视觉电生理在眼挫伤检查中的意义

目的 观察眼挫伤后伴有视网膜振荡及视神经挫伤的F-ERG、F-VEP、P-VEP的变化特点.方法 应用眼电生理仪检测临床诊断为眼挫伤658眼,分别行F-ERG和P-VEP或F-VEP检查,记录ERG b波潜伏期和振幅,P100或P2潜伏期和振幅.结果 视网膜振荡者ERG b波振幅降低,潜伏期延长;神经挫伤者P100或P:潜伏期明显延长,振幅降低;二者合并存在时ERG b波振幅降低,潜伏期延长,P100或P2潜伏期明显延长,振幅降低.结论 F-ERG与VEP的联合应用对眼挫伤的诊断、预后估计、指导治疗及伤情鉴定有临床应用价值.     

粉防己碱抑制激光诱导鼠脉络膜新生血管

目的 观察玻璃体腔注射粉防己碱对实验性鼠脉络膜新生血管的抑制作用及其对视网膜结构和功能的影响。 方法 应用半导体激光（波长810 nm，曝光时间0.1 s，光斑直径100 μm，能量120 mW）光凝诱导20只Brown Norway (BN) 大鼠20只眼的脉络膜新生血管(CNV)模型。将大鼠随机分为实验组和对照组，每组各10只大鼠20只眼，实验组大鼠激光光凝后0、3 d玻璃体注射0.05 ml浓度为3.21 μmol/L的粉防己碱药液，对照组玻璃体内注射同体积的生理盐水；两组均在激光光凝14 d后行荧光素眼底血管造影，观察其新生血管的发生率。另有5只健康BN大鼠，每只鼠右眼玻璃体内注射入0.05 ml浓度为3.21 μmol/L的粉防己碱药液，左眼注射同体积生理盐水，第一次注药前及注药后1 h、1 d和第二次注药后1 h、1、7、14 d行视网膜电图（ERG）检查，第二次注药后14 d行光学、电子显微镜检查。 结果 实验组大鼠CNV发生率为23.26%，明显低于对照组63.33%（P<0.01）。3.21 μmol/L的粉防己碱玻璃体内注射b波波幅比率与注药前相比差异无统计学意义(P>0.05)。光学、电子显微镜检查未见明显细胞异常。 结论 粉防己碱能抑制鼠CNV形成；3.21 μmol/L浓度的粉防己碱玻璃体内注射对视网膜无毒性作用。 (中华眼底病杂志, 2006, 22, 242-244)     

川芎嗪对兔缺血性视网膜疾病的疗效

目的:分析川芎嗪对缺血性视网膜疾病的治疗效果。方法:将1μmol/L内皮素(endothelin,ET-1),10μL注入兔眼后部玻璃体腔中,制成缺血性视网膜疾病的动物模型。治疗组(n=15)给予川芎嗪(20mg/kg,iv,1次/d),对照组(n=15)给予等量的生理盐水。7d后分别检测两组闪光视网膜电图(F-ERG),闪光视觉诱发电位(F-VEP),眼底荧光血管造影(FFA),视网膜环核苷酸(cAMP,cGMP)的含量。结果:玻璃体腔内注射ET-1,2d后F-ERGa,b波振幅均下降(P<0.05)。F-VEPP波幅值下降,峰值潜伏期时延长(P<0.01)。FFA显示:视网膜血管变细。视网膜cAMP,cGMP浓度和cAMP/cGMP比值均下降。与对照组相比,川芎嗪则显著改善了上述病变。结论:川芎嗪对缺血性视网膜疾病有明显的治疗作用。     

应用OCT对衣霉素诱导视网膜损伤大鼠模型的检测评估

目的:利用光学相干断层扫描仪(OCT)评价衣霉素损伤的大鼠视网膜形态及功能形态改变.方法:SD大鼠60只,随机分为3组(每组20只):对照组、低剂量组和高剂量组,各组分别应用微量注射器行大鼠眼球玻璃体腔内注射,剂量均为0.3μL,对照组给予9g/L生理盐水、低剂量组给予浓度0.5mg/kg衣霉素、高剂量组给予浓度1.5mg/kg衣霉素进行玻璃体腔内注射.在造模后每天散瞳观察眼底,第1、7、14d 通过OCT、眼底照相、眼底荧光、视网膜电图及HE染色观察不同浓度下视网膜各层形态学变化.结果:OCT结果提示衣霉素对视网膜形态及结构有损伤作用,呈现出时间-剂量依赖性;眼底照相结果提示在衣霉素注射2wk后,随着衣霉素浓度的变化,视网膜周边及黄斑区颜色逐渐苍白,视盘区水肿,高剂量组出现视网膜血管变细,视神经萎缩;荧光素造影结果提示:衣霉素注射玻璃体腔2wk后,视网膜血管功能损伤,逐渐出现周边至中央部血管造影剂渗漏;电生理表明,衣霉素诱导的视网膜电图紊乱,a波、b波逐渐地振幅降低,甚至变平,具有明显的统计学意义(P<0.05);石蜡切片HE染色结果提示衣霉素对视网膜各层的损伤呈现剂量-时间依赖性,与OCT结果相一致.结论:衣霉素可以通过诱导视网膜损伤模拟视网膜疾病模型,OCT可以动态观察视网膜的损伤改变,作为一种非侵入性检查手段对于评价视网膜损伤具有一定积极意义.     

眼挫伤的闪光视网膜电流图和视觉诱发电位

目的 观察眼挫伤后伴有视网膜震荡及视神经挫伤的F-VEP、P-VEP和F-ERG的变化特点。方法 应用眼电生理仪检测临床诊断为眼挫伤105眼，分别行F-ERG和P-VEP或F-VEP检查，记录：Pl00潜时和振幅，ERGa、b波峰时和振幅，OPs峰时和振幅。结果 伴有视网膜震荡者P100潜时正常或轻度延迟，振幅中、重度降低，ERGa、b波振幅降低，峰时延迟；伴有视神经挫伤者：Pl00潜时重度延迟，振幅重度降低，甚至波形消失；二者合并存在时，P100潜时重度延迟，振幅重度降低，ERGa、b波及OPs峰时延迟，振幅降低。结论 F-ERG与VEP的联合应用对眼挫伤的诊断、预后估计、指导治疗及伤情鉴定等具有较高的临床应用价值。     

双氯酚酸钠玻璃体内应用对视网膜结构和功能的影响

目的 了解非甾体类抗炎药物双氯酚酸钠（diclofenac sodium,DFS)玻璃体内注射对视网膜的毒性作用，探索眼内应用DFS的安全剂量范围。方法 28只健康成年大耳白兔，随机分为7组，分别于每组右眼玻璃体内注入4、5、6、7、8、9、10mg/ml的DFS溶液0.1ml，左眼为对照组。注药前及注药后1、3、7、14、21、28d分别行双眼视网膜电图（electroretinogram,ERG)检查。注药后10、28、30d分别摘除眼球行光学显微镜和透射电镜检查。结果 注药剂量0.4、0．5mg组ERG明、暗适应b波波幅比率与注药前相比差异无显著意义，透射电镜及光学显微镜检查均未见组织结构有明显异常。0.6mg组在注药后1d ERG明适应b波波幅比率较注药前明显下降（P＜0．05），注药后3d开始恢复，至注药后14d已达注药前水平（P＞0．05），光学显微镜及透射电镜检查显示视网膜组织已出现水肿等可逆改变，部分仍维持正常结构。0.7-1.0mg组ERG b波波幅比率与注药前相比明显下降（P＜0．05），且不能恢复，光学显微镜及透射电镜检查显示视网膜各层结构损伤，在注药后10、30d均可见到细胞核染色质浓缩集聚、细胞坏死等不可逆改变。结论 DFS玻璃体内注射的最大安全剂量不得超过0.6mg。当注药剂量大于或等于0.7mg时，对视网膜各层结构产生毒性，主要表现为锥、杆细胞的不可逆损害。     

正常成年家猫不同暗适应时间闪光视网膜电图的变化

目的:探讨不同暗适应时间正常成年家猫闪光视网膜电图(flash electroretinogram,F-ERG)最大反应变化正常值范围.方法:选取成年家猫20只,在不同暗适应时间1/12,1/6,2/6,0.5,4/6,5/6,1,1.5,2,3,4,5,6,7,8,9,10,15,20,30,40,50min用标准刺激参数刺激,常规程序采集记录F-ERG的a,b波的峰潜时及振幅进行分析并绘出各波峰潜时及振幅在不同暗适应时间点的变化曲线.结果:不同暗适应时间点均成功记录到典型且重复性好的F-ERG波形.不同暗适应时间,a,b波潜伏期均无明显差异,b波的振幅变化较为明显,暗适应20min,振幅值达高峰.结论:成年家猫F-ERG检测实用且创伤较小.     

65—75岁老年人F—ERG观察

目的：观察65-75岁正常老年人暗适应闪光视网膜电图（F-ERG）,评价其视网膜功能。方法：对41例（69只眼）正常老年人行标准化视多膜电图（F-ERG）最大反应测定,将结果与对照组（30-40岁正常人）比较;并分别比较老年人中不同性别以及（老年性白内障）不同晶状体混浊度（按WHO白内障分级）对F-ERG影响。结果：65-75岁正常老年人F-ERG最大反应中a波振幅小于对照组（0.01＜P＜0.05),b波振幅明显小于对照组（P＜0.01);白内障眼F-ERG最大反应中a波振幅小于无白内障眼（0.01＜P＜0.05),b波振幅明显小于无白内障眼（P＜0.01);老年男性F-ERG最大反应中a波振幅组略上于女性,但差异无显著性（P＞0.1),而b波振幅明显小于女性（P＜0.01)。结论：随年龄增长,正常老年人暗适应闪光视网膜电图（F-ERG）反应减弱,视网膜功能将发生生理性减退;白内障所致晶状体混浊将进一步减弱ERG反应交影响视觉功能;F-ERG最大反应存在着性别差异。     

基质金属蛋白酶-1治疗兔眼增生性玻璃体视网膜病变的效果

目的:评价基质金属蛋白酶-1(matrix metalloproteinase-1,MMP-1)对富含血小板血浆(platelet-rich plasma,PRP)所诱导的兔眼实验性增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)增殖膜的降解作用。方法:健康成年有色家兔30只,采用日本大耳白兔动脉血制备富含血小板血浆(PRP)诱导家兔双眼PVR动物模型。A组玻璃体腔注入组织型纤溶酶原激活剂(tissue plasminogen activator,t-PA)12.5μg(0.05mL),B组注入t-PA12.5μg+MMP-1100ng(0.1mL),C组注入t-PA12.5μg+MMP-1800ng,各组均以右眼为实验眼,左眼注入等量BSS为对照,共观察28d。采用裂隙灯和间接眼底镜等方法行临床观察,PVR分级评分,闪光视网膜电图(F-ERG)b波波幅值评价注药前及注药后各时间点视网膜功能状态,光镜观察视网膜各层结构改变,电镜观察视网膜感光细胞超微结构变化。结果:C组注药后各时间点PVR级别与对照组比较差异有显著统计学意义(P<0.01);注药后各时间点F-ERGb波波幅值比较,B组及C组分别于对照组比较差异具统计学意义(P<0.05,P<0.01),注药后28d时,B组与C组比较差异也具有统计学意义(P<0.05),C组与正常F-ERGb波波幅值比较差异也具有统计学意义(P<0.05)。结论:MMP-1玻璃体腔注射能对实验性兔眼增生性玻璃体视网膜病变中的增殖膜产生一定的降解作用。     

阈值和阈值前期早产儿视网膜病变儿童视网膜电图观察

目的用全视野闪光视网膜电图（F-ERG）评价既往患阈值或阈值前期早产儿视网膜病变（ROP）JL童的视网膜功能。方法用F-ERG检查34例（68眼）既往有早产儿童,患阈值或阈值前期ROP者24例（48眼）,出生年龄体重匹配的未患ROP者10例（20眼）。统计分析两组儿童暗视和明视各反应a波、b波潜伏期和振幅的差异。结果ROP组较对照组暗视视杆反应和最大混合反应a波、b波潜伏期延长,振幅降低,差异有统计学意义,P〈O．05。ROP组与对照组明视视锥反应a波、b波振幅和潜伏期无明显差别,P〉0．05。结论阈值或阈值前期ROP视网膜功能受到影响,以视杆细胞的功能降低为主。F-ERG是评价早产儿视网膜功能有效检测手段。     

Experimental intravitreal application of trovafloxacin in rabbits.

This study was performed to examine the retinal toxicity of trovafloxacin, a broad-spectrum fourth-generation fluoroquinolone, in rabbit eyes after intravitreal injection. The left eyes of 20 albino rabbits were divided into four groups, and each was injected intravitreally with 0.1 ml of trovafloxacin in a 50-microg, 100-microg, 250-microg or 500-microg concentration. The right eyes of these rabbits served as control and received normal saline solution. Retinal function was assessed from the electroretinogram (ERG), and retinal structure was also examined by ophthalmoscopy and histologic study (light microscopy). The intravitreal injections of 50 microg, 100 microg, and 250 microg trovafloxacin did not significantly change the ERG a-wave, b-wave or the oscillatory potential throughout the follow-up period of 4 weeks. While no ERG changes were observed at 4 weeks after injection, in the 3 eyes that received trovaloxacin 500 microg/0.1 ml, the a-wave amplitudes showed a diminution of 56-49% and those of b-waves one of 53-44% of the preinjection amplitudes at 4 weeks after injection, but oscillatory potentials remained unchanged in the other 2 rabbits intravitreally injected with 500 microg trovafloxacin. However, in none of the injected eyes and the control eyes in all groups were ophthalmoscopically visible fundus changes and histologic abnormality observed. The results suggest that intravitreally injected trovafloxacin at a dose of up to 500 microg is nontoxic to the rabbit retina. If future studies in other species confirm our findings, intravitreal trovafloxacin may be a good alternative in the treatment and prevention of clinical bacterial endophthalmitis.     

DL—α-AAA诱发恒河猴特发性黄斑旁毛细血管扩张症

目的：选择性干扰黄斑区Mueller细胞,试图建立特发性黄斑旁毛细血管扩张症（idiopathic perifoveal telangiectasis,IPT）动物模型。方法：恒河猴12只随机分为6组,前3组单眼视网膜下注入DL—α—AAA（DL—α-aminoadipic acid）5,10,50mmol／L30μL,后3组单眼玻璃体腔分别注入DL—α—AAA16,50,80mmol／L100μL。术前1wk及术后6,12wk行眼底彩色照相、荧光素眼底血管造影、黄斑自发荧光、光学相干断层成像（optical coherence tomography,OCT）、多焦视网膜电图（muhifocal electroretinogram,mfERG）检测,并摘除眼球行光镜检查。结果：视网膜下5,10mmol／LDL—α—AAA及玻璃体腔50mmol／LDL-α-AAA,给药后6wk均出现IPT且OCT和光镜亦有相应病理改变;视网膜下50mmol／LDL—α—AAA,及玻璃体腔80mmol／LDL-α-AAA,病理损伤严重但未出现IPT。结论：视网膜下5～10mmol／LDL-α-AAA、玻璃体腔50mmol／LDL-α-AAA均可诱发IPT。     

DL-α-AAA诱发恒河猴特发性黄斑旁毛细血管扩张症

目的:选择性干扰黄斑区Mller细胞,试图建立特发性黄斑旁毛细血管扩张症(idiopathic perifoveal telangiectasis,IPT)动物模型。方法:恒河猴12只随机分为6组,前3组单眼视网膜下注入DL-α-AAA(DL-α-aminoadipic acid)5,10,50mmol/L30μL,后3组单眼玻璃体腔分别注入DL-α-AAA16,50,80mmol/L100μL。术前1wk及术后6,12wk行眼底彩色照相、荧光素眼底血管造影、黄斑自发荧光、光学相干断层成像(optical coherence tomography,OCT)、多焦视网膜电图(multifocal electroretinogram,mfERG)检测,并摘除眼球行光镜检查。结果:视网膜下5,10mmol/LDL-α-AAA及玻璃体腔50mmol/LDL-α-AAA,给药后6wk均出现IPT且OCT和光镜亦有相应病理改变;视网膜下50mmol/LDL-α-AAA,及玻璃体腔80mmol/LDL-α-AAA,病理损伤严重但未出现IPT。结论:视网膜下5～10mmol/LDL-α-AAA、玻璃体腔50mmol/LDL-α-AAA均可诱发IPT。     

药物性玻璃体后脱离对增生性玻璃体视网膜病变影响的实验研究

目的 观察药物性玻璃体后脱离（PVD）对增生性玻璃体视网膜病变（PVR）的影响。方法 24只有色成年家兔,左眼为实验眼。兔自体富含血小板血浆玻璃体腔注射建立兔眼PVR模型,同时随机将实验兔分为A、B组及对照组,每组各8只眼。建模后3 h A组玻璃体腔内注入1 U纤溶酶（0.05 ml）+20 U透明质酸酶（0.05 ml）共0.1 ml、B组玻璃体腔内注入纤溶酶0.1 ml、对照组玻璃体腔内注入等量的平衡盐溶液。给药后1、7、28 d记录实验眼PVR级别,进行各组PVR等级评分,并行闪光视网膜电图（F-ERG）、眼部B型超声检查及视网膜组织病理学检查。结果 PVR模型成功建立,并在注药后7 d,A组发生完全性PVD 5只眼,不完全性PVD3只眼;B组不完全性PVD 5只眼,未见完全性PVD,另3只及对照组无PVD发生。A、B组在注药后28 d PVR等级评分均低于对照组,差异有统计学意义（D=75.6, 98.9;P=0.003,P=0.011）;注药后7、28 d,A、B 两组F-ERG b 波波幅均高于对照组;产生PVD的眼中PVR级别均较无PVD的眼级别低,其中完全性PVD眼中PVR级别仅为0～1级。结论 在兔眼PVR建模后3 h,纤溶酶与透明质酸酶联合玻璃体腔注射诱导的完全性PVD在一定程度上可以阻止兔眼PVR的发生和发展,纤溶酶单独或联合透明质酸酶玻璃体腔注射诱导的不完全 性PVD对PVR的发展有减缓作用。     

玻璃体腔重复注射抗血管内皮生长因子单克隆抗体bevacizumab对糖尿病大鼠视网膜的毒性观察

目的 观察玻璃体腔重复注射抗血管内皮生长因子(VEGF)单克隆抗体bevacizumab(商品名Avastin)对糖尿病大鼠视网膜的毒性作用.方法 40只健康成年雄性Sprague-Dawley大鼠随机分为正常组(A组)和糖尿病组,分别为10、30只.糖尿病组采用链脲佐菌霉素(STZ)尾静脉注射方法制作糖尿病动物模型.随机选取10只作为糖尿病视网膜病变(DR)组(B组),不作任何处理;其余20只大鼠左眼为实验组(C组),玻璃体腔注射25 mg/ml的bevacizumab 3 μ1,共注射3次,每次间隔10 d;右眼为实验对照组(D组),不给予任何处理.末次注射后20 d,采用闪光视网膜电图(F-ERG)对各组大鼠行视网膜功能检测;溴化乙锭(EB)染色视网膜铺片,荧光显微镜观察各组大鼠视网膜血管变化情况;苏木精-伊红(HE)染色,光学显微镜观察大鼠视网膜形态学变化;免疫组织化学染色法观察大鼠视网膜各层Thy-1及VEGF阳性表达情况.结果 F-ERG检测显示,A、B、C、D 4组暗适应a、b波潜伏期,暗适应b波振幅及振荡电位(Ops)总振幅比较,差异均有统计学意义(F=33.165,36.162,19.955,23.243;P值均=0.000);A、B、C、D4组暗适应a波振幅比较,差异无统计学意义(F=0.097,P=0.961).荧光显微镜观察发现,A组大鼠视网膜血管走行良好,B组大鼠视网膜血管走行纡曲、扩张,C组大鼠视网膜血管走形规则、变细,D组大鼠视网膜可见微血管瘤.光学显微镜观察发现,A组大鼠视网膜层次结构整齐分明,B组大鼠视网膜各层细胞结构排列紊乱,C组大鼠视网膜各层细胞排列整齐,D组大鼠视网膜各层细胞排列不整齐.免疫组织化学染色发现,Thy-1阳性表达主要位于神经节细胞层(GCL),极少数位于内丛状层、内核层.VEGF阳性表达主要定位于GCL,少量位于神经纤维层、内核层及视网膜色素上皮层.结论 玻璃体腔重复注射bevacizumab对糖尿病大鼠视网膜有一定毒性作用.

Abstract：

Objective To observe the retinal toxicity of repeated intravitreal injection with bevacizumab(Avastin)in diabetic rats.Methods Forty male Sprague Dawley(SD)rats were randomly divided into normal group(Group A,10 rats)and diabetes mellitus group(30 rats).The rats in diabetes mellitus group were induced with streptozotocin injection for diabetic retinopathy model.And then randomly divided into diabetic retinopathy(DR)group(Group B,10 rats),the rats were not intervened;the left eyes of the other 20 rats were intravitreal injected with bevaeizumab 3 μ1(25 mg/m1)for 3 times as experimental group(Group C);the right eyes of the 20 rats were not intervened as experimental control group(Group D),20 days after last intravitreal injection,retinal function was measured by Flicker Electroretinogram (F-ERG);retinal vascular pattern was determined by fluorescence microscopy of ethidium bromide(EB)stained retinal flat mounts;retinal morphological changes were determined by light microscope on hematoxylin-eosin (HE) stained sections;Thy-1 and VEGF expression was measured by immunohistochemistry staining.Results F-ERG showed that-the differences of a-and b-waves-the b-wave amplitude and the Ops-wave amplitude in the implicit time between group A,B,C and D were significant (F=33.165,36.162,19.955,23.243;P=0.000);the differences of a-wave amplitude between group A,B,C and D was not significant(F=0.097,P=0v961).Retinal blood vessel pattern was normalin Group A;retinal vascular vessels were tortuous and irregularly expanded in Group B:retinal vascular vessels of Group C were regular and thinner than Group A;microaneurysm were showed in Group D.Light microscope displayed that the layers of the rat retina of Group A were regular,the retinal architectures of Group B were irregular,the retinal layers were regular in Group C,the retinal layers were irregular in Group D.Immunohistochemistry staining discovered that Thy-1 and VEGF were mainly expressed in ganglion cell layer(GCL).Conclusion Repeated intravitreal injection of bevacizumab iS toxic tO retina of diabetes mellitus rats.     

Effects of intraocular irrigation with melphalan on rabbit retinas during vitrectomy

Purpose To investigate the toxic effects of perfusion of intravitreal melphalan during vitrectomy on the rabbit retina. Methods We performed electoretinography (ERG) in 18 eyes of 18 healthy albino rabbits before and after intraocular melphalan perfusion at concentrations of 5-, 10-, and 20-μg/ml during pars plana vitrectomy. Fellow eyes that underwent vitrectomy without melphalan served as controls. The histopathologic retinal changes were observed in both eyes of two rabbits from each group. Results In the 5-μg/ml perfusion group, the ERGs and histology showed no substantial changes compared with control fellow eyes during 28 days postoperatively. In the 10- and 20-μg/ml groups, the mean a-wave amplitude decreased to 52% and 31% respectively of the fellow eye; the mean b-wave amplitude decreased to 52% and 19% respectively. However, the peak implicit time of the a- and b-waves did not significantly differ in the 10- and 20-μg/ml groups during 28 days postoperatively. Histologic sections showed necrosis of the inner nuclear layer and thinning of the outer nuclear layer in the 10-μg/ml group. Loss of the outer nuclear layer and the photoreceptor layer and necrosis of the inner nuclear layer were observed in the 20-μg/ml group. Conclusion The intravitreal 5-μg/ml melphalan perfusion during vitrectomy appears to be nontoxic to the retina. This therapeutic modality might be a potential treatment for retinoblastoma with vitreous seeding. Grant Support: Supported in part by a grant from the Health and Welfare Ministry, Japan.     

兔眼玻璃体腔内注射透明质酸酶诱导形成玻璃体后脱离

目的:考察透明质酸酶(hyaluronidase,HS)兔眼内注药诱导形成玻璃体后脱离(posterior vitreous detechment,PVD)的作用。方法:取新西兰大白兔20只,将HS5U注入20只右眼玻璃体腔内,左眼内各注入等量生理盐水作为对照。在设定的时间点(15min~7d),通过活体的直、间接眼底镜、视网膜电图(electroretinogram,ERG)检查和摘除眼球的光、电镜检查,从形态学方面对酶作用于玻璃体的效应及其眼部毒性进行观测。结果:在实验观察期内,实验眼从第3d开始有肉眼可见的PVD形成;所有眼ERGb波振幅(bA)注药前后比值没有明显差异;光、电镜下视网膜的各层结构在玻璃体注射后无明显改变。结论:玻璃体腔内注射5UHS酶可有效地诱导产生PVD,而且对视网膜的结构和功能无毒性损害。     

Retinal Function Assessed by ERG Before and After Induction of Ocular Aspergillosis and Treatment by the Anti-fungal, Micafungin, in Rabbits

This study was conducted to evaluate the effectiveness of a new antifungal drug, micafungin, and standard antifungal drugs against endophthalmitis induced in a rabbit by intravitreal injection of Aspergillus fumigatus, an important fungal pathogen. Effectiveness was evaluated by the preservation of b-wave amplitude at 72 h after injection of the fungus relative to the b-wave amplitude at baseline before any intravitreal injections. A 0.06 ml inoculum of 10⁶ conidia of A. fumigatus was injected into the vitreous of the right eye of all rabbits; and, 12 h later, a 0.06 ml solution containing one of 3 antifungal drugs or saline was injected into the vitreous of both eyes. All three antifungal drugs produced significant b-wave preservation at 72 h in infected eyes compared to that in infected eyes receiving saline injections. There was no statistically significant difference between the effects of micafungin and amphotericin B in the right eyes with fungal endophthalmitis, and both produced significantly more preservation of b-wave amplitude than voriconazole. Amphotericin B, but neither micafungin nor voriconazole produced significant reduction of the b-wave amplitude in the left eyes.     

国产猪源纤维蛋白黏合剂玻璃体腔注射后对兔眼视网膜组织的生物安全性研究

背景 猪源纤维蛋白黏合剂已广泛应用于临床手术中,能够起到止血和闭合伤口的作用.目前眼科学者认为猪源纤维蛋白黏合剂在玻璃体切割术中可替代长效气体或硅油作为填充物,但国产猪源纤维蛋白黏合剂是否对视网膜有毒性作用仍在研究中. 目的 研究国产猪源纤维蛋白黏合剂在眼内应用后对视网膜组织的生物安全性. 方法 15只青紫兰兔任选一眼作为实验眼,对侧眼作为对照眼.兔眼行玻璃体切割术,实验眼术毕于玻璃体腔内注射猪源纤维蛋白胶0.5 ml,对照眼注射等量平衡盐溶液.术后1、3、7、15、30 d用裂隙灯及直接/间接检眼镜检查眼前后节的炎症反应,术后1、3、7d用Schi(o)tz眼压计测量眼压,分别于术前和术后30 d进行视网膜电图(ERG)检查,评估视网膜的功能变化,术后30 d行眼科B型超声检查.玻璃体腔内注射后第30天摘除眼球并制备视网膜切片,光学显微镜下检查视网膜的组织形态学变化,透射电子显微镜下观察视网膜的超微结构变化. 结果 实验组15只兔眼中出现并发症者7只眼,其中晶状体损伤后发生白内障者3只眼,术后增生性玻璃体病变和视网膜脱离者5只眼,眼内炎者1只眼.对照组15只兔眼晶状体损伤后发生白内障者2只眼,术中发生视网膜损伤者2只眼.眼内注射后30d实验组未出现并发症的8只眼及对照组的11只眼均未见明显的眼内炎症反应,术后眼压均正常,2个组间及手术前后各时间点间的眼压变化差异均无统计学意义(F分组=0.008,P=0.929;F时间=3.600,P=0.075).实验组及对照组间兔眼注药前后ERG a波、b波振幅的总体差异均无统计学意义(a波:F分组=0.728,P=0.405;b波:F分组=0.222,P=0.644);各组兔眼手术前后ERG a波、b波振幅的总体差异均无统计学意义(a波:F时间=0.516,P=0.482;b波:F时间=0.057,P=0.814).眼内注射后30 d,实验眼和对照眼视网膜组织层次清晰,无水肿及阳性细胞浸润,各层视网膜的细胞及视网膜光感受器、视网膜色素上皮的色素细胞形态均正常,亚细胞器结构清晰,细胞膜和核膜完整,线粒体嵴排列整齐. 结论 国产猪源纤维蛋白黏合剂玻璃体腔注射后对兔眼视网膜无毒性作用.     

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。