CAJ | 학술논문

目的对比分析硅油与重硅油眼内填充对兔眼视功能、视网膜超微结构及组织形态的影响.方法健康标准家兔28只随机分为A、B、C组,分别为12、12、4只.所有兔常规行玻璃体切割手术,A组填充硅油,B组填充重硅油,C组填充平衡盐溶液.手术后4、8、12、24周,采用视网膜电图(ERG)和光相干断层扫描(OCT)检查,测量其b波振幅和后极部视网膜厚度;取各组兔眼视网膜全层组织,采用透射电子显微镜和光学显微镜观察视网膜超微结构及组织形态变化.结果 ERG检查结果显示,与C组比较,B组兔眼b波振幅于手术后4周开始下降,手术后8周下降明显;A组兔眼b波振幅于手术后8周开始下降,手术后24周下降明显.手术后8、12、24周,B组兔眼b波振幅下降幅度均较A组更大,差异均有统计学意义(P＜0.05).OCT检查发现,手术后24周,A、B组兔眼后极部视网膜厚度均较C组降低,差异有统计学意义(P＜0.05);B组兔眼后极部视网膜厚度下降幅度较A组更大,差异也有统计学意义(P＜0.05).透射电子显微镜和光学显微镜观察发现,A、B组兔眼视网膜超微结构与组织形态分别于手术后12、8周出现严重病理改变.B组兔眼视网膜超微结构中的视锥视杆细胞、盘膜、线粒体、细胞质、细胞核等细胞器造成的水肿及坏死程度均较同时期A组更重.B组兔眼视网膜组织形态损害及神经节细胞、内核层细胞的变性程度均较同时期A组更重.且随着硅油或重硅油填充时间的延长,视网膜超微结构、视网膜组织形态的损害及细胞变性程度更为严重.结论重硅油眼内填充后对兔眼视功能、视网膜超微结构与组织形态的同期影响均大于硅油,且随着时间的延长两种填充物对其的影响越发显著.
목적 대비분석규유여중규유안내전충대토안시공능、시망막초미결구급조직형태적영향.방법 건강표준가토28지수궤분위A、B、C조,분별위12、12、4지.소유토상규행파리체절할수술,A조전충규유,B조전충중규유,C조전충평형염용액.수술후4、8、12、24주,채용시망막전도(ERG)화광상간단층소묘(OCT)검사,측량기b파진폭화후겁부시망막후도;취각조토안시망막전층조직,채용투사전자현미경화광학현미경관찰시망막초미결구급조직형태변화.결과 ERG검사결과현시,여C조비교,B조토안b파진폭우수술후4주개시하강,수술후8주하강명현;A조토안b파진폭우수술후8주개시하강,수술후24주하강명현.수술후8、12、24주,B조토안b파진폭하강폭도균교A조경대,차이균유통계학의의(P＜0.05).OCT검사발현,수술후24주,A、B조토안후겁부시망막후도균교C조강저,차이유통계학의의(P＜0.05);B조토안후겁부시망막후도하강폭도교A조경대,차이야유통계학의의(P＜0.05).투사전자현미경화광학현미경관찰발현,A、B조토안시망막초미결구여조직형태분별우수술후12、8주출현엄중병리개변.B조토안시망막초미결구중적시추시간세포、반막、선립체、세포질、세포핵등세포기조성적수종급배사정도균교동시기A조경중.B조토안시망막조직형태손해급신경절세포、내핵층세포적변성정도균교동시기A조경중.차수착규유혹중규유전충시간적연장,시망막초미결구、시망막조직형태적손해급세포변성정도경위엄중.결론 중규유안내전충후대토안시공능、시망막초미결구여조직형태적동기영향균대우규유,차수착시간적연장량충전충물대기적영향월발현저.
Objective To investigate the medium and long-term influence of silicon oil versus heavy silicone oil on rabbit retinas.Methods 28 health standard rabbits were randomly divided into A,B and C groups,with 12,12 and 4 rabbits respectively.All rabbits received routine vitrectomy and tamponade with silicone oil (group A),or heavy silicone oil (group B) or balanced salt solution (group C).After 4,8,12 and 24 weeks,the retinal b-wave amplitude was measured by ERG,posterior retinal thickness was measured by optical coherence tomography (OCT).Retinal ultrastructure and tissue morphology were observed by transmission electron microscopy and optical microscopy.Results Compare to group C,the b-wave amplitude decreased at 4 weeks after surgery,and decreased at 8 weeks after surgery for group B,and decreased at 8 weeks after surgery,and decreased at 24 weeks after surgery for group A.The decreases were greater in group B than group A at 8,12,24 weeks after surgery,the difference was statistically significant (P＜0.05).The posterior retinal thickness of group A and B was thinner than group C at 24 weeks after surgery (P＜0.05).The decreases were greater in group B than group A,the difference was statistically significant (P＜0.05).Transmission electron microscopy and optical microscopy revealed severe pathological changes of retinal ultrastructure and morphology in group A and B rabbit eyes,at 12 weeks and 8 weeks after surgery respectively.The changes were more severe in group B and group A,including edema and necrosis in cone/rod cells,in disk membranes,mitochondria,cytoplasm,nucleus and other organelles.The morphological changes were also more severe in group B and group A,including degenerations of ganglion cell layer,inner nuclear layer changes.Those changes became more severe when the tamponade time extended.Conclusion The heavy silicone influence on visual function,ultrastructures,histomorphology of rabbit retinas is much worse than the silicon oil,and the effect is more significant with its time prolong.