养血补肾方对形觉剥夺性高度近视模型巩膜超微结构的影响

Effect of blood-nourishing and kidney-tonifying decoction on scleral ultrastructure in form deprivation high myopia model

目的建立豚鼠形觉剥夺性高度近视(FDM)模型,观察后极部巩膜的病理及超微结构变化,及养血补肾方对高度近视超微结构的干预作用。方法取2周龄大的健康豚鼠,用半透明白色气球眼罩行右眼遮盖60d制备形觉剥夺性近视模型。通过光镜及电镜检查分析巩膜厚度及形态学的变化。随机分为治疗组和对照组,治疗组以养血补肾方灌胃,15d后再行光镜和电镜检测。结果豚鼠右眼以半透明眼罩遮盖60d后成功制备剥夺性近视模型,与自身对照眼相比屈光度增加明显,遮盖前屈光度为(3.924±3.392)D,遮盖后(-2.583±2.954)D,差异有统计学意义(P<0.05)。高度近视模型眼的巩膜明显变薄,胶原纤维分布稀疏,直径变小,排列紊乱,细胞外基质增多,而对照眼巩膜胶原纤维直径分布均匀,细胞外基质少。治疗组模型眼显示巩膜胶原排列较为紧致,走行较规则。结论应用遮盖法对豚鼠施行长期单眼形觉剥夺会形成高度近视。高度近视巩膜明显变薄,结构紊乱,这些病理形态改变可能导致巩膜抗压能力降低,眼轴增长。因此阻止后巩膜延伸、增强巩膜抗力,对预防近视及阻止近视向高度近视发展具有重要意义。养血补肾方能延缓巩膜重塑变薄的病理改变,高度近视患者定期服用对延缓其进展有一定帮助。

OBJECTIVE Establishing a guinea pig model of form deprivation high myopia,to observe the pathological and ultrastructural changes of the posterior sclera and the effect of blood-nourishing and kidney-tonifying decoction on ultrastructure of high myopia.METHODS A model of form deprivation myopia(FDM)was made with a translucent eye mask made of white balloon for 60 days in 2 week old healthy guinea pigs.The changes in the thickness and morphology of scleral in high myopia were analyzed by light and electron microscopy.All the guinea pigs were randomly divided into treatment group and control group.Blood-nourishing and kidney-tonifying decoction was given to the treatment group for 15 days,then light microscopy and electron microscopy detection were done.RESULTS The model of experimental ocular deprivation myopia was successfully prepared by a translucent mask covering the right eye of the guinea pig after 60 days.The diopter was significantly increased compared with the control eye.The diopter was(3.924±3.392)D before deprivation,and(-2.583±2.954)D after deprivation,and the difference was statistically significant(P<0.05).The sclera of high myopia model eyes were thinner,collagen fibers were sparse,smaller in diameter,arranged in disorder,and extracellular matrix increased,while the sclera collagen fibers in controlled eyes were evenly distributed and had less extracellular matrix.The scleral collagen arrangement was more compact and regular in the treatment group.CONCLUSIONS The long-term monocular form deprivation of the guinea pig could lead to high myopia by the application of cover method.The sclera of high myopia was obviously thinner and disorganized,and these pathological changes may lead to the decrease of scleral compression ability and the growth of ocular axis.Therefore,it is of great significance in prevention and treatment of high myopia by preventing the extension of the posterior sclera and strengthening the resistance of the sclera.Blood-nourishing and kidney-tonifying decoction delayed the pathological changes of scleral remodeling,and high myopia patients regularly using it would get benefits in a slowing down progress.