道诺霉素脂质体防治实验性增殖性玻璃体视网膜病变

采用巨噬细胞诱发的增殖性玻璃体视网膜病变模型，评价了抗代谢药道诺霉素及其脂质体的防治效果。在兔眼玻璃体注入巨噬细胞后，再分别注入5μg 道诺霉素（40眼），10μg 道诺霉素脂质体（DL,30眼）或磷酸缓冲液/空白脂质体（40眼）。28天时77.5%的对照眼发生视网膜脱离，而DL治疗组为33.3%（P＜0.01），道诺霉素组为50%（P＜0.05）.由此提示脂质体载药能增强药效。根据发病阶段选择不同的药物，是影响疗效的重要因素。 （中华眼底病杂志，1993，9：77-80）     

去炎松与道诺霉素脂质体联合应用对玻璃体切除兔眼视网膜的影响

研究去炎松与道诺霉素脂质体联合应用对玻璃体切除兔眼视网膜的影响。方法对１６只兔双眼行玻璃体切除术并分为４组,分别在各组兔的１眼玻璃体内注入空内脂质体、１ｍｇ去炎松、１０μｇ道诺霉素脂质体,另１眼作对照。结论１ｍｇ去炎松和１０μｇ道诺霉素脂质体联合应用的对玻璃体切除兔眼视网膜无损害。     

道诺霉素及脂质体对玻璃体切除兔眼视网膜的毒性

道诺霉素及脂质体对玻璃体切除兔眼视网膜的毒性周健惠延年郭守一马吉献骆阁大关键词桑红霉素／毒性视网膜／药物作用脂质体／毒性疾病模型，动物视网膜超微结构有关道诺霉素对玻璃体切除眼的毒性研究尚未见报道。本研究观察了道诺霉素及其脂质体对玻璃体切除兔眼的视网膜...     

氟尿嘧啶脂质体玻璃体内注射对兔视网膜毒性

目的了解氟尿嘧啶脂质体玻璃体内注射对兔眼视网膜的毒性作用,探索其安全剂量范围。方法30只家兔,随机分为5组。右眼为实验眼,玻璃体内注射药物,其中氟尿嘧啶脂质体组,浓度分别为0.8 mg/0.1 mL,1.6 mg/0.1 mL,3.2 mg/0.1 mL,6.0 mg/0.1 mL;游离氟尿嘧啶组,浓度为1.6 mg/0.1 mL。左眼为对照眼,注射磷酸缓冲液0.1 mL。注药前后分别行双眼闪光及图形视网膜电图检查,求出双眼振幅平均值的比率(实验眼/对照眼)。注药后第28天摘除眼球行光镜和透射电镜检查。结果氟尿嘧啶脂质体组浓度0.8 mg,1.6 mg,3.2 mg剂量组未见视网膜电图及光镜下异常.6.0 mg氟尿嘧啶脂质体组及1.6 mg游离氟尿嘧啶组均呈现视网膜电图及光镜下异常。透射电镜在3.2 mg剂量脂质体组即发现视网膜结构异常。结论脂质体作为氟尿嘧啶的缓释载体能降低其视网膜毒性作用,其玻璃体内注射的最大安全剂量不超过1.6 mg。     

哌仑西平脂质体在家兔眼内的药代动力学研究

目的研究哌仑西平脂质体结膜囊内应用后在家兔眼部的药代动力学。方法48只家兔随机分为磷酸盐缓冲液组和脂质体组，分别于给药后0．5、1、2、4、6、8、10、12h取材，采用高压液相色谱技术进行测定，3P97软件拟合药代动力学参数，统计学分析采用t检验和单因素方差分析。结果脂质体组各组织中哌仑西平的质量浓度和质量分数较磷酸缓冲液组高，用药2h后各时间点各组织间相比均有显著统计学差异（P〈0．01），它们在各组织中的变化均呈一室开放模型。同一种组织中除脉络膜的消除半衰期外，其余组织各药代动力学参数间（Cmax、t1/2、MRT、AUC）差异有统计学意义（P〈0．05）。巩膜中哌仑西平的质量分数高于脉络膜和视网膜（P〈0．05）。结论哌仑西平脂质体眼部应用有缓释效应，生物利用度高，其很可能是以非角膜途径吸收为主进入眼内的。     

丁胺卡那霉素地塞米松复方脂质体在兔眼玻璃体内的药代动力学研究

目的 应用丁胺卡那霉素地塞米松(丁卡地塞)复方脂质体玻璃体内注射以延长两种药物的半衰期.方法 大白兔随机分4组,正常眼2组和眼内炎眼2组均分别注射复方脂质体和游离药物.结果 丁卡在正常眼复方脂质体的半衰期较游离药物延长1.8倍,在眼内炎眼延长3.4倍.地塞在正常眼复方脂质体半衰期较游离药物延长22.5倍,在眼内炎眼延长46.2倍.结论 丁卡地塞复方脂质体玻璃体内注射使丁卡和地塞两种药物的半衰期有明显延长.     

丁胺卡那霉素地塞米松复方脂质体的眼毒性研究

为探讨治疗细菌性眼内炎的新型制剂丁胺卡那霉素地塞米松复方脂质体的视网膜毒性,将２０只新西兰白兔随机分为四组,第一、二、三组分别于玻璃体内注射不同剂量的丁卡地塞复方脂质体,第四组玻璃体内注入注射用水作对照。术后行裂隙灯、检眼镜活体检查,并行ＥＲＧ检查和视网膜透射电镜检查。结果：含丁卡６００μｇ、地塞米松５２５μｇ的０．１５ｍｌ复方脂质体对视网膜无明显毒性,而含丁卡８００μｇ、地塞米松７００μｇ的复方脂质体则显示毒性反应。结论：丁卡地塞复方脂质体较游离药物毒性小、作用时间长,是一种治疗细菌性眼内炎的安全有效药物制剂     

Liposome-bound cyclosporine: Clearance after intravitreal injection

The concentration of cyclosporine in the vitreous after intravitreal injection of 100 micrograms of either free or liposome-bound cyclosporine was studied in albino rabbits. We found that the half-life of free cyclosporine was about 6 hours and that of liposome-bound cyclosporine was about 3 days. The finding indicates that liposome-bound cyclosporine prolongs the availability of the drug.     

超微结构研究玻璃体后脱离

目的：通过纤维蛋白溶解酶(以下简称纤溶酶)和透明质酸酶兔玻璃体腔内注射，研究玻璃体视网膜超微结构改变，阐明玻璃体后脱离的发生机制。方法：16只新西兰白兔随机分为A、B、C三组各8、4、4只兔，均以右眼为实验眼，左眼为对照。A组实验眼玻璃体腔内注射0．1ml纤溶酶1U联合透明质酸酶20U，B组注射纤溶酶1U，C组注射透明质酸酶20U，所有对照眼注射0．1mlBSS液。术后7天摘除眼球做扫描电镜检查。结果：扫描电镜发现A组赤道后内界膜(ILM)表面较光滑，残留玻璃体皮质大部分位于直径2～15μm的小凹陷上方，其下为Mueller细胞足板。完全性PVDl00％。B组后极部ILM表面较光滑，残留玻璃体皮质较A组多，部分性PVD75％。C组直径l0～30nm的玻璃体胶原纤维网状支架塌陷，在赤道后平行排列于ILM表面，无PVD。所有对照眼无PVD。结论：药物诱发PVD的实质是解除后界膜与内界膜之间分子胶的粘附。诱发PVD的药物应既能解除玻璃体视网膜界面之间的粘连，又能液化玻璃体。纤溶酶1U联合透明质酸酶20U能诱发出完全性PVD。     

巨噬细胞刺激人成纤维细胞增生及去炎松和道诺霉素对其的抑制

采用离体培养的人皮肤成纤维细胞并加入巨噬细胞调理培养液（MCM），及3H-胸腺嘧啶掺入液体闪烁检测，观察了成纤维细胞受MCM刺激后的增殖及药物对其的抑制作用。结果，加入MCM组细胞增殖率较对照组明显增加（P＜0．01），150ng／ml道诺霉素及联合用药组的细胞抑制率最高达95％以上（P＜0．01），250μg／ml去炎松的抑制率在不加MCM组约为20％～40％，而在加MCM组约为40％～60％（P＜0．01）。证实去炎松除有直接抑制作用外，更能明显抑制巨噬细胞活性因子对成纤维细胞增生的刺激作用。     

Metastatic Tumor to the Retina and Vitreous Cavity from Primary Melanoma of the Skin: Treatment with Systemic and Subconjunctival Chemotherapy

The cases of two young women with metastatic tumors to the retinas and vitreous cavities from primary melanoma of the skin are discussed. Each presented with 20/20 central visual acuity in both eyes and complaints of floaters related to singularly unusual golden brown cellular aggregates infiltrating the vitreous cavities. Some cells appeared to be emanating from the region of the optic nerves whereas others appeared to originate from the superficial retina, presumably from the retinal vessels. The cellular aggregates were comprised of malignant melanoma cells as determined by histocytology of a vitrectomy specimen in one case and an aqueous aspirate in the other. The clinical appearance of cellular aggregates in the form of regular spherules should alert the clinician to the possibility of malignant rather than inflammatory cellular infiltration. The combined administration of repeated systemic and subconjunctival DTIC in case 1 and BCNU in case 2 was unsuccessful in promoting tumor regression. Histology of one eye, removed because of uncontrolled neovascular glaucoma, revealed numerous melanoma cells in the superficial retina and adjacent vitreous     

玻璃体切除术对兔眼视网膜电图和超微结构的影响

对19只兔眼行玻璃体切除术，动态观察了术后28天内ERGb波的变化和28天时视网膜结构的变化。结果玻璃体切除后1、4天ERGb波明显降低（P＜0．01），第7天较1.4天回升（P＜0．05），14～28天与术前无显著差异（P＞0．05）。28天时光镜及电镜检查视网膜无明显结构损害。此结果为判断玻璃体手术后疗效、评价玻璃体手术后应用药物对视网膜的毒性作用提供了实验依据。     

Liposome-bound cyclosporine: Aqueous and vitreous level after subconjunctival injection

The concentration of cyclosporine in the aqueous and vitreous humors of albino rabbits was measured, using HPLC at intervals of 24, 48, 96, and 192 hours after subconjunctival injections of 2.5 mg of free or liposome-bound cyclosporine. The aqueous concentration was reasonably high in both groups until day 4: 1050 nanograms per milliliter in the group receiving free cyclosporine, and 1438 nanograms per milliliter in the group receiving liposome-bound cyclosporine. The vitreous concentration was very low in both groups.     

玻璃体结构和荧光素动力学——玻璃体的临床评价与荧光素浓度曲线的比较

对34例患者玻璃体情况进行详细的临床检查，并进行眼底荧光素血管造影和静脉注射荧光素30分钟后轴性玻璃体荧光扫描测定。观察到6种类型玻璃体结构变化，即：同源性玻璃体；退行性变的玻璃体；完全性玻璃体后脱离；三种不同类型的不完全性玻璃体后脱离。玻璃体荧光素浓度曲线显示出5种不同的模式。通过比较玻璃体临床检查结果和玻璃体荧光扫描曲线，我们认为，可将玻璃体荧光扫描测定与眼底荧光素血管造影相结合用于临床，以做为常规的玻璃体检查评价的方法。     

Heterogeneity in the ultrastructure of the mucous (goblet) cells of the rabbit palpebral conjunctiva

Aim: The purpose of this study was to assess objectively the ultrastructure of the secretory granules in rabbit conjunctival mucin‐producing ‘goblet’ cells. Method: The upper eyelids from five young adult dioestrous female rabbits were dissected out, stretched onto a cardboard support and prepared for transmission electron microscopy by repeated application of an isotonic two per cent glutaraldehyde fixative at room temperature. Post‐fixation treatment included osmium tetroxide and staining with uranyl acetate and lead citrate. Low magnification micrographs were taken of the goblet cells of the conjunctiva, printed at a magnification of approximately 6,000 and the number, size and features of the secretory granules assessed. Results: Across the entire palpebral conjunctiva of ail five rabbits, the majority of mucous cells displayed a goblet shape and the secretory granules were uniformly pale in staining. The average width of the goblet cells was 10.8 ± 1.1 μm and the diameter of the secretory granules was 0.82 ± 0.16 μm. However, in localised regions across the palpebral conjunctiva of two of the rabbits, some goblet cells were different in that the secretory granules had either a denser‐staining core, in which some of the granules were densely staining (while others were pale) or most of the granules were densely staining. These mucous cells had an average diameter of 10.3 ± 1.7 μm and the granule diameters averaged 0.88 ± 0.01 μm. For these abnormal goblet cells, inflammatory cells were found in their immediate vicinity. Occasionally, goblet cells were seen to be in the process of degranulation with associated apparent cell necrosis and the mucin granule diameter was close to 1 μm. Conclusions: The ultrastructure of the mucin‐containing secretory granules of the conjunctival mucous cells is not necessarily homogeneous in character and further attention needs to be given to the effects of localised inflammation in the tissue and to possible hormonal influences.     

Vitreous surgery for macular hole in patients with Vogt‐Koyanagi‐Harada disease

We describe two patients with Vogt‐Koyanagi‐Harada (VKH) disease, both in the convalescent stage, who presented with unilateral macular holes together with clinically significant epi‐retinal membranes. Vitreo‐retinal surgery was performed on the affected eyes and the surgical technique involved a standard three‐port vitrectomy, peeling of the epi‐retinal and internal limiting membrane (ILM). In both cases the retinae were tamponaded with air resulting in anatomical closure of the macular holes. The histology of the excised membrane was available in one case and this revealed multiple layers of presumed retinal pigment epithelial cells with cytoplasmic processes and intercellular junctions forming a basal lamina attached to the smooth surface of the ILM. Our findings demonstrate that macular holes can develop in patients with VKH but that the hole can be successfully closed with vitreo‐retinal surgery. The convalescent stage tends to occur several weeks after the acute stage when the uveitic process has subsided and is characterized by choroidal depigmentation, producing a sunset glow appearance to the ocular fundus. Patients may also demonstrate varying degrees of cutaneous hypopigmentation, poliosis and/or alopecia. Macular holes have also been reported previously in patients during the convalescent stage of VKH and this communication describes the outcome of two patients who underwent vitreo‐retinal surgery for this problem.