经瞳孔温热疗法后视网膜和脉络膜的细胞凋亡研究

目的探讨经瞳孔温热疗法（TTT）对视网膜、脉络膜层细胞凋亡表达的影响。方法利用恒河猴做动物模型，于治疗后不同时间点摘除双眼。应用组织学及TUNNEL检测技术，研究TTT治疗与细胞凋亡的相互关系，及对视网膜、脉络膜的组织病理学影响。结果正常猴眼视网膜及脉络膜均未见细胞凋亡发生。TTT治疗后，可见光斑中央细胞坏死、周边细胞凋亡发生。1h至4周，均可见凋亡阳性细胞，4个月时，仍可见少量凋亡细胞存在。同时，TTT治疗可引起视网膜不同程度的组织病理学损害。结论TTT可引起视网膜组织病理学损害。局部温度的升高会诱导视网膜脉络膜细胞凋亡的产生，减少坏死和炎症的程度。

Cell apoptosis of retina and choroid after transpupillary thermotherapy in monkey model

ObjectiveTranspupillary thermotherapy(TTT) has been widely applied in ophthalmology since the first report of Oosterhuis.This study aimed to assess the cell apoptosis of retina and choroid induced by TTT in a rhesus model.MethodsTwo rhesus were anesthetized and TTT were performed on the eyes using an 810-nm diode laser installed on a slit lamp.Four decreasing progressively laser power settings from 130-220mW were used to irradiate the superior,inferior,temporal,nasal quadrants of the retina.One monkey did not irradiated as negative control.At 1 hour,1 day,1 week,2,4 weeks and 4 months after laser irradiation,histological examination of choriod and retina was performed.An in situ cell detection kit(TUNEL) was used to identify apoptotic cells in the retina.ResultsThere were no apoptotic cells on normal retina and choroids in negative control.However,after TTT irradiation,there were many apoptotic cells on both retinal and choroidal layer from 1 hour to 4 weeks.At four months after laser irradiation,there were still some apoptotic cells in the retina.Characteristics of apoptotic cell included shrinkage of cell body,the compaction of cytoplasm and nucleus in the outer nuclear layer and inner nuclear layer.Necrotic cells could also be found in the center of laser spot.At four months,the irradiation area of retina became atrophy and thinner.No tissue architecture modification was observed in laser spot.ConclusionTTT can cause retinal and choroidal damage.Apoptosis can be induced by TTT in monkey model.