光动力与经瞳孔温热疗法诱导前部缺血性视神经病变的动物模型研究

Photodynamic and Transpupillary Thermal Therapy Method Indusined Anterior Ischemic Optic Neuropathy of Rabbit Model

摘要: 目的：前部缺血性视神经病变(anterior ischemic optic neuropathy, AION)是严重损害中老年患者的常见视神经疾患，目前对其发病机理尚不十分清楚，疗效也不令人满意。因此，通过建立AION动物模型来探讨其发病机理就成为研究的关键。方法：比较光动力(photodynamic therapy, PDT)与经瞳孔温热治疗(transpupillary thermal therapy)造模的优劣。采用随机数字表将体重1.3~2.8 kg的12只家兔分为2组，A组为PDT模型组，B组为TTT模型组。2组均采用右眼造模，左眼作为空白对照组。PDT模型组从家兔耳缘静脉注射维替泊芬光敏剂，使用689 nm激光对视盘中上范围进行照射；TTT模型组采用810 nm红外激光进行照射。造模后第一天观察家兔眼底，1周后对A，B组模型眼与对照眼进行眼底彩色照相，无赤光眼底照相，荧光素眼底血管造影(fundus fluorescence angiography, FFA)检查，观察视盘的组织形态变化。结果：造模后第一天TTT模型组右眼视盘上半水肿，PDT模型组右眼视盘无变化，2组左眼视盘无变化。1周后眼底彩色照相显示2组模型右眼视盘上半色素淡白，无赤光照相显示右眼视盘上半色泽暗，FFA显示2组造影早期右眼视盘上半弱荧光，15 min后2组右眼视盘上半荧光素轻微渗漏，视盘荧光素染色。2组对照眼视盘FFA未见异常荧光表现。结论：经PDT，TTT建立的r AION模型，经眼底照相，FFA检查是成功的，为人类的AION研究提供了动物模型研究基础。

Abstract: Anterior ischemic optic neuropathy (AION) is a common optic neuropathy severely affecting the visual function on middle and elder population. However, the pathogenesis of AION is not com-pletely clear and its treatment results are dissatisfactory. Therefore, the current research on AION is focused on establishing the suitable animal model and the pathogenesis of AION. Methods: Comparing the model of photodynamic with transpupillary thermal therapy, 12 rabbits of weight from 1.3 to 2.8 kg were divided into two groups at random. A group was PDT model and B was TTT model. All of the right eyes were the model eyes and the left ones were the control. After Photo-sensitizer, visudyne was injected from ear edge vein of rabbit. The rabbit middle-up area of optic disc was treated with wave length of 689 nm laser; TTT was treated with wave length of 810 nm laser on B model group. Using fundus photo, green photo and fundus fluorescence angiography (FFA) observed and recorded retinal vascular filling process and optic disc ischemic edema after induction one week. Results: TTT model revealed superior optic disc edema after induction and PDT model eyes and control eyes non-changed after induction one day. Both of two groups model optic disc became white on fundus photo, and the color was dark on green photo after induction one week. In early FFA, hypofluorescence appeared at the superior optic disc of both two model groups eyes. And in 15 min. later stage, the superior showed fluorescence leaking, revealed hyperfluorescence after one week induction. Conclusion: PDT and TTT methods are simple, reliable and successful by fundus photo, green photo and FFA. And they are helpful for the fundamental study of the human NAION.