家兔视网膜缺血-再灌注损伤后形态学的动态变化

目的　观察家兔视网膜缺血 -再灌注后视网膜结构的动态变化。方法　通过前房灌注加压至 16 .7k Pa,维持 1h,建立缺血模型 ,观察再灌注 2～ 14d内其结构变化及内层视网膜平均厚度的变化。结果　家兔视网膜在缺血 -再灌注后 2～ 14d内表现为神经细胞持续丢失 ,视网膜层次逐渐不清 ,萎缩、变薄。其中神经节细胞、神经纤维及视锥、视杆对缺血最敏感 ,外颗粒层次之 ,内颗粒层最能耐受缺血 -再灌注后的损伤。结论　视网膜缺血 -再灌注损伤是个持续性、进行性的损伤过程 ,与功能变化相一致     

葛根素对大鼠视网膜缺血再灌注损伤的保护作用

目的观察葛根素(puerarin)对大鼠视网膜缺血再灌注的保护作用及机制。方法成年Wistar大鼠随机分成对照组、缺血再灌注未治疗组、缺血再灌注葛根素治疗组。采用前房灌注液体形成高眼压而建立RIR模型。治疗组在缺血前30min给予大鼠腹腔内注射葛根素。缺血60min后恢复血流。光镜观察各组视网膜内层厚度以及浸润入视网膜的中性粒细胞数目、神经节细胞数变化;免疫组化法检测Caspase-3蛋白在各组视网膜中的表达。结果葛根素治疗组再灌注6h以后各时间段视网膜内层厚度均较未治疗组视网膜缺血再灌注厚,早期视网膜内层水肿增厚,晚期视网膜神经节细胞数目减少及视神经纤维层萎缩变薄,神经节细胞数目多于未治疗组,而视网膜中的中性粒细胞数目少于未治疗组;Caspase-3蛋白于再灌注后24h达到高峰,但各时间段治疗组表达强度均较未治疗组明显减弱。结论葛根素对视网膜缺血再灌注损伤有治疗作用,抑制缺血再灌注损伤后的炎症反应和Caspase-3蛋白的表达是其可能的保护机制。     

蛇毒神经生长因子对大鼠视网膜缺血再灌注损伤的神经保护研究

目的 探讨玻璃体腔内注射蛇毒神经生长因子,对实验性视网膜缺血再灌注损伤是否具有神经保护作用.方法 采用升高大鼠眼内压的方法,制作实验性视网膜缺血再灌注损伤模型.实验组和对照组分别注入蛇毒神经生长因子和平衡盐溶液,应用图像分析系统计数视网膜神经节细胞和测量视网膜内层厚度,透射电镜观察视网膜超微结构.结果 视网膜缺血再灌注开始,实验组大鼠视网膜水肿、视网膜内层厚度变薄和视网膜神经节细胞(RGCs)数目减少较对照组轻,并且实验组于再灌注24h后RGCs数目逐渐增多,48h后视网膜内层厚度逐渐增加.再灌注后168h,对照组大鼠视网膜内层厚度及RGCs数目明显低于实验组,差异显著有统计学意义(P＜0.05);电镜观察对照组再灌注后24 h出现膜盘排列紊乱、变形,神经纤维层内大量的线粒体肿胀、空泡化和RGCs核染色质浓缩、边集,出现凋亡小体,胞浆内细胞器空泡化且大量减少.而实验组膜盘排列尚整齐,RGCs轻度肿胀,胞浆内细胞器较丰富,神经纤维层中的线粒体轻度肿胀,微管结构较清楚.结论 通过向大鼠玻璃体腔内注射蛇毒神经生长因子可以减轻视网膜内层的损伤,对实验性视网膜缺血再灌注损伤有神经保护作用.     

腺病毒载体介导的色素上皮衍生因子对大鼠视网膜缺血再灌注损伤的保护作用

目的:观察重组腺病毒介导的色素上皮衍生因子(Ad-PEDF)对大鼠视网膜缺血再灌注损伤的保护作用及机制。方法:选用健康大鼠96只,随机分为正常组、缺血再灌注组、缺血再灌注+Ad-CMV组,缺血再灌注+Ad-PEDF组,以前房加压的方法制备大鼠视网膜缺血再灌注模型,缺血再灌注+Ad-CMV组,缺血再灌注+Ad-PEDF组分别玻璃体腔注射Ad-CMV或Ad-PEDF1μL(滴度3.8×109/PFU),每组按照时间点12,24,72,168h,为4亚组,光学显微镜观察视网膜组织切片情况,并测量视网膜内层厚度及神经节细胞层神经节细胞数量。以TUNEL方法观察大鼠视网膜神经节细胞凋亡情况。结果:Ad-PEDF组视网膜内层厚度均超过缺血组及缺血+Ad-CMV组,Ad-PEDF组神经节细胞数目多于缺血组及Ad-CMV组,Ad-PEDF组视网膜神经节细胞凋亡细胞少于缺血组及Ad-CMV组,凋亡程度减轻,上述差异均具有显著性(P<0.05)。结论:腺病毒介导的色素上皮衍生因子玻璃体腔注射能够恢复大鼠视网膜缺血再灌注损伤所致的视网膜内层厚度降低,神经节细胞密度减少,具有保护作用。     

缺血再灌注损伤诱导大鼠视网膜细胞凋亡

目的 观察缺血再灌注大鼠视网膜损伤及细胞凋亡情况。 方法 采用升高大鼠眼压到109.725 mm Hg(1 mm Hg=0.133 kPa)持续1 h的方法制作视网膜缺血再灌注模型，采用常规眼球切片观察不同缺血和再灌注时间的视网膜损伤的组织病理改变；采用DNA琼脂糖凝胶电泳法检测视网膜神经元凋亡情况；采用DNA原位末端标记(terminal dUTP nick end labelling, TUNEL)法定位凋亡的视网膜细胞。 结果 缺血30 min 再灌注24、48 h的大鼠视网膜无明显的病理改变；缺血60 min再灌注24、48 h的大鼠视网膜神经节细胞层和内核层细胞明显变薄；缺血60 min再灌注12、24 h的大鼠视网膜有梯状条带。而正常对照组、缺血30 min再灌注24、48 h组及缺血60 min再灌注48 h组大鼠视网膜均无类似表现。TUNEL法显示视网膜内的细胞凋亡主要发生在节细胞和内核层光感受细胞。 结论 大鼠视网膜缺血再灌注主要是导致视网膜神经节细胞层和内核层细胞损伤，细胞凋亡可能是损伤的重要机制。 (中华眼底病杂志, 2002, 18: 296-298)     

小鼠视网膜缺血-再灌注后核因子-κB的激活

目的 研究小鼠视网膜缺血-再灌注所致视网膜神经细胞凋亡中,核因子-κB的表达。方法 通过升高小鼠眼内压造成视网膜缺血,用计算机图像分析方法测量视网膜再灌注后神经细胞凋亡的比例和视网膜厚度的改变。免疫组化标记核因子-κB p65亚单位,并与原位缺口末端标记（TUNEL）做双重荧光标记,分析核因子-κB的表达与细胞凋亡之间的时相关系。结果 视网膜缺血-再灌注后最初24h,视网膜内层厚度增加,至168h,厚度显著减少。再灌注后6h,神经节细胞和内核细胞层中p65的免疫表达增强,至24h达到高峰,这一过程与TUNEL标记的时相一致。结论 视网膜缺血-再灌注损伤后,核因子-κB的激活对于视网膜神经细胞的凋亡有重要作用,对于其起促进凋亡还是抑制凋亡的作用,则有待于进一步研究。     

大鼠视网膜缺血-再灌注损伤超微结构观察及机制探讨

目的研究大鼠视网膜缺血-再灌注损伤中的超微结构改变以及凋亡相关基因表达的变化,探讨其损伤机制。方法将28只大鼠随机分为正常组和手术组,手术组按照再灌注后不同时间段分为1h、6h、12h、24h、48h、72h组。前房加压法制作大鼠视网膜缺血-再灌注损伤模型,透射电镜检测视网膜超微结构改变,免疫组织化学法检测视网膜组织中bcl-2、bax、Fas的表达。结果(1)正常组视网膜神经纤维中微管及线粒体清晰可见;视网膜神经节细胞(retinal ganglion cells,RGCs)核大,电子密度低,核仁明显,细胞器丰富;再灌注损伤后RGCs核膜肿胀,线粒体嵴模糊不清,可见凋亡小体,神经纤维中微管模糊、减少甚至消失,以再灌注后24h为甚;(2)再灌注后6h,bax表达逐渐递增,24h达到高峰,48h开始下降,72h不明显;(3)bcl-2在视网膜神经节细胞层、纤维层及内核层有微弱表达,各个时间段变化不明显;(4)Fas表达改变与bax基本一致。结论视网膜缺血-再灌注损伤中,细胞凋亡是引起视网膜内核层和神经节细胞层细胞死亡的主要方式,其损伤机制与凋亡相关基因bcl-2、bax、Fas的表达变化有关。     

碱性成纤维细胞生长因子对鼠视网膜缺血再灌注损伤的治疗作用

目的探讨玻璃体腔注射碱性成纤维细胞生长因子(basic fibroblast growth factor, bFGF)对实验性视网膜缺血再灌注损伤的治疗作用.方法采用升高眼内压的方法,制作实验性视网膜缺血再灌注损伤大鼠模型.将Wistar大鼠随机分为正常组、缺血组及治疗组.再灌注开始时,缺血组大鼠玻璃体腔内注入平衡盐溶液,治疗组注入bFGF 2 μg.观察再灌注后不同时间段各组鼠视网膜组织学及超微结构变化,光镜下计数视网膜神经节细胞(retinal ganglion cells, RGCs),应用图像分析系统测量视网膜内层厚度.结果视网膜缺血再灌注早期,治疗组大鼠视网膜水肿较缺血组轻,各时间段治疗组大鼠视网膜内层厚度均较缺血组厚,治疗组大鼠RGCs数目多于缺血组.再灌注后168 h,缺血组大鼠神经纤维层厚度及RGCs数目明显低于正常组,而治疗组大鼠神经纤维层厚度及RGCs数目与正常组比较,差异无显著意义(P<0.05).再灌注后24 h,缺血组大鼠RGCs核膜肿胀,线粒体嵴模糊不清,可见凋亡小体,神经纤维中微管模糊、减少甚至消失;而治疗组仅部分核膜轻度肿胀,胞浆内细胞器丰富,线粒体及微管结构较清楚.结论大鼠玻璃体腔注射bFGF对实验性视网膜缺血再灌注损伤具有治疗作用.     

α-硫辛酸对视网膜缺血-再灌注损伤大鼠视网膜中血管内皮生长因子和基质金属蛋白酶表达的影响

目的探讨α-硫辛酸对大鼠视网膜缺血-再灌注损伤中血管内皮生长因子（VEGF）和基质金属蛋白酶-9（MMP-9）表达的影响及作用机制。方法按随机数字表法将78只SPF级健康成年Wistar大鼠分为正常对照组6只及α-硫辛酸组和缺血-再灌注组各36只。α-硫辛酸组和缺血-再灌注组根据再灌注时间的不同分为6、12、24、48h,3d和7d组。采用前房灌注生理盐水升高眼压的方法建立视网膜缺血-再灌注动物模型,其中α-硫辛酸组大鼠自造模前3d开始腹腔注射α-硫辛酸100mg/（kg.d）,缺血-再灌注组大鼠以同样的方法注射等体积生理盐水。在上述时间点分别处死大鼠并摘除眼球,行苏木精-伊红染色评估各组大鼠在各时间点视网膜组织的结构变化;应用免疫组织化学法检测大鼠视网膜缺血-再灌注损伤后不同时间点视网膜组织中VEGF和MMP-9的表达,并对各组VEGF和MMP-9的表达量进行比较。结果缺血-再灌注组大鼠在再灌注后6h出现视网膜水肿和视网膜神经节细胞（RGCs）的轻度改变,随着时间的延长,RGCs的结构改变明显加重。α-硫辛酸组视网膜水肿和RGCs结构的异常变化过程同缺血-再灌注组,但程度较轻。实验前后正常对照组大鼠视网膜中未见VEGF的表达;缺血-再灌注组于再灌注后12h开始出现VEGF的表达,随着时间的延长VEGF表达逐渐增加,到再灌注后48h达到高峰。各时间点缺血-再灌注组和α-硫辛酸组VEGF在视网膜的表达水平明显高于正常对照组,差异均有统计学意义（P〈0.05）,但各时间点α-硫辛酸组VEGF在视网膜的表达水平明显低于缺血-再灌注组,差异均有统计学意义（P〈0.05）。正常对照组大鼠视网膜未检测到MMP-9的表达;缺血-再灌注组在再灌注后6h可检测到MMP-9在视网膜中的表达,24h后其表达水平达到高峰。各时间点缺血-再灌注组MMP-9的表达明显高于正常对照组（P均〈0.05）,α-硫辛酸组视网膜中MMP-9的表达与缺血-再灌注组比较明显下降,差异均有统计学意义（P〈0.05）。缺血-再灌注组视网膜VEGF和MMP-9的表达呈正相关（r=0.834,P〈0.05）。结论视网膜缺血-再灌注损伤可诱导VEGF及MMP-9的表达在视网膜中过度表达,α-硫辛酸可通过抑制视网膜缺血-再灌注损伤中VEGF及MMP-9的表达而对视网膜起保护作用。     

激活的小胶质细胞在大鼠视网膜缺血再灌损伤模型中的作用

目的探讨活化的小胶质细胞在视网膜缺血再灌注损伤过程中的作用。方法前房灌注法建立视网膜缺血再灌注动物模型,在损伤发生后2 h、12 h、24 h、48 h、72 h,采用免疫组织化学染色方法检测特异性抗原标志物CD68的表达,观察活化小胶质细胞的分布、活化程度等,同时观察相应时间点的视网膜超微结构变化。结果对照组中视网膜小胶质细胞主要位于神经节细胞层。缺血再灌注损伤后2 h组视网膜小胶质细胞的分布部位、表达量等基本与对照组相同;缺血再灌注损伤后12 h组视网膜中CD68+细胞表达增多,内丛状层可见阳性细胞。缺血再灌注损伤后24 h组CD68+细胞表达明显增多,部分向视网膜外层迁移。缺血再灌注损伤后48 h组进入视网膜外层的CD68+细胞多数出现于视网膜内丛状层、内核层、外丛状层。缺血再灌注损伤后72 h组活化小胶质细胞数量达到最高水平。视网膜超微结构显示:缺血再灌注损伤后12 h组开始出现损伤表现,视网膜神经节细胞间隙扩大、光感受器细胞外节膜盘疏松变形、可见散在小胶质细胞;缺血再灌注损伤后24 h组病变继续加重,小胶质细胞数量明显增多;缺血再灌注损伤后72 h组病变继续加重,视网膜神经节细胞数量明显减少,细胞核膜肿胀溶解,细胞器溶解,大鼠视网膜神经节细胞层内可见凋亡小体、小胶质细胞,证明了小胶质细胞对光感受器的损伤作用。结论视网膜缺血再灌注损伤出现明显小胶质细胞活化,活化的小胶质细胞在视网膜超微结构的损伤中发挥着重要作用。     

电刺激大鼠小脑顶核对视网膜缺血再灌注损伤的保护作用

目的　探讨电刺激大鼠小脑顶核对视网膜缺血再灌注损伤的保护作用。方法　大鼠随机分为缺血再灌注组、电刺激组和假手术组。观察视网膜形态学改变 ;用NADPH黄递酶组织化学染色法 (NADPH NDP)观察视网膜内诱导型一氧化氮合酶 (iNOS)的表达 ;采用TUNEL法检测视网膜细胞凋亡情况。结果　 (1)缺血再灌注组的内视网膜层 (包括内核层、内丛状层、节细胞 )、神经纤维层和内界膜厚度增加 ,尤其是内丛状层厚度明显高于假手术组 (t=3 6 80 ,P <0 0 1) ;电刺激组的内视网膜厚度与假手术组相比 ,差异无显著意义 (t=1 0 6 4 ,P >0 0 5 ) ;(2 )光镜观察可见缺血再灌注组有明显的细胞核染色质致密浓缩、核碎裂等改变 ,电刺激组仅见少量核浓缩及碎裂 ;(3)电刺激组的iNOS阳性的神经节细胞数明显低于缺血再灌注组 ,其差异有显著意义 (t=3 32 6 ,P <0 0 1) ;(4)电刺激组大鼠发生凋亡的视网膜细胞数明显低于缺血再灌注组 ,其差异有显著意义 (t=4 0 38,P <0 0 1)。结论　电刺激大鼠小脑顶核对缺血再灌注所导致的视网膜组织损伤具有保护作用。     

Involvement of calpain isoforms in ischemia-reperfusion injury in rat retina

PURPOSE: Much evidence has accumulated suggesting that activation of calpain causes neuronal cell death in ischemic brain. However, little is known about the involvement of calpain in retinal cell death in ischemic injury. Thus, the purpose of present study was to investigate the involvement of calpain isoforms (m- and mu-calpain) in ischemia-reperfusion injury in retina from rat. METHODS: Retinal ischemia was produced by occlusion of the central retinal artery for one hour, and this was followed by reperfusion for seven days. Calpain mRNAs, calpain activities, total calcium content and proteolysis of alpha-spectrin were determined in retina. Effect of a calpain inhibitor SJA6017 was histologically tested in retinal injury after ischemia-reperfusion. RESULTS: Following retinal ischemia, most of cells in the ganglion cell layer were sloughed off by day 1 after reperfusion, followed by loss of cells in the inner plexiform layer on day 3 and loss of cells in the inner nuclear layer by day 5. These morphologic changes were accompanied by several presumptive biochemical indicators of calpain activation: increased calcium, proteolysis of alpha-spectrin (a sensitive substrate for calpains), decreased caseinolytic activity for both calpains (suggesting calpain activation followed by autolytic degradation), increased mRNA levels for mu-calpain and calpastatin - the endogenous inhibitor of calpains - and decreased mRNA levels for mu-calpain. Moreover, the calpain inhibitor SJA6017 protected the reduction of cell density in the ganglion cell layer after ischemia-reperfusion. CONCLUSION: These results suggest that calpain isoforms may play an important role in neuronal cell death induced by retinal ischemia-reperfusion injury in rat.     

大鼠视网膜缺血-再灌注损伤后P38丝裂原活化蛋白激酶和半胱氨酸天冬氨酸蛋白酶表达的变化及尼莫地平对二者的影响

目的探讨L型钙通道阻滞剂尼莫地平对大鼠视网膜缺血一再灌注损伤的保护作用及其对细胞信号转导通路的影响。方法Wistar大白鼠95只,随机分为4组。A组正常（空白）对照组5只,B组视网膜缺血-再灌注组（实验对照组）30只,C组视网膜缺血-再灌注＋尼莫地平组（实验组）30只,D组低压灌注组（假手术组）30只,以前房灌注升高眼压的方法制备大鼠视网膜缺血-再灌注模型,分别于再灌注发生后2、6、12、24、72、168h各处死5只大鼠,石蜡包埋后切片。以原位杂交方法检测各时间点视网膜P38丝裂原活化蛋白激酶类（P38MAPK）mRNA表达情况,以免疫组化法检测视网膜半胱氨酸天冬氨酸蛋白酶3（caspase-3）表达情况。结果于Metamorph软件上处理,取平均吸光度值作统计分析。结果视网膜缺血-再灌注损伤后,P38MAPK和caspase-3表达增强。视网膜P38MAPK mRNA原位杂交信号位于节细胞层和内核层的细胞核内,正常视网膜只有少量表达。P38于B组缺血-再灌注后,6h表达即明显增加,至12h达到顶峰,持续至24h,72h后逐渐下降。C组使用尼莫地平后,P38表达趋势与B组相同,但表达水平下降。caspase-3表达情况与P38相似。2h开始见内核层细胞核散在阳性,6h后节细胞层内核层细胞核阳性数增加,至24h达到顶峰。C组caspase-3表达趋势同B组,阳性细胞数及着染深度均小于B组。对平均吸光度值行统计学分析表明：P38MAPK mRNA表达,在6、12、24、72h,B组与A、C组,C组与A、D组间差异有统计学意义。caspase-3表达,除0h、168h这两个时间点外,其他各时间点A、D组与B组,A、D组与C组,B组与C组间差异均有统计学意义。A组与D组间差异无统计学意义。结论P38 MAPK和caspase-3均参与了视网膜缺血-再灌注损伤中视网膜神经细胞信号的转导,尼莫地平通过下调P38MAPK和caspase-3的表达而实现对视网膜的保护作用。（中华眼科杂志,2006,42：435-442）     

Protective effect of ischemic preconditioning on retinal ischemia-reperfusion injury in rats

BACKGROUND: A short period of ischemia can induce remarkable tissue resistance to the deleterious effects of subsequent ischemia and reperfusion. We performed a study to investigate the effect of ischemic preconditioning on retinal ischemia-reperfusion injury in rats. METHODS: Ten Wistar albino rats were divided into two groups of five animals (10 eyes): one group underwent 5 minutes of ischemic preconditioning (achieved by clamping the common carotid arteries at the time of vertebral artery cauterization), and the other did not (control group). In both groups, the vertebral arteries were occluded bilaterally with an electric needle coagulator under an operating microscope. Forty-eight hours later the rats were reanesthesized, and both common carotid arteries were clamped to interrupt blood flow.The duration of ischemia was 30 minutes. The clamp was then removed to enable reperfusion for 4 hours. The animals were killed by decapitation, and retinal sections were evaluated under light and electron microscopy.The signs of ischemia-reperfusion injury (cellular degeneration, vacuolization between retinal layers, increase in retinal thickness due to edema, mononuclear cell infiltration and apoptotic cell count) were recorded. RESULTS: Light microscopy of retinal sections from rats in the ischemic preconditioning group showed a well-preserved retinal structure. The mean thickness values (and standard deviation [SD]) for the inner nuclear layer (104.0 microm [2.54 microm] vs. 49.0 microm [ 10.83 microm]) and inner plexiform layer (134.8 microm [10.13 microm] vs. 88.5 microm [17.46 microm]) were significantly higher in the control group than in the preconditioning group (p = 0.009), indicating increased retinal thickness in the former group due to tissue edema resulting from ischemia-reperfusion injury.The mean mononuclear cell count (6.67 [SD 1.97] vs. 2.5 [SD 1.0]) and apoptotic cell count (18.2 [SD 5.7] vs. 5.3 [SD 1.0]) were significantly higher in the control group than in the preconditioning group (p = 0.002), indicating an inhibitory effect of ischemic preconditioning on leukocyte infiltration and apoptotic cell death. INTERPRETATION: Ischemic preconditioning attenuated ischemia-reperfusion injury in the rat retina.     

大鼠视网膜缺血再灌注后HIF-1α的表达与视网膜细胞凋亡的研究

目的:探讨大鼠视网膜细胞缺血再灌注后低氧诱导因子(HIF-1α)的表达、视网膜细胞凋亡的发生以及二者之间的关系.方法:采用前房灌注生理盐水升高大鼠眼压到110mmHg(1kPa=7.5mmHg)持续1 h的方法制作实验性视网膜缺血再灌注损伤模型,分别于再灌注不同时间点取材,行免疫组织化学法染色观察HIF-1α在视网膜细胞的阳性表达;采用DNA原位末端标记(terminal dUTP nick end labelling,TUNEL)法定位凋亡的视网膜细胞来检测视网膜凋亡细胞.结果:缺血再灌注2h组视网膜神经节细胞层及内核层细胞出现HIF-1α弱阳性表达,12h组阳性表达至高峰,24h组HIF-1α表达渐减少.视网膜组织细胞凋亡见于缺血再灌注12,24及48h组,凋亡细胞主要位于内核层,且24h组凋亡阳性表达最强.结论:缺血再灌注后大鼠视网膜HIF-1α的表达增加.参与视网膜缺血再灌注损伤;视网膜细胞的损伤部分以凋亡的形式发生,HIF-1α的表达可能与视网膜细胞凋亡有密切的关系.     

Degeneration of retinal cells of the rat in pressure-induced ischemia-reperfusion damage: an electron microscopy study]

An ischaemia-reperfusion insult to the retina was produced in one eye of 29 rats by transitory elevation of the intraocular pressure. The ultrastructural morphology of the degenerating retinal cells was studied at several time points after the insult. Three morphologically distinct types of cell death could be individualized. Type I exhibited progressive karyolysis and cytolysis and was consistent with necrosis. Type II was characterized by progressive shrinkage and condensation of the nucleus and cytoplasm followed by heterophagic elimination, thus resembling apoptosis. The main features of type III cell death were homogenization of the nucleoplasm and cytoplasm and dilatation of the perinuclear cisternae; thus, they were evocative of "non-lysosomal vesiculate" cell death. Transitional stages were observed as well.     

Caspase‐related apoptosis in chronic ischaemic microangiopathy following experimental vein occlusion in mini‐pigs

Purpose: Acute brain ischaemia (stroke) causes a central area of coagulation necrosis. Peripheral to it and after a few hours, apoptosis causes neurons throughout the entire area to die progressively. However, this sequence of events is related to the reperfusion of regenerated capillaries or collateral circulation, and is considered to be potentially salvageable. Similar findings have been reported in the retina after ischaemia?reperfusion injury in rats. In the present study, we intended to investigate whether delayed cell death is involved in neuronal injuries to the inner retina during chronic retinal ischaemia. Methods: Experimental branch retinal vein occlusion (BRVO) was induced in miniature pigs using indirect argon laser. The eyes were prelevated at 4, 24 and 48 hours and at 1 and 3 weeks following BRVO. The caspase inhibitor Z‐VAD was injected intravitreally 24 hours after BRVO. Affected retinas were examined 24 hours later for any protective effect from apoptotic cell death. Histological examination with cresyl violet staining and TUNEL (TdT‐mediated dUTP?biotin nick‐end labelling) was performed on the samples. Results: A progressive oedema of the nerve fibre, ganglion cell and inner plexiform layers, related to a widely diffused cell necrosis, was observed in the affected territory within 4–24 hours after BRVO. This was followed by a wave of apoptosis localized at the periphery of the affected territory, which peaked approximately 48 hours after BRVO and was associated with a diffuse oedema of the inner nuclear layer. A progressive atrophy of the inner retina was observed 1–3 weeks after BRVO. Injection of the caspase inhibitor Z‐VAD (24 hours after BRVO) decreased the amount of apoptotic cell bodies 48 hours after BRVO. Conclusions: This study shows that although necrosis is the predominant form of neuronal death in the early phase, massive delayed neuronal cell death caused by apoptosis occurs on a widespread basis as a result of chronic ischaemia after BRVO in the retina. Further studies are needed to evaluate the possibility of rescuing retinal neurons from death by neuroprotective treatments.     

Cell death in the rat retina after a pressure-induced ischaemia-reperfusion insult: an electron microscopic study. I. Ganglion cell layer and inner nuclear layer.

In rats, a pressure-induced ischaemia-reperfusion insult can lead to retinal cell death. In order to elucidate the underlying mechanisms, we performed a qualitative study of the ultrastructural morphology of degenerating retinal cells in the ganglion cell and inner nuclear layers at several time points after the insult. Three morphologically distinct types of cell death could be individualized. Type I was characterized by progressive karyo- and cytolysis and was consistent with necrosis. Type II exhibited progressive shrinkage and condensation of the nuclear and cytoplasmic components followed by heterophagic elimination, thus resembling apoptosis. Type III was characterized mainly by homogenization of the nucleoplasm and cytoplasm and dilation of the perinuclear cisternae and endoplasmic reticulum, thus showing features of 'non-lysosomal vesiculate' cell death. This study lends support to the concept that there may exist a fair but limited number of types of cell death in the retina.     

Lipid peroxidation and peroxynitrite in retinal ischemia-reperfusion injury

PURPOSE: To investigate whether lipid peroxides play a role in retinal cell death due to ischemia-reperfusion injury, whether recombinant human thioredoxin (rhTRX) treatment reduces production of lipid peroxides of the retina, and whether such treatment reduces the number of cells expressing c-Jun and cyclin D1. METHODS: Retinal ischemia was induced in rats by increasing the intraocular pressure to 110 mm Hg for 60 minutes. After reperfusion, immunohistochemical staining for lipid peroxide, peroxynitrite, c-Jun, and cyclin D1 and propidium iodide (PI) staining were performed on retinal sections from animals treated intravenously with and without rhTRX, a free radical scavenger. Quantitative analyses of PI-, c-Jun-, and cyclin D1-positive cells were performed after the ischemic insult. Concentration of lipid peroxides in the retina was determined by the thiobarbituric acid assay. RESULTS: Specific immunostaining for lipid peroxides was seen in the ganglion cell layer at 6 hours after reperfusion, in the inner nuclear layer at 12 hours, and in the outer nuclear layer at 48 hours. Time course studies for PI-positive cells in the three nuclear layers coincided with those of specific immunostaining for lipid peroxides. The specific immunostaining was weakened by pre- and posttreatment with 0.5 mg of rhTRX. The number of PI-, c-Jun-, and cyclin D1-positive cells and the concentration of lipid peroxides were significantly decreased by treatment with rhTRX compared with those of vehicle-treated control rats (P: < 0. 01). CONCLUSIONS: Lipid peroxides formed by free radicals may play a role in neuronal cell death in retinal ischemia-reperfusion injury.