Kaufman P L, Rohen J W, Gabelt B T, Eichhorn M, Wallow I H, Polansky J R
Department of Ophthalmology, Universities of Wisconsin, Madison.
Curr Eye Res. 1991 May;10(5):437-55. doi: 10.3109/02713689109001751.
Cynomolgus monkeys underwent unilateral panretinal scatter photocoagulation (PRP) and/or nasal and temporal horizontal retinal meridional photocoagulation (HRMP) with xenon arc or argon or krypton laser light. Shortly thereafter, in the PRP-treated eyes, accommodative responsiveness to topical eserine and electrical stimulation of the Edinger-Westphal nucleus (EWN) was diminished, accommodative responsiveness to intramuscular (i.m.) pilocarpine was enhanced, and the number of muscarinic receptors in the ciliary muscle was reduced compared to the contralateral controls. In most instances, these parameters returned to normal over 6-12 wks and the abnormalities could be induced again by another round of PRP. However, in some PRP-treated eyes, accommodative responsiveness to EWN stimulation and topical eserine remained subnormal permanently (greater than 1 yr). Shortly after HRMP alone, accommodative responses to i.m. pilocarpine, topical eserine, and central stimulation did not differ markedly in the treated and control eyes. Morphologic studies 1 to 78 wk following PRP revealed that myelinated and unmyelinated nerves within the entire circumference of the choroid and ciliary muscle were severely damaged early on. The number of unmyelinated nerves between the individual ciliary muscle fibers was drastically reduced, those which remained were swollen or deteriorated, and agranular synaptic vesicles were rarely seen. Thereafter, the nerves in the choroid and ciliary muscle gradually regenerated. Following HRMP, only the choroidal nerves which passed through the photocoagulated areas and the ciliary muscle nerves in the corresponding meridians showed signs of deterioration, and there was minimal effect on the physiologic responses examined. These findings collectively indicate that intraocular parasympathetic denervation of the ciliary muscle is produced by PRP, although all nerve types are likely damaged.
食蟹猴接受了单侧全视网膜散射光凝（PRP）和/或鼻侧及颞侧水平视网膜子午线光凝（HRMP），使用氙弧、氩或氪激光。此后不久，在接受PRP治疗的眼睛中，对局部应用依色林和对动眼神经核（EWN）进行电刺激的调节反应减弱，对肌肉注射毛果芸香碱的调节反应增强，与对侧对照相比，睫状肌中毒蕈碱受体的数量减少。在大多数情况下，这些参数在6 - 12周内恢复正常，并且通过另一轮PRP可再次诱发异常。然而，在一些接受PRP治疗的眼睛中，对EWN刺激和局部应用依色林的调节反应永久性地保持低于正常水平（超过1年）。仅在HRMP后不久，治疗眼和对照眼对肌肉注射毛果芸香碱、局部应用依色林和中枢刺激的调节反应没有明显差异。PRP后1至78周的形态学研究表明，脉络膜和睫状肌整个圆周内的有髓和无髓神经在早期受到严重损伤。单个睫状肌纤维之间的无髓神经数量急剧减少，剩余的神经肿胀或退化，很少见到无颗粒突触小泡。此后，脉络膜和睫状肌中的神经逐渐再生。HRMP后，仅穿过光凝区域的脉络膜神经和相应子午线中的睫状肌神经显示出退化迹象，对所检查的生理反应影响最小。这些发现共同表明，PRP可导致睫状肌的眼内副交感神经去神经支配，尽管所有神经类型可能均受到损伤。
