光动力学治疗实验性猴眼脉络膜新生血管的组织病理学研究

目的通过眼底荧光血管造影(fundus fluorescein angiography,FFA)检查、光镜及电镜观察,在影像学、组织病理学及超微结构上探讨光动力学治疗(photodynamic thera-py,PDT)猴眼脉络膜新生血管(choroidal neovascularization,CNV)模型的机制。方法采用过量激光凝固破坏猴眼视网膜及Bruch膜,建立猴眼CNV模型,采用FFA证明CNV的产生;对PDT治疗后1个月、2个月、3个月、6个月CNV模型进行FFA、光镜、电镜检查;将正常猴眼和未作PDT治疗的CNV模型眼分别作为对照1、2组。结果治疗组中,经FFA证实PDT治疗后1个月的CNV渗漏几乎停止,PDT治疗2～6个月CNV再次出现渗漏,程度较对照2组均有减轻。光镜、电镜下PDT治疗后1个月时CNV内有红细胞形成的血栓,并见CNV的内皮细胞增生。PDT治疗的非CNV区的视网膜解剖结构与对照1、2组相比在光镜、电镜下未见明显损伤。结论PDT治疗猴眼CNV模型是有效的,从病理组织学上证实了PDT治疗CNV主要是引起血管内血栓形成,PDT治疗对病变浅层及其周围的视网膜组织是安全的。

Histopathologic study of photodynamic thera py on experimental choroidal neovasculariza tion in monkey eyes

Objective To study the mechanism of photodynamic therapy(PDT) for experimental choroidal neovascularization(CNV) with fundus fluorescein angiography(FFA),light microscope and electronic microscope on the level of imageology,histopathology and ultramicrostructure.Methods Monkey model of CNV proven by FFA was established by destroying retina and Bruch membrance with intense laser photocoagulation,and were observed with FFA,light microscopy and electronic microscopy at month 1,2,3 and 6 following PDT.Normal eyes and CNV eyes without PDT were selected as control group 1 and 2,respectively.Results In treated group,CNV leakage was almost ceased at month 1 on FFA,and reappeared at month 2 to 6,but less compared with control group 2.Thrombosis and endothelial proliferation in CNV were identified treated with PDT for 1 month under light microscope and electronic microscope.No particularly abnormal histopathological findings were noted in non-CNV area compared with control groups.Conclusion It is suggested that PDT may be an effective modality in treating experimental CNV.The major therapeutic effect might be due to the formation of thrombosis in CNV.PDT should be considered safe for superficial lamella and peripheric tissues of retina.