeon to treat RD. At that time, vitreous surgery was extremely challenging because we could not visualize the retina or vitreous during surgery. Observing success in simplifying ILM peeling with ICG staining, I developed a method to visualize the vitreous using triamcinolone. Lacking knowledge about patents (At that time, we were already using this method), I initially let another doctor publish the first report, but later we conducted a prospective comparative study demonstrating that triamcinolone-assisted vitrectomy made the surgery safer. Our group then developed a safer vital dye called brilliant blue, which is now used worldwide. While surgical techniques improved, the subjective nature of surgery made objective assessment difficult. To address this issue, I believed a national retinal RD was necessary and established the Japan RD Registry to collect data. Our findings revealed the reality of RD treatment in Japan, including a significant result that in more conservative regions, women were less likely to undergo surgery. This highlighted the need for societal intervention to ensure all patients receive care. Despite my efforts to avoid social activities by focusing on basic medicine and RD treatment, I concluded that improving society was essential to effectively treat RD.