Knudsen L L, Olsen T, Nielsen-Kudsk F
Department of Ophthalmology, Arhus University Hospital, Denmark.
Acta Ophthalmol (Copenh). 1992 Oct;70(5):570-7. doi: 10.1111/j.1755-3768.1992.tb02135.x.
Nine normal and 24 diabetic subjects were examined by long-term vitreous and plasma fluorescein fluorophotometry and the observed concentration profiles were described by biexponential time courses. The rate constant of elimination of fluorescein from the body (K10) was significantly decreased in diabetics with background and proliferative retinopathy, presumably caused by affection of the liver and possibly representing alterations in membranes of liver cells. Increased kidney albumin excretion was observed with increasing degree of retinopathy. The apparent rate constant of fluorescein penetration into the eye (Kin) was found significantly decreased in background as well as in proliferative retinopathy; while the permeability index, calculated as areas under vitreous and plasma fluorescein curves, was significantly increased. In the normal subjects Kin was significantly higher than the rate constant of fluorescein transfer (K12) from the apparent central to the peripheral tissue compartment, whereas in the diabetics this difference was only found in the group with background retinopathy. The findings seem compatible with the concept that the breakdown of the blood-ocular barrier could be caused at least partly by affection of an active transport system for fluorescein, but thickening and compositional changes of the basement membranes in the eye might also be of importance.
对9名正常受试者和24名糖尿病受试者进行了长期玻璃体和血浆荧光素荧光光度测定，并通过双指数时间进程描述了观察到的浓度曲线。在患有背景性和增殖性视网膜病变的糖尿病患者中，荧光素从体内消除的速率常数（K10）显著降低，这可能是由肝脏受到影响所致，可能代表肝细胞膜的改变。随着视网膜病变程度的增加，观察到肾脏白蛋白排泄增加。发现在背景性和增殖性视网膜病变中，荧光素进入眼睛的表观速率常数（Kin）显著降低；而以玻璃体和血浆荧光素曲线下面积计算的通透指数则显著增加。在正常受试者中，Kin显著高于荧光素从表观中央组织隔室向周边组织隔室转移的速率常数（K12），而在糖尿病患者中，这种差异仅在患有背景性视网膜病变的组中发现。这些发现似乎与以下概念相符，即血眼屏障的破坏至少部分可能是由荧光素主动转运系统受到影响引起的，但眼部基底膜的增厚和成分变化也可能很重要。
