“二步法”激光诱导脉络膜视网膜静脉吻合术治疗兔视网膜中央静脉阻塞的视觉电生理变化  

Electroretinogram of central retinal vein occlusion treated with two-step laser-induced chorioretinal venous anastomosis in rabbits

作　　者：陈立军[1] 王雨生[1] 王海燕[1] 张鹏[1] 王伟[1] 马吉献[1] 

机构地区：[1]第四军医大学西京医院眼科

出　　处：《眼科新进展》2006年第4期253-256,共4页Recent Advances in Ophthalmology

基　　金：第四军医大学西京医院新技术;新业务项目(编号:XJGX03008Z08)~~

摘　　要：目的 评价“二步法”激光诱导脉络膜视网膜静脉吻合术（laser-induced chorioretinalvenousanastomosis，LCRVA）治疗实验性视网膜中央静脉阻塞（centralretinalveinocclusion，CRVO）的有效性。方法 青紫蓝兔30只，8只（16眼）设为正常对照组，其余22只（44眼）采用光动力学方法建立双眼的CRVO模型。CRVO模型成功后，对双眼CRVO兔（15只），随机选1眼先后用倍频Nd：YAG激光器和Nd：YAG激光器分剐在选定部位击破Bruch膜及相邻的静脉壁，以建立视网膜静脉与脉络膜血管之间的吻合通道；对侧眼作为CRVO对照眼；4只单眼CRVO兔中，2只为LCRVA治疗组，另2只为CRVO对照组。于术前1d，术后4h、1d、3d、1周、2周、3周、4周、8周、12周和16周各时间点，分别进行ERG检测。结果 34眼（77．3％，15只兔双眼，4只兔单眼）一次性建立了CRVO模型。对其中的17眼行LCRVA，每眼击射2个点。经眼底荧光素血管造影检查证实，在8眼（47．0％）中的11个点（32．4％）存在功能性吻合。CRVO对照组较正常对照组在各时间点主要表现为ERGb波潜伏期延长，振幅下降。经LCRVA治疗后2～3周，b波振幅呈恢复趋势，与CRVO对照组有显著性差异（P〈0．05）。OPs波振幅与ERGb波呈现相似变化。ERGa波变化不明显。结论 兔CRVO眼的视网膜功能明显受损，LCRVA可一定程度减轻CRV0对视功能的损害。Objective To evaluate therapeutic effect of two-step laser-induced chorioretinal venous anastomosis （LCRVA） for treatment of experlmental central retinal vein occlusion （CRVO）. Methods CRVO models were established in 22 （44 eyes） of 30 rabbits by photedynamic method.In 15 rabbits with bilateral CRVO,one eye of each animal was randomly treated to rupture the Burch＇ s membrane and the adjacent venous wall by using multiple-frequency Nd： YAG and Nd： YAG laser devices, respectively. Another eye was assigned as CRVO control group. In 4 rabbits with unilateral CRVO, 2 underwent LCRVA, and 2 were as CRVO control group. Electroretinography was taken before treatment, as well as 4 hours, 1 day, 3 day, lweek,2weeks,3 weeks,4 weeks,8 weeks, 12 weeks and 16 weeks after treatment. Results Thirty-four eyes（77.3%）were accomapltshed CRVO model and 17 of them were treated with LCRVA at two different sites in each retina. Fundus fluorescein angiogmphy revealed that the functional anastomosis were established in 8 eyes （47.0%,11 sites） after 3 to 5 weeks. The implicit time of ERG b waves prolonged and the amplitude decreased in CRVO group compared with normal group at various times. ERG b waves in LCRVA group improved 2-3 weeks later compared with CRVO control group（P〈 0.05）. The pattern of OPs waves was similar to ERG b waves, whereas no obvious change was detected in ERG a waves. Conckusion LCRVA could relieve the impairment to retinal function induced by CRVO in some extent.

关 键 词：脉络膜视网膜静脉吻合术 视网膜中央静脉阻塞 兔 视网膜电图 

分 类 号：R779.63[医药卫生—眼科]