视盘内注射组织凝血酶原激活剂治疗视网膜中央静脉阻塞的初步研究(英文)

Injection of tissue plasminogen activator into the optic nerve in an animal model of retinal vein occlusion

目的:研究探讨视盘内注射组织凝血酶原激活剂治疗视网膜中央静脉阻塞的可行性及有效性。方法:利用光敏剂及氩激光制备兔眼视网膜静脉组塞模型,经FA确认后随机分组。治疗组(10眼,20支静脉)视盘内注射12.5μg tPA/0.05mL。对照组(12眼,24支静脉)视盘内注射0.05mL BSS。分别在注入后的第3,7d行FAG检查确认视网膜静脉的再通情况,同时行裂隙灯及间接眼底镜检查,并行病理组织学检查。结果:利用光敏剂及氩激光成功地复制出了兔眼视网膜静脉组塞模型并经视网膜静脉荧光造影确认。治疗组阻塞静脉的再通率是70.0%(14/20),对照组阻塞静脉的再通率是16.7%(4/24)(P=0.001)。结论:视盘内注射12.5μg tPA/0.05mL提高了阻塞静脉的再通率,经睫状体扁平部向视神经内注射tPA有望成为局部用药治疗CRVO的新方法。视神经内注射tPA的安全性量及最佳量-效关系有待进一步研究。

AIM： To investigate the feasibility and efficacy of tissue plasminogen activator （tPA） injection into the optic nerve as a treatment for retinal vein occlusion in rabbits. METHODS： Rose Bengal-mediated laser-induced retinal vein occlusions were produced in rabbit eyes. Fluorescein angiography （FA） was performed on each eye 3 days before laser irradiation and 30 minutes after laser irradiation. The treatment group （ n = 20 veins） received intra-optic nerve injection of tPA （12.51μg in 0.05mL BSS） and the controls （ n = 24 veins） received 0.05mL BSS. FA was repeated to determine the recanalization of the vessel at 3 and 7 days after treatment, followed by histological examination. RESULTS： Rose Bengal-mediated laser-induced retinal vein occlusions were successfully developed and confirmed by FA. The incidence of the recanalization of the vessels in treatment animals was 70.0%, while 16.7% in the control animals （P= 0. 001）. CONCLUSION ： Intra-optic nerve tPA injection increased the incidence of recanalization of the occluded vessels. Although further studies are needed, our data suggested that injection of tPA into the optic nerve may have a potential benefit in the treatment of central retinal vein occlusion.