黄酮对眼部血流量和脉络膜新生血管的作用

目的:观察黄酮对兔眼部血流量和大鼠脉络膜新生血管(CNV)的作用。方法:在体研究中,我们采用彩色微球技术测定黄酮对兔眼部血流量的影响。预先给予5g/L黄酮滴眼液(3次/d),1wk后用激光诱导大鼠CNV的生成,在2和4wk末,采用荧光血管造影(FA)测量CNV面积。离体研究中,采用MTT法检测黄酮对人脐静脉内皮细胞(HUVECs)存活率的影响。结果:黄酮显著的增加了兔眼部血流量,抑制了由激光诱导的CNV的生成。离体研究结果表明,黄酮抑制了HU-VEC的增生。结论:黄酮能够增加眼部血流量,并且抑制CNV的生成。     

柚皮素对大鼠眼血流和脉络膜新生血管的作用(英文)

目的:研究柚皮素对激光诱发大鼠脉络膜新生血管形成(CNV)、高眼压兔眼血流和缺血大鼠眼视网膜功能恢复的作用。方法:选择雄性棕色挪威大鼠,采用激光诱发Bruch膜破裂后,予10g/L(20mg/kg)柚皮素,1次/d,持续4wk;光凝后2,4wk分别做眼底荧光血管造影,评估CNV的形成。采用彩色微球技术、眼电生理技术检测兔眼血流和大鼠视网膜功能恢复。结果:与对照组比较,10g/L柚皮素能明显增加高眼压兔眼脉络膜血流(P<0.05),能明显增加缺血大鼠眼视网膜功能恢复(P<0.05),能明显减轻光凝点荧光素渗漏(75.8%～95.0%,P<0.01)。结论:柚皮素能抑制激光诱发大鼠络膜新生血管形成;增加高眼压兔眼脉络膜血流;增加缺血大鼠眼视网膜功能恢复。     

Effects of naringenin on ocular blood flow and choroidal neovascularization in experimental animals

AIM: To investigate the effects of naringenin on laser- induced experimental choroidal neovascularization (CNV) in rat models, ocular blood flow and retinal function recovery after ischemic insults in rat eyes. METHODS: Male Brown Norway rats were treated to break the Bruch's membrane. Naringenin 10g/L (20mg/kg) was given once per day through intraperitoneal injection for 4 weeks after laser treatment. The development of CNV was determined by fluorescein angiography (FA) performed on week 2 and 4. The colored microsphere technique and electroretinography method were used for the study of ocular blood flow and retinal function recovery, respectively. RESULTS: The choroidal blood flow in elevated intraocular pressure (IOP) rabbit eyes was significantly increased by 10g/L naringenin solution as compared to control group (P < 0.05). The retinal function recovery after ischemic insults in rat eyes indicated significant increase of b-wave recovery in treated group, as compared to control group (P <0.05). The intensity of fluorescein leakage from the photocoagulated lesions significantly decreased in treated group, compared to the control group (75.8%-95.0%, P <0.01). CONCLUSION: Naringenin could prevent the development of CNV on laser-induced experimental rat models, increase the choroidal blood flow in elevated IOP rabbit eyes and be beneficial on retinal function recovery in ischemic rat eyes.     

Z,E-butlidedephthalide对大鼠脉络膜新生血管和兔眼血流的影响

目的:研究Z,E-butylidedephthalide(Bdph)对激光诱导的大鼠脉络膜新生血管(CNV)和兔眼脉络膜血流的影响.方法:雄性Brown Norway大鼠行Nd:YAG激光诱导眼底Bruch膜破裂,而后分别予30 mg/kg和15 mg/kg Bdph 1 次/d腹腔注射,连续4 wk.2 wk及4 wk末行眼底荧光血管造影检查.4 wk末制作脉络膜平片测量新生血管的面积.用1 g/L Z,E-butylidenephthalide给雌性新西兰大白兔点眼,采用彩色微球技术测量大白兔眼部血流的变化.结果:和对照组相比,Bdph 30 mg/kg和15 mg/kg组大鼠眼底血管荧光渗漏明显减少,P＜0.01;在此两组中,眼底荧光血管造影测定的新生血管面积以及脉络膜平片测定的新生血管面积都比对照组减少.10 g/L Z,E-butylideneph-thalide滴入兔眼30和60 min后脉络膜血流均比对照组增加,P＜0.05.结论:Z,E-butylidedephthalide可以抑制大鼠脉络膜新生血管的生长,增强兔眼脉络膜血流,可能成为治疗年龄相关性黄斑变性的新药.     

Effect of Z,E-butylidedephthalide on experimental choroidal neovascularization in rat and ocular blood flow in rabbits

To investigate the effect of Z,E-butylidedephthalide (Bdph)on laser-induced experimental choroidal neovasculari- zation (CNV) in rat model and choroid blood flow in rabbits' eyes. · METHODS: Male Brown Norway rats were treated with Nd:YAG laser to break Bruch's membrane. 30mg/kg and 15mg/kg Bdph were given daily through intraperitoneal injection for 4 weeks after laser treatment. Fluorescein angiography (FA) and choroidal flat mount were used to measure the development of CNV. Female New Zealand white rabbits' eyes were instilled with 10g/L Z,E-BdPh solution, and ocular blood flow was measured with colored microsphere technique. · RESULTS: The intensity of fluorescein leakage, indicating the ocular lesion, decreased significantly in group Bdph 30mg/kg and 15mg/kg, as compared to the control at P <0.01. The area of neovascularization checked by FA in both groups of Bdph, at 30mg/kg and 15mg/kg decreased significantly compared to the control group at P <0.05. On the choroid flat mount, the areas of CNV were also smaller in both Bdph groups than that in control group. One percent drug solution instilled into rabbits' eyes could improve the choroid blood flow at 30 and 60 minutes after drug instillation (P <0.05). · CONCLUSION: Z,E-butylidedephthalide can inhibit the development of CNV in the rat eyes and increase the choroid blood flow in the rabbit eyes. These results suggest that Z,E-butylidedephthalide may be a good agent for the treatment of age-related macular degeneration (AMD).     

Effects of hydralazine on ocular blood flow and laser-induced choroidal neovascularization

AIM: To investigate the effect of hydralazine on choroidal blood flow in rabbits and laser-induced choroidal neovascularization (CNV) in rats and on tube formation of human umbilical vein endothelial cells (HUVEC). METHODS: Female New Zealand white rabbits were used with raised intraocular pressure (IOP) of the left eye to 40mmHg. Hydralazine (10g/L) eye drops were instilled and ocular blood flow was measured with colored microspheres technique. Male Brown Norway rats were treated with Nd:YAG laser to break Bruch's membrane. Hydralazine (5, 10, 20g/L) eye drops or saline alone was instilled three times a day for 4 weeks after laser treatment. Fluorescein angiography (FA) and choroidal flat mount were used to measure the area of CNV. Tube formation of HUVEC was studied at different concentrations of hydralazine. RESULTS: With raised IOP to 40mmHg on rabbits, 10g/L hydralazine eye drops enhanced the choroidal blood flow significantly at 30 and 60 minutes after drug instillation. After 4 weeks of drug treatment, 5, 10 and 20g/L hydralazine eye drops all reduced the CNV formation dramatically measured by fluorescein angiography and choroidal flat mount. When HUVEC was cultured on matrix gel for 48 hours, the tube formation of HUVEC were prevented.by hydralazine at 3-30mg /L. CONCLUSION: Hydralazine prevents CNV formation in vivo and HUVEC tube formation in vitro, and enhances rabbits' choroidal blood flow after ischemia. It is hoped that hydralazine could be used to treat age-related macular degeneration in the future.     

经瞳孔透热治疗黄斑下新生血管

目的 老年性黄斑变性是目前老年人中心视力丧失的主要因素之一。黄斑凹下脉络膜新生血管即视网膜色素上皮层与Bruch膜之间新生血管形成是其致盲的病理基础。黄斑部光凝治疗证实其对部分患者有效，但经1a随访视力下降明显，经瞳孔区透热疗法其机理是应用810nm激光，将热通过瞳孔透入到脉络膜和视网膜色素上皮区，早期研究主要用于治疗脉络膜黑色素瘤，近来研究证实对治疗老年性黄斑变性患者隐匿性脉络膜新生血管有效，且无其他副作用。     

光动力疗法治疗脉络膜新生血管性疾病的初步临床观察

目的:观察使用维替泊芬光动力疗法(photodynamic thera-py,PDT)治疗年龄相关性黄斑变性(age-related maculardegeneration,AMD)、病理性近视和特发性脉络膜新生血管(choroidal neovascularization,CNV)等3种主要的CNV相关疾病的临床效果。方法:对96例(109眼)经临床确诊的上述CNV患者进行PDT治疗,随访1～24(平均9.4)mo。采用最佳矫正视力、荧光素血管造影、吲哚青绿血管造影、光学相干断层成像等指标,观察治疗前后患者的视功能、CNV病灶大小及渗漏情况、以及视网膜水肿变化等,评价PDT治疗CNV的疗效。结果:本组病例包括AMD42例(54眼),病理性近视17例(18眼),特发性CNV患者37例(37眼)。AMD、病理性近视和特发性CNV的平均治疗次数分别为1.2,1.5和1.2次;视力稳定和提高者各组分别为83.3%,83.3%和86.5%;CNV渗漏停止或减少者各组分别为90.7%,83.3%和89.2%:视网膜水肿减轻者各组分别为77.8%,88.9%和86.5%。除3例AMD患者出现眼部严重不良反应外,未发现其他严重不良反应。结论:PDT可有效地改善或稳定AMD、病理性近视和特发性CNV患者的视功能,控制病变进展,近期随访结果安全有效。     

玻璃体腔内注射Avastin治疗老年性黄斑变性引起的脉络膜新生血管

年龄相关性黄斑变性(age-related macular degeneration,AMD)是一种严重威胁老年人视功能的眼底疾病,随着抗VEGF药物(avastin)的诞生,治疗该病显现出蓬勃的发展趋势,它不但可以延缓脉络膜新生血管(choroidal neovascularization,CNV)的进展,还可以提高视力。现将avastin治疗AMD中CNV的相关应用作一综述。     

Genetic analysis of simultaneous geographic atrophy and choroidal neovascularization

AimTo investigate clinical presentation and genotypes in patients with simultaneous geographic atrophy (GA) and choroidal neovascularization (CNV) and to compare with patients with GA or CNV only.Patients and methodsTwenty patients with combined CNV-GA and 154 CNV only and 154 GA only were chosen based on clinical exam and imaging. Six single-nucleotide polymorphisms (SNPs)-rs2274700 and rs1061170 (complement factor H), rs10490924 and rs11200638 (HTRA1/LOC387715), rs2230199 (C3), rs9332739 (C2)-were genotyped using the SNaPshot method. Chi-squared tests were used for genetic analysis.ResultsIn patients with CNV-GA, GA progressed slowly and often preceded CNV. CNV presented as subretinal haemorrhage or fluid, with a sudden drop in visual acuity (VA). Comparing combined CNV-GA to GA and CNV only, patients with both had a higher frequency of at-risk alleles at both SNPs within the HTRA1 gene-rs10490924 (52.5%), rs11200638 (52.6%). Statistical significance was not achieved. CNV-GA patients had no protective alleles at SNP rs9332739 (C2), compared with GA (27%) and CNV only (10%).ConclusionThere is a paucity of reports describing simultaneous CNV-GA. Clinical and genetic results may support the fact that GA and CNV fit on an age-related macular degeneration (AMD)-disease continuum and may clarify the disease processes in AMD.     

Low dose radiation for subfoveal choroidal neovascularization in age-related macular degeneration. A pilot study

The aim of our pilot study was to test the effect of low dose radiation on classic and occult subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD). The posterior pole of the afflicted eye of 12 patients was irradiated with 5 Gray (Gy), and that of 34 patients with 8 Gy. The radiotherapy was done by a linear accelerator (6 MV X-rays) during 4 consecutive days with daily doses of 1.25 Gy and 2 Gy respectively. At the time of treatment, and 6 weeks, 6 months and 1 year after, a simultaneous fluorescein and ICG angiography of both eyes were carried out, and the distance visual acuity was measured. In none of the cases were we able to note a reduction in the subfoveal membrane's size. With regards to the visual acuity, the evolution was slightly better than the spontaneous courses described in existing literature. Further prospective randomized studies with higher dose radiation are necessary in order to determine the significance of radiotherapy in the treatment of this pathology.     

Intravitreal bevacizumab for subfoveal choroidal neovascularization secondary to age-related macular degeneration in an Indian population

Purpose To investigate the 6-month safety profile and clinical outcomes of intravitreal bevacizumab for treating subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods We performed a prospective nonrandomized interventional study of 40 consecutive patients (40 eyes) with subfoveal CNV due to AMD. Patients underwent standard ophthalmic examination, optical coherence tomography, and fundus fluorescein angiography. All patients were administered one or more intravitreal injections of bevacizumab (1.25 mg) as primary therapy. Outcomes were also analyzed in subgroups based on lesion type (classic or occult) and lesion size (≤3000 μm or >3000 μm). Results At the 6 months’ follow-up, mean best-corrected visual acuity (BCVA) improved from 20/160 to 20/100 (P = 0.014), and the mean contrast sensitivity improved from 0.38 to 0.62 (P = 0.001). The mean greatest linear diameter and mean central macular thickness significantly decreased from 3.79 mm to 2.4 mm (P = 0.0001) and from 438.5 μm to 363 μm (P = 0.0001), respectively. Visual acuity gain of 15 letters or more was seen in 20% of patients, and the gain was more in the small-lesion subgroup (31.5%) than in the large-lesion subgroup (9.5%). No significant adverse effects were observed. Conclusion Intravitreal bevacizumab is a safe and effective modality for treatment of CNV secondary to AMD. A significant improvement in BCVA with intravitreal bevacizumab was observed for all lesion types.     

Limited macular translocation for subfoveal choroidal neovascularization in age-related macular degeneration

Purpose: To examine the safety and efficacy of limited macular translocation followed by laser photocoagulation in the management of subfoveal choroidal neovascularization (CNV) in age‐related macular degeneration (AMD). Methods: A prospective study was conducted on eight consecutive patients undergoing limited macular translocation followed by laser photocoagulation for the treatment of subfoveal classic CNV form of AMD. Patients were followed up for a minimum of 12 months. The magnitude of foveal translocation, visual outcomes and complications were assessed. Results: In all cases the fovea was successfully translocated inferiorly, with a median displacement of 1.1 mm. Thermal laser photocoagulation was subsequently performed in all cases. Visual acuity improved in five eyes, remained unchanged in two eyes and worsened in one eye. The mean improvement in visual acuity was by 0.19 logMAR. At 12 months, six of the eight patients (75%) achieved Snellen visual acuity of at least 6/15, with four patients (50%) achieving Snellen visual acuity of 6/9. Conclusion: In this small case series, limited macular translocation was found to be an effective and reproducible means of treating small well‐defined subfoveal CNV.     

经瞳孔温热疗法治疗脉络膜新生血管的临床研究

目的探讨经瞳孔温热疗法(TTT)治疗老年性黄斑变性(AMD)及高度近视患者脉络膜新生血管(CNV)的临床疗效及安全性。方法分别对经眼底血管造影证实有经典型或隐匿型CNV的33例37眼AMD或高度近视患者进行TTT治疗。TTT各光斑平均功率密度为(18.32±2.23)W/cm2。定期随访视力、眼底等,平均随访(3.7±2.3)个月(1～7个月)。结果经过1次或多次TTT治疗,17眼(45.9%)症状减轻或消失;视力稳定或提高者32眼(86.5%),下降≥1行者5眼(13.5%);7眼于TTT过程中视网膜出血增加,3眼随访过程中出现其他部位的新鲜出血。在行造影复查的患者(22例22眼)中,14眼(63.6%)渗漏减轻或消失。结论TTT治疗CNV是一种安全、有效的方法,但其疗效的最终评价以及激光参数的选择依据等需要进一步大样本、长时间的临床研究。     

A 5-year follow-up study for distance visual acuity after low dose radiation on subfoveal choroidal neovascularization in age-related macular degeneration

In a prospective study with a 5-year follow-up, we assessed the effect of a single series of low-dose radiation on the distance visual acuity in eyes with angiographically confirmed subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). The posterior pole of 12 eyes was treated with 5 Gy (4 x 1.25 Gy), and 34 eyes treated with 8 Gy (4 x 2 Gy). The best corrected distance visual acuity was measured at the time of treatment, and annually thereafter for 5 years. The study obtained complete follow-up for 11 patients in the 5-Gy group (nine classic, two occult CNVs), and 29 patients in the 8-Gy group (12 classic, 17 occult CNVs). At baseline, the mean distance visual acuity of the treated eyes was 0.16 (20/125) in the 5-Gy group, and 0.2 (20/100) in the 8-Gy group. Five years later, an average loss of 3.2 lines was present in the 5-Gy group, and 4 lines in the 8-Gy group. After 5 years, an average loss of 2 lines was found in a control group consisting of 18 second eyes with low stage dry ARMD, with a mean distance visual acuity of 0.5 (20/40) at baseline. Statistical analyses with Wilcoxon and Mann-Whitney U-tests showed that a single series of low dose radiation with either 5 Gy or 8 Gy was not able to stabilize the distance visual acuity of eyes with subfoveal CNV in ARMD during a 5-year follow-up.     

脉络膜厚度与年龄相关性黄斑变性发病关系的研究进展

年龄相关性黄斑变性(ARMD)是一种慢性的、进行性的黄斑视网膜退行性疾病,是目前中老年人的主要致盲性眼病,其发展过程和发病机制复杂。研究表明,脉络膜厚度在ARMD不同分期和分类中均有显著变化。鉴于脉络膜是一种能够快速改变血流的血管结构,脉络膜厚度的变化可能主要是由脉络膜血流的变化引起的。并且,脉络膜的异常血流灌注可进一步损害视网膜色素上皮细胞的功能,导致视网膜色素上皮层缺氧、缺血,最终诱发ARMD。目前,越来越多的人意识到脉络膜厚度的测量在ARMD的诊断和治疗中的重要性,因此本文将针对脉络膜厚度和脉络膜血流在ARMD病程和治疗后的改变以及相关发病机制进行综述,这可能为ARMD发病提供新的预测指标,并为开发新的ARMD治疗方法提供新的目标。     

胼酞嗪对眼血流和激光诱导的脉络膜新生血管及体外培养的内皮细胞的影响

目的：研究胼酞嗪对兔脉络膜血流和激光诱导的鼠脉络膜新生血管及人脐静脉内皮细胞管状结构形成的影响。方法：雌性新西兰白兔左眼眼内压升高至40mmHg后，滴入10g／L胼酞嗪滴眼液，采用彩色微球技术测量眼血流变化。用Nd：YAG激光诱导雄性BrownNorway大鼠至Bruch膜破裂，而后分别予生理盐水或5，10和20g/L胼酞嗪滴眼液点眼，3次／d，连续4wk。采用眼底荧光血管造影和脉络膜平片测量新生血管的面积。此外亦用不同浓度的胼酞嗪作用于培养之人脐静脉内皮细胞并探讨对其管状结构形成的影响。结果：10g／L胼酞嗪滴眼液滴入眼内压为40mmHg的兔眼30，60min后，脉络膜血流明显增加。眼底荧光血管造影和脉络膜平片测量均显示，经过4wk药物治疗，5，10，20g／L胼酞嗪滴眼液均明显抑制了鼠眼CNV的形成。3—30mg／L胼酞嗪对在基质凝胶中培养了48h的人脐静脉内皮细胞的管状结构的形成有抑制作用。结论：胼酞嗪可以抑制体内脉络膜新生血管及体外培养的人脐静脉内皮细胞管状结构的形成，并增强缺血后的兔脉络膜血流。胼酞嗪有望成为治疗年龄相关性黄斑变性的药物。     

人参皂苷RG3对脉络膜新生血管的抑制作用

目的 分别从体外实验和体内实验两个方面探讨人参皂苷RG3对脉络膜新生血管的抑制作用.方法 体外实验:MTT检测人参皂苷RG3对人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVEC)增殖的抑制作用,HUVEC分为正常组(含体积分数10％胎牛血清的DMEM/F-12培养基)、对照组(含2 g· L-1 DMSO)和12.5 μmol·L-1、25.0 μmol·L-1、50.0 μmol·L-1、100.0 μmol·L-1人参皂苷RG3给药组,给药处理6h后测定其吸光度值.HUVEC分为对照组(含2g·L-1DMSO)和100.0Iμmol·L-1人参皂苷RG3组,小管形成实验检测人参皂苷RG3对小管形成的抑制作用,Western blotting检测人参皂苷RG3对VEGF蛋白表达的影响.体内实验:雄性C57BI/6J小鼠20只,随机分为对照小鼠组和人参皂苷RG3小鼠组,皮下注射预处理给药2周,半导体激光造模,于光凝后第1天和第21天行荧光素眼底血管造影检查.结果 MTI结果显示,正常组、对照组、12.5 μmol·L-1、25.0 μmol·L-1、50.0 μmol·L-1、100.0 μmol·L-1人参皂苷RG3给药组的吸光度值分别为0.43±0.17、0.43 +0.05、0.33±0.02、0.24±0.02、0.18 +0.01、0.15 +0.01,对照组与正常组相比差异无统计学意义(P＞0.05),其余各组与对照组相比差异均有统计学意义(均为P＜..05).小管形成实验结果显示,对照组与100.0 μmol·L-1人参皂苷RG3组小管形成数目分别为(72.5±5.56)个和(11.33±3.71)个,差异有统计学意义(P＜0.01).Western blotting结果显示,100.0 μmol·L-1人参皂苷RG3组的VEGF蛋白相对表达量(0.14±..01)明显低于对照组(0.46±0.0l),差异有统计学意义(P＜0.01).体内实验荧光素眼底血管造影结果显示,人参皂苷RG3小鼠组的荧光渗漏面积明显低于对照小鼠组.结论 人参皂苷RG3可以抑制脉络膜新生血管的形成.