光动力学疗法治疗角膜新生血管后角膜的光电镜改变  

Histological evaluation of photodynamic therapy for corneal neovascularization

作　　者：黄映湘[1] 张风[2] 李彬[2] 李志辉[2] 严伟[2] 熊颖[2] 周辉[2] 

机构地区：[1]首都医科大学附属北京友谊医院眼科,北京100050 [2]北京同仁医院眼科

出　　处：《眼科研究》2005年第2期162-165,共4页Chinese Ophthalmic Research

基　　金：北京高科技实验室重点课题;北京市自然科学基金资助(7982020)

摘　　要：目的观察应用国产光敏剂行光动力学疗法(PDT)治疗角膜新生血管后角膜的组织学改变。方法碱烧伤有色兔角膜制作角膜新生血管模型。血啉单醚5mg/kg自耳缘静脉注射,不同的能量密度61.2-52.8J/cm2的氲绿激光照射角膜新生血管根部,不注射血啉单醚并单纯行同等能量密度的激光照射组作为对照组,PDT治疗后3h、1周、1个月行角膜光电镜检查。结果PDT后3h可见角膜急性炎症反应,有大量中性粒细胞浸润和少量嗜酸性白细胞浸润,虹膜组织无损伤。PDT后1周角膜炎症反应大部分消失,可见新生血管腔内有无定形物质填塞和许多影子血管。透射电镜显示:PDT组角膜新生血管内皮细胞内线粒体显示出空泡样变,细胞形态不完整。结论血啉单醚作为光敏剂,应用氩绿激光对角膜新生血管行PDT治疗,导致新生血管内皮细胞损伤,能有效封闭角膜新生血管,对周围组织无明显损伤。Objective To investigate the histological change of cornea after photodynamic therapy (PDT) for corneal neovascularization (CoNV) . Methods Experimental CoNV was induced by alkali burn in 18 eyes of 18 pigmented rabbits. The trunks of CoNV were irradiated by argon green laser at the fluence of 61. 2 to 152. 8 J/cm2 following intravenous injection of 5 mg/kg hematoporphyrin monomethyl ether (HMME). A matched laser irradiation without injection of HMME was designed in the control group. The histopathologic changes were observed under the light and electron microscopy after 3 hours,1 week and 1 month of PDT. Results Acute inflammatory reaction of cornea was seen under the light microscopy at 3 hours after PDT and disappeared 1 week later. There was no obvious injury of iris. Ghost vessels were seen in the cornea after PDT. Electron microscopy demonstrated vacuolation of mitochondrions and non-integrity in the new vessels' endothelial cells. Conclusion PDT can destroy endothelial cells of new vessels, suggesting that this modality is a possible treatment for CoNV.

关 键 词：氩绿激光 血啉单醚 角膜新生血管 光动力学治疗 

分 类 号：R772.2[医药卫生—眼科]