Blair N P
Laboratory of Retinal Circulation and Metabolism, Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago College of Medicine, USA.
Trans Am Ophthalmol Soc. 2000;98:305-29.
Little is known about the total ocular oxygen consumption rate (QO2) in human diseases. Reductions in QO2 may indicate the amount of tissue loss produced by conditions such as retinal ischemia. We sought a method to estimate QO2 that eventually could be used in patients during vitrectomy surgery.
We performed vitreoperfusion (perfusion of the vitreous cavity after vitrectomy) in 22 cat eyes with no ocular blood flow. The solution contained nutrients and a high partial pressure of oxygen (PO2). In 8 eyes we placed an oxygen electrode on the sclera, choroid, or outer retina to evaluate oxygen delivery from the vitreoperfusion solution (group 1). In 8 eyes the retinas were undisturbed (group 2), and in 6 eyes we excised the retinas (group 3). In groups 2 and 3 we estimated QO2 from the temporal decline of PO2 in the vitreoperfusion solution according to a pharmacokinetic model.
Group 1 demonstrated oxygenation of the entire retina. The means and standard deviations of QO2 were 3.2 +/- 0.8 and 0.4 +/- 0.7 microL/min in groups 2 and 3, respectively, the difference being the retinal contribution, 88%. In group 2, metabolism accounted for an average of 82% of the oxygen loss from the vitreoperfusion solution, whereas flow and diffusion accounted for 13% and 5%, respectively.
Ocular oxygen consumption can be estimated by means of vitreoperfusion. Further developments may allow measurements in patients during vitreous surgery to clarify the pathophysiology of their diseases and assess the amount of retinal tissue that has been lost.
关于人类疾病中眼的总氧消耗率(QO2),我们知之甚少。QO2的降低可能表明视网膜缺血等情况所导致的组织损失量。我们寻求一种最终可用于玻璃体切除手术患者的估计QO2的方法。
我们对22只无眼血流的猫眼进行了玻璃体灌注(玻璃体切除术后对玻璃体腔进行灌注)。灌注液含有营养物质和高氧分压(PO2)。在8只眼中,我们将氧电极置于巩膜、脉络膜或视网膜外层,以评估玻璃体灌注液的氧输送情况(第1组)。在8只眼中,视网膜未受干扰(第2组),在6只眼中,我们切除了视网膜(第3组)。在第2组和第3组中,我们根据药代动力学模型,从玻璃体灌注液中PO2随时间的下降来估计QO2。
第1组显示整个视网膜均有氧合。第2组和第3组的QO2均值及标准差分别为3.2±0.8和0.4±0.7微升/分钟,差异即视网膜的贡献,为88%。在第2组中,代谢平均占玻璃体灌注液氧损失的82%,而血流和扩散分别占13%和5%。
眼的氧消耗可通过玻璃体灌注来估计。进一步的发展可能使在玻璃体手术期间对患者进行测量,以阐明其疾病的病理生理学并评估已损失的视网膜组织量。