壳聚糖抑制兔外伤性增生性玻璃体视网膜病变的作用

Chitosan inhibits traumatic proliferative vitreoretinopathy in rabbits

背景:在眼科领域,已发现壳聚糖可以抑制青光眼手术瘢痕形成,但还未有明确的报道可以阻止和减缓增生性玻璃体视网膜病变的发生。目的:观察壳聚糖对兔外伤性增生性玻璃体视网膜病变的防治作用及作用机制。方法:用自体富含血小板血浆玻璃体内注射制备兔外伤性增生性玻璃体视网膜病变模型,并同时将生理盐水、5%壳聚糖、10%壳聚糖和15%壳聚糖溶液0.1mL注入兔眼玻璃体内,在不同时间点观察壳聚糖对增生性玻璃体视网膜病变形成的防治作用。结果与结论:对照组第10天就出现视网膜脱离,增生性玻璃体视网膜病变随着时间延长发展至更严重等级。壳聚糖组也发生增生性玻璃体视网膜病变,但其严重程度均低于对照组。10%和15%壳聚糖组给药5d后,增生性玻璃体视网膜病变的临床分级显著低于对照组(P<0.05)。组织学检查壳聚糖组未发现明显视网膜形态改变。结果说明壳聚糖玻璃体腔内注射是安全的,并能有效抑制兔外伤性增生性玻璃体视网膜病变的发生发展。

BACKGROUND： The research has found that chitosan can inhibit the scar formation in glaucoma surgery. However, there is not yet a clear report whether chitosan can prevent and slow the formation of proliferative vitreoretinopathy （PVR）. OBJECTIVE： To investigate the effect of chitosan on traumatic PVR in rabbits and its mechanism. METHODS： Rabbit traumatic PVR model was made by intravitreal injection of platelet-rich plasma. Subsequently, the rabbit vitreous body received an intravitreal injection of 0.1 mL normal saline, 5%, 10% and 15% chitosan. The preventive and therapeutic effect of chitosan on traumatic PVR was examined at different time points. RESULTS AND CONCLUSION： In the control group, the retina was detached after 10 days; the PVR had progressed to high stage over time. In chitosan group, the PVR also developed; however, the severity of PVR in chitosan group was lower than that in control group. The clinical grading of traumatic PVR in 10% and 15% chitosan group was significantly lower than that in the control group at 5 days after injection （P 0.05）. Histological examination showed that there was no obvious morphological change of the retina in chitosan group. Intravitreal injection of chitosan is a safe and effective mean to reduce the development of traumatic PVR.