Injection Of Sodium Hyaluronate Research Articles

Sodium Hyaluronate Improves Outcomes After Arthroscopic Lysis and Lavage in Patients With Wilkes Stage III and IV Disease

Among patients with Wilkes stage III and IV disease undergoing arthroscopic lysis and lavage, does the use of an intra-articular injection of sodium hyaluronate (SH), when compared with Ringer lavage, result in better postoperative pain control and temporomandibular joint (TMJ) function? We designed and implemented a randomized, double-blind, pilot controlled clinical trial. The study sample was composed of patients with middle Wilkes stage (late stage III and early stage IV) disease. Subjects were randomized to 1 of 2 treatment limbs. The treatment group received Ringer lactate plus an injection of 1 mL of SH after arthroscopy, whereas the control group was given Ringer lactate during arthroscopy. The primary outcome variables were pain and TMJ function measured by use of visual analog scales. Appropriate descriptive and bivariate statistics were computed. A P value less than .05 was considered statistically significant. The study sample was composed of 40 patients with 20 subjects enrolled in both treatment groups. There were no statistically significant differences between the 2 groups in terms of demographics and preoperative variables. Postoperative analgesia was statistically significant in the treatment group with respect to the control group on the visits on days 14 and 84. No statistically significant differences were observed between the 2 groups in the maximum interincisal opening and tolerance. An intra-articular injection of SH after arthroscopic lysis and lavage is effective in reducing pain in patients with TMJ dysfunction, enhancing postsurgical recovery. The analgesic effect of treatment with SH is maintained in the long term.

Does Osteoarthritis Of The Knee Also Have A Psychogenic Component? Psycho-emotional Treatment With a Radio-electric Device vs. Intra-articular Injection Of Sodium Hyaluronate: An Open-label, Naturalistic Study

This study is to compare, in patients suffering of knee joint disorder, the effects of intra-articular injection of Sodium Hyaluronate, and those of a treatment aiming at the improvement of the emotional status carried out by means of a Radio Electric Device (REAC). 30 subjects were divided into two groups: 15 who preferred a non-drugs approach (Group A) and 15 who preferred an infiltrative treatment (Group B). The evaluations were expressed for both pain level and knee bending and extension. Group A showed significant decrease in pain, stiffness, joint noises and intra-articular effusion, and significant improvement in motion range, without any patients worsening. 8 patients showed complete disappearance of pain in Visual Analog Pain Scale (VAS) evaluation, evident by a level of 0. The initial VAS results were between 8 and 4. One month after treatment's end, VAS results of the patients in Group A were between 3 and 0. Group B showed significant decrease in pain, stiffness, joint noises and intra-articular effusion, but no significant improvement in motion range; 2 of 15 patients showed worsening symptoms and no significant improvement in muscular hypotrophy. Initial VAS results were between 7 and 4. One month after treatment's end, VAS results were between 6 and 0.

Clinical and biochemical characteristics after intra-articular injection for the treatment of osteoarthritis of the knee: prospective randomized study of sodium hyaluronate and corticosteroid

BackgroundIntra-articular injections of sodium hyaluronate (Na-HA) and corticosteroid (CS) are often used for the treatment of osteoarthritis (OA), and the clinical usefulness of such treatment has been reported. Some studies have discussed the effectiveness of intra-articular drug injection therapy in terms of the clinical results, but no cohort studies have performed evaluations of effectiveness based on changes in joint biomarkers. This prospective randomized study compared the efficacy of Na-HA and CS injections based on clinical scores and levels of biochemical markers for osteoarthritis. MethodsA total of 51 patients with knee osteoarthritis received intra-articular injections of either Na-HA or CS and were followed for 6 months after treatment. Pain and inflammatory scores were evaluated at the baseline, at 5 weeks, and at 6 months. We also measured joint fluid levels of hyaluronan (HA), chondroitin 6-sulfate, chondroitin 4-sulfate, matrix metalloproteinase (MMP)-9, and tissue inhibitor of MMP (TIMP)-1 at the baseline and at 5 weeks. ResultsIn both groups, injection therapy significantly improved pain/inflammation scores and visual analog scale scores with time (P < 0.01). HA levels were significantly increased after injection only in the Na-HA group (P < 0.05); and the MMP-9 level decreased significantly after injection only in the Na-HA group (P < 0.01). Other marker levels did not differ significantly between groups. ConclusionsThe results of this prospective randomized study suggest that the clinical effects of Na-HA and CS as local therapies for OA are comparable and that both drugs are useful. Considering the results of the measurement of biomarkers, compared with CS injection therapy Na-HA injection therapy may have protective effects on the articular cartilage by increasing the HA concentration in synovial fluid, as well as inhibitory effects on the catabolism of articular cartilage by reducing the MMP-9 concentration.

Effect of sodium hyaluronate treatment on rotator cuff lesions without complete tears: A randomized, double-blind, placebo-controlled study

A randomized, double-blind, placebo-controlled study of sodium hyaluronate (ARTZ Dispo) treatment was performed in 51 patients with rotator cuff lesions without complete tears. We hypothesized that ARTZ Dispo would render better results than the placebo. Twenty-five patients (ARTZ Dispo group) had injections of 25 mg/wk of sodium hyaluronate into the subacromial bursa for 5 consecutive weeks. Twenty-six patients (placebo group) were given 2.5 mL of normal saline solution with the same injection protocol as the ARTZ Dispo group. No significant difference in age, height, weight, gender, vocation, involved shoulder, duration of symptoms, baseline Constant score, or visual analog scale (VAS) score existed between the 2 groups. The 2 groups did not significantly differ with regard to Constant scores, VAS scores, or global improvement assessments 1 week after injections. The ARTZ Dispo group had a better Constant score (P = .0095) and VAS score (P = .0018) than the placebo group 6 weeks after treatment. Patients in the placebo group were given 5 sodium hyaluronate injections, rather than placebo, after disclosure of the blind list, if they wished. Forty-one patients who underwent hyaluronate injection exhibited a significantly improved Constant score, from 64.0 +/- 11.7 at baseline to 88.9 +/- 10.4 (P < .0001), and a significantly improved VAS score, from 6.4 +/- 1.3 to 1.5 +/- 1.6 (P < .0001), at a mean follow-up of 33.1 months. No significant adverse effect was noted. Subacromial injections of sodium hyaluronate are effective in treating rotator cuff lesions without complete tears.

Randomized Controlled Trial for Efficacy of Intra-Articular Injection for Adhesive Capsulitis: Ultrasonography-Guided Versus Blind Technique

Lee H-J, Lim K-B, Kim D-Y, Lee K-T. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique. Objective To evaluate the clinical effect of ultrasonography (US)-guided intra-articular injections compared with a blind (unguided) technique for the treatment of adhesive capsulitis. Design Randomized controlled trial. Setting Outpatient rehabilitation clinic. Participants Patients (N=43) diagnosed as having adhesive capsulitis after clinical examinations and radiologic and ultrasonographic study. Intervention Under either US-guided or a blind technique, patients received a 20-mg intra-articular injection of triamcinolone mixed with 1.5mL 2% lidocaine and 4mL normal saline in the first week followed by 5 weekly injections of sodium hyaluronate. Main Outcome Measures A visual analog scale for pain intensity, range of motion (ROM) of the shoulder (flexion, abduction, external rotation, and internal rotation), and general shoulder function during daily activities at preinjection as a baseline and then every week after injection for 6 weeks for each patient. Results Twenty patients out of 22 in the blind injection group and 20 out of 21 in the US-guided group finished the entire 6-week study period. The improvement in pain intensity, ROM, and shoulder function score was significantly greater in the US-guided injection group than in the blind injection group by the second week postinjection ( P<.05). However, there were no further significant differences in the improvement between the 2 groups beyond the third week. Conclusions US-guided intra-articular injections may offer advantages over a blind technique for the treatment of adhesive capsulitis and may deliver clinical benefits during the first few weeks of treatment. This finding suggests that the improved targeting to the intra-articular space by using US can result in better treatment of adhesive capsulitis.

Retinal Oxidative Stress Induced by Intraocular Hypertension in Rats May be Ameliorated by Brimonidine Treatment and N-acetyl Cysteine Supplementation

To investigate the effect of brimonidine and N-acetyl cysteine (NAC) on retinal oxidative status under ocular hypertension. Ocular hypertension is produced in right eyes of 60 rats through intraocular injection of sodium hyaluronate. The left eyes received intracameral saline as sham. Twenty right eyes (brimonidine group) received topical brimonidine twice a day for a week. Other 20 eyes received intraperitoneal NAC (NAC group) once a day. Another group of 20 eyes were followed without any drugs but only intracameral sodium hyaluronate (sodium hyaluronate group) into right eyes. Intraocular injection of sodium hyaluronate increased intraocular pressure for a week and caused retinal peroxidation and decreased glutathione peroxidase and catalase levels. Brimonidine and NAC treatment reversed the retinal oxidative stress created by high intraocular pressure. Brimonidine and NAC supplementation provide antioxidative properties to retina and decrease retinal damage induced by ocular hypertension.

Minocycline Inhibition of Photoreceptor Degeneration

To determine whether systemic minocycline can protect photoreceptors in experimental retinal detachment (RD). Retinal detachment was induced in mice by subretinal injection of sodium hyaluronate, 1.4%. In 1 experiment, mice received daily injections of minocycline (group 1) or saline (group 2). In a second experiment, mice were treated with minocycline or saline beginning 24 hours prior, immediately after, or 24 hours after experimental RD. In both experiments, photoreceptor cell survival and apoptosis were assessed by immunohistochemistry with primary antibodies against photoreceptor cell markers, rod rhodopsin, and cone opsin, and by terminal deoxynucleotidyl transferase-mediated dUTP-biotin end labeling. Photoreceptor cell apoptosis was detected at day 1 after experimental RD, with apoptotic cells peaking in number at day 3 and dropping by day 7. Treatment with minocycline significantly reduced the number of apoptotic photoreceptor cells associated with RD when given 24 hours before or even 24 hours after RD. Our data suggest that minocycline may be useful in the treatment of photoreceptor degeneration associated with RD, even when given up to 24 hours after RD. Use of minocycline in patients with macula-off RD may prevent photoreceptor apoptosis and glial cell proliferation, improving final visual outcomes.

Intra-articular sodium hyaluronate injections in the osteoarthritic ankle joint: Effects, safety and dose dependency

To determine the efficacy, safety and dose dependency of intra-articular Orthovisc(®) hyaluronic acid injections in the ankle. A prospective single blinded study in patients with symptomatic ankle-osteoarthritis. Patients were randomly allocated to 1, 2, 3 ml, or 3 weekly injections of 1 ml (3 × 1 ml). Primary outcome was 'pain during walking' at 15 weeks measured on a 100mm VAS. Twenty-six patients (ITT) participated. The 3 × 1 ml dose group showed statistically significant decreases at week 7 for 'pain during walking' and 'pain at rest' (p=0.046). At week 15 decreases were significant for 'pain at rest' (p=0.046). There was no significant decrease of VAS-scores in any of the single dose groups. Seven patients experienced temporary local swelling and increased pain in the injected ankle. Orthovisc(®) viscosupplementation in the ankle joint is effective and well tolerated. The 3 × 1 ml dose regimen shows the best results.

Observation of the curative effects of Dahuoluo capsule combined with Sodium Hyaluronate on knee osteoarthritis

Objective To study the curative effects of Dahuoluo capsule combined with Sodium Hyaluronate injection on knee osteoarthritis.Methods 62 cases of patients with knee osteoarthritis,average age of 61 years old,were treated with 1.0 g Dahuoluo capsule three times a day by oral administration for 5 weeks and 2 ml Sodium Hyaluronate once a week by injection into the osteoarthritie knee for 5 weeks.Joint pain at rest and activity,tenderness over the joint,joint swelling and movement range were observed and compared before and after treatment by self.Results After 5 week treatment,joint pain at rest and activity,tenderness over the joint,joint swelling and movement range were all improved significantly(P＜0.01),with the efficiency rates over 83%.Conclusion Dahuoluo capsule combined with Sodium Hyaluronate injection shows significant curative effects on knee osteoarthritis. Key words: Dahuoluo capsule; Sodium Hyaluronate; Knee osteoarthritis

Hylan G-F 20 Has Better Pain Relief and Cost-effectiveness than Sodium Hyaluronate in Treating Early Osteoarthritic Knees in Taiwan

Intra-articular injection of hyaluronan (hyaluronic acid; HA) products is available to treat early osteoarthritis (OA) of the knee in Taiwan. We tested whether HA products with different molecular weights have significantly different effects on clinical efficacy and cost-effectiveness. Thirty-seven patients with mild to moderate OA of both knees underwent five weekly intra-articular injections of sodium hyaluronate (Artz) in one knee and three weekly intra-articular injections of chemically cross-linked Hylan G-F 20 (Synvisc) in the other. Visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne's index, and Hospital for Special Surgery (HSS) knee scores were compared initially and at the last injection, and at 8, 12, 16, 20, and 26 weeks after the first injection. VAS, WOMAC, WOMAC-A1 (pain when walking on a flat surface) scores before week 16, HSS scores before week 12, and Lequesne's index scores except at week 26 all showed that HA significantly improved the scores time-dependently. In VAS scores, Synvisc showed better improvement before week 20, while this effect appeared at week 12 for the WOMAC-A1 scores. The incremental cost-effectiveness ratio of the Taiwan National Health Insurance Program, of the patient, and both of these was lower for Synvisc, which also reduced the number of additional hospital visits for injections by two. Synvisc possesses better symptom-modifying ability and cost-utility in treating early OA of the knee in Taiwan.

Viscoanaesthesia in cataract surgery: a prospective, randomized clinical trial

We aimed to compare viscoanaesthesia (VisThesia) with intracameral lidocaine in cataract surgery carried out under topical anaesthesia. In this prospective study 98 patients were randomly assigned to receive VisThesia (group 1, n = 49) or 0.5 cc of 1% unpreserved lidocaine (group 2, n = 49). All surgery was carried out by one surgeon using clear corneal technique. Pachymetry, the status of the cornea and anterior chamber, and intraocular pressure (IOP) were checked pre- and postoperatively. Mean pain scores were 0.12 (maximum: 3) in group 1 and 0.37 in group 2; the difference between the groups was not statistically significant (95% confidence interval [CI] 0.003-0.487; p = 0.05). A total of 48 patients in group 1 (98%) and 49 in group 2 (100%) reported no discomfort or only mild discomfort. No significant differences in flare and cells in the anterior chamber or IOP were found between the two study groups. There was a significantly greater frequency of corneal oedema in group 1 (p = 0.001). Postoperative central corneal thickness values were also significantly higher in group 1 (95% CI 11.64-57.24; p = 0.003). Results suggest that viscoanaesthesia provides a level of comfort during cataract surgery under topical anaesthesia similar to that facilitated by intracameral lidocaine. However, patients who are given viscoanaesthesia may have increased risk for postoperative corneal oedema.

Effects of hyaluronan on vascular endothelial growth factor and receptor-2 expression in a rabbit osteoarthritis model

BackgroundLittle is known about the expression of vascular endothelial growth factor (VEGF) and its receptor-2 (VEGFR-2) mRNA in the cartilage of a rabbit osteoarthritis model or the influence of intraarticular injection of hyaluronan (HA) on the expression of VEGF and VEGFR-2 in cartilage during the process of osteoarthritis (OA). The therapeutic mechanism of HA is not completely understood, and we hypothesize that the mechanism is through the effects of VEGF and VEGFR2. In this study, we determined the VEGF and VEGFR-2 mRNA expression in a rabbit OA model and assessed the therapeutic mechanism of HA against OA. MethodsWe carried out this study at the Center Laboratory of Renmin Hospital at Wuhan University and the Key Laboratory of Respiratory Disease of the Ministry of Public Health, Huazhong university of Science and Technology. Between October 2006 and April 2008a total of 24 mature New Zealand white rabbits were divided into three groups: normal controls, a no-HA group, and an HA group. The no-HA and HA groups underwent unilateral anterior cruciate ligament transection. At 4 weeks after the operation, animals in the HA group received intraarticular injections of 1% sodium hyal-uronate (HA) once a week for 5 weeks as per the clinical treatment presently utilized. The no-HA rabbits were not given HA. At death, 11 weeks following surgery, cartilage was harvested and total RNA was extracted. VEGF and VEGFR mRNAs were analyzed using the reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR for each group. ResultsCartilage damage (both extent and grade) was less severe in the HA group than in the no-HA group. VEGF and VEGFR-2 mRNA expression was enhanced in the cartilage of the OA model. Intraarticular 1% sodium hyaluronate injection inhibited VEGFR-2 expression but had no effect on reducing the VEGF mRNA expression in cartilage. ConclusionsThese results suggested that VEGF and VEGFR-2 may be involved in the progression of OA and in the therapeutic mechanism of HA at least partly through the

Validity of tumour necrosis factor as a biomarker for joint disease

Background and Objectives: Tumour necrosis factor alpha (TNF-α) is a potent proinflammatory cytokine produced by several cell types. It has been detected in the synovium and synovial fluid of patients with internal derangements of the temporomandibular joint (TMJ). The objectives of this study was to detect soluble tumour necrosis factor receptors in synovial fluids aspirates from temporomandibular joints with internal derangements after arthrocentesis with injection of sodium hyaluronate or cyclooxygenase-2 inhibitor in patients suffering from temporomandibular joint internal derangements.

The efficacy of arthroscopic surgery for the treatment of moderate osteoarthritis of the knee

Objective To identify the effectiveness of arthroscopic debridement(AD) in moderate knee OA on pain and function. Methods 87 patients with moderate degenerative osteoarthritis of knees diagonocised according to ARA,were randomly assigned to two groups:43 patients in therapy group were subjected to AD in combine with sodium hyaluronate injection and physiotherapy,44 patients in the control group only received so-dium hyaluronate injection and physiotherapy. The relief of joint pain, swell, fluidity, and the improvement of joint range of motion before and after the treatment were evaluated by score of Lysholm. Results There is no si-ganificant different between in the therapy group and the control group in the score of Lysholm(P<0.05). Con-clusion The sodium hyaluronate injection combined with physiotherapy can relieve clinical symptoms and im-prove joint function in the patients with moderate degenerative osteoarthritis of knees, arthroscopic surgery for moderate osteoarthritis of the knee provides no additional benefit to optimized physical and HA therapy. Key words: Moderate osteoarthritis of knees; AD; Sodium hyaluronate; Intraarticular injection; Physio-therapy

Intraarticular Hyaluronic Acid Injection for the Treatment of Reducing and Nonreducing Disc Displacement of the Temporomandibular Joint

Temporomandibular dysfunction (TMD) has been established as a therapeutic challenge in the plastic and maxillofacial clinics. The current treatment recommendations for TMD include resting the jaw, soft diet, and pain medication with nonsteroidal analgesic agents. If conservative and noninvasive techniques do not work, more invasive techniques may be considered. The main goal of this study was to assess the safety and clinical utility of intraarticular injection of sodium hyaluronate for the treatment of symptoms associated with internal derangement of the temporomandibular joint (TMJ). In this prospective study, 40 TMJs of 33 patients who have TMD were treated with intraarticular sodium hyaluronate injections at weekly intervals for 3 weeks. Pre- and postinjection pain intensity, the presence of joint sounds, and interincisial distance were documented. The follow-up period was 12 months. There was a statistically significant reduction of pain intensity (P < 0.01) and joint sound (P < 0.05) in all patients. This study shows that intraarticular hyaluronic acid injection for the treatment of reducing and nonreducing disc displacement of TMJ is an effective and safe management.

Comparison of therapeutic effects of sodium hyaluronate and corticosteroid injections on trapeziometacarpal joint osteoarthritis

This was a randomized, open-label, evaluator-blinded clinical study including 40 women with stage II or III trapeziometacarpal joint osteoarthritis. The steroid group (n = 20) received one injection of 20 mg triamcinolone acetonide once and the hyaluronate group (n = 20) received three injections of 5 mg sodium hyaluronate at 1-week intervals. The pain level was assessed using a visual analog scale and grip and pinch strengths were measured using a hand grip dynomemeter and pinch gauge. The Duruöz Hand Index was used to evaluate hand function. Pain level decreased significantly over 12 months for the steroid group and over 6 months for the sodium hyaluronate group. Pinch strength did not improve in either group, but grip strength improved significantly in both groups. Hand function improved in both groups but it was only significant in the steroid group. Our findings showed that both intra-articular injection of steroid and sodium hyalurunate are effective in trapeziometacarpal joint osteoarthritis. However the steroid injection was found to be superior to sodium hyaluronate injection in reducing pain and improving hand function.

A Randomized Controlled Trial of Superior and Inferior Temporomandibular Joint Space Injection With Hyaluronic Acid in Treatment of Anterior Disc Displacement Without Reduction

To compare the outcome of inferior and superior joint space injection of sodium hyaluronate in patients with disc displacement without reduction of the temporomandibular joint (TMJ). One hundred twenty patients with disc displacement without reduction of TMJ were randomized into 2 experimental groups. One group of patients received superior joint space injections of sodium hyaluronate and the other group was treated with inferior joint space injections. Patient's TMJ status and clinical symptoms were evaluated at the 3 and 6 month follow-up appointments. The clinical parameters recorded were maximal mouth opening (MMO), pain intensity on a visual analog scale (VAS), and modified Helkimo's clinical dysfunction index and analyzed with ANCOVA. Fifty of the superior and 54 of the inferior joint space injection therapy group returned for the 3 and 6 month evaluations; 86.67% of the patients were retained in the follow-up. MMO, VAS, and Helkimo's index of both groups improved at the 3 and 6 month follow-ups. The results of MMO changes and TMJ function were almost the same in both groups at 3 month follow-up. However, there was a significant reduction in TMJ pain in the inferior joint injection group at 3 month follow-up compared with the superior joint injection group (P< .001). There were also significant differences between the inferior joint injection group and superior joint injection group in MMO (P< .005), VAS (P< .001), and Helkimo's index (P< .001) at 6 month follow-up. This study showed that inferior joint space injection with sodium hyaluronate is a valid method of treating disc displacement without reduction of TMJ and a long-term study will be needed to assess the effect of inferior joint injection on the morphologic changes of the TMJ.

The Protective Effect of Sodium Hyaluronate on the Cartilage of Rabbit Osteoarthritis by Inhibiting Peroxisome Proliferator-Activated Receptor-Gamma Messenger RNA Expression

PurposeThe purpose of this study was to study the protective effect and influence of sodium hyaluronate (Na-HA) on mRNA expression of peroxisome proliferators-activated receptor gamma (PPAR-γ) in cartilage of rabbit osteoarthritis (OA) model.Materials and MethodsForty eight white rabbits were randomly divided into A, B, and C groups. Group A was normal control group, B and C groups underwent unilateral anterior cruciate ligament transection (ACLT). The rabbits in group B were injected normal saline after ACLT; and Group C received intraarticular1% sodium hyaluronate (HA) injection 5 weeks after surgery, 0.3 mL once a week. At 11th week after surgery, all the rabbits were sacrificed. The cartilage changes on the medial femoral condyles were graded separately. Cartilage sections were stained with safranin-O and HE, and messenger RNA (mRNA) expression of PPAR-γ was detected by using real time polymerase chain reaction (Real Time-PCR).ResultsCartilage degeneration in group B was significantly more severe than in A and C injection group. The grey value of Safranin-O of B group was higher than A and C groups. Expression of PPAR-γ mRNA in group B was higher than group A and C.ConclusionThis study shows that Na-HA has a protective effect on articular cartilage degeneration, and the inhibitory effect on the PPAR-γ mRNA expression may be one of therapeutic mechanism of Na-HA.

Poster 231: Comparison of Sono-Guided Intraarticular Injection of Triamcinolone and Sodium Hyaluronate in Patients With Adhesive Capsulitis of the Shoulder

Objective: To compare the effects of sono-guided intraarticular injection of triamcinolone and sodium hyaluronate in patients with adhesive capsulitis of the shoulder. Design: Randomized clinical trial. Setting: Physical medicine and rehabiliation department of Sanggye Paik Hospital. Participants: 38 patients with adhesive capsuitis of the shoulder were selected as study subjects. Interventions: Patients with adhesive capsuitis of the shoulder were selected as study subjects and assigned randomly into 2 groups, group A and B.

Ceramide production associated with retinal apoptosis after retinal detachment

During retinal detachment, premature apoptosis of photoreceptors and a loss of optimally corrected visual acuity occur. We hypothesized that retinal cell death and generation of ceramide, a pro-apoptotic lipid, would progress as a function of time following experimental retinal detachment, and undertook to define the appropriate temporal window. Unilateral retinal detachment was induced in white New Zealand rabbits by subretinal injection of sodium hyaluronate. In experimental animals, we injected sphingosine-1-P into the vitreous 2 hours before retinal detachment. Both eyes were removed on days 1, 3 and 6 for histological and biochemical examination. The number of photoreceptors was counted in section, the level of apoptosis was assessed using the TUNEL assay, and the production of ceramide was analyzed in situ with immunohistochemistry. The concentration of ceramide was also determined on retinal homogenates using a diacylglycerol kinase assay. We confirmed that the average number of live photoreceptors decreased gradually after retinal detachment. In eyes pre-treated with sphingosine-1-P the number of apoptotic photoreceptors was significantly lower. The proportion of apoptotic photoreceptors (14%) remained constant as a function of time in the window studied. As compared to controls, the detached retina showed intense ceramide immunostaining that was prominent in the photoreceptors, but also present to a lesser extent in other retinal layers. The total concentration of intra-retinal ceramide increased by 40% on the first day and continued augmenting through the sixth day after retinal detachment. Retinal apoptosis during experimental retinal detachment is associated with in vivo production of ceramide.