Grüntzig J, Schicha H, Huth F
Z Lymphol. 1979 Jun;3(1):35-45.
Up to now lymphatics in the eye could not be pointed out. An ocular lymph drainage is denied. Földi succeeded in producing experimentally the syndrome of "lymphostatic encephalopathy and ophthalmopathy" by operative blockade of the cervical lymphatics in animals. In the first part of the present paper a historical view considering the subject "Eye and lymphatic system" is given. In the second part it is entered into the particulars of own experimental studies. As to our own investigations, rabbits have been injected 99mTc-sulfur-colloid, 99mTc-microcolloid, 99mTc-Albumin and 198Au-colloid into the retrobulbar space, anterior chamber, vitreous body and subconjuctival space of one eye. Measurements of the activity's distribution have been made in vivo with an Anger type camera (pho-Gamma-IV Hp, Searle Nuclear Chicago) and in vitro after section with a sodium iodine crystal well counter (Clinimat-200, Picker). In some animals the investigation has been combined with a bilateral dissection of the cervical lymph nodes. After injection in the retrobulbar space a significant concentration of the activity could be observed for the most part in the equilateral Lymphonodulus cervicalis profundus. By the cervical lymph blockade the removal of lymphoctopic substances from the retrobulbar space was largely inhibited. After injection in the anterior chamber a significant concentration could be observed for the most part in the equilateral Lymphonodulus cervicalis superficialis. After intravitreal injection a drainage to the bilateral deep cervical lymph nodes could be observed. After injection into the subconjunctival space a significant accumulation of activity could be registered in the equilateral Lymphonoduli mandibulares and cervicales superficiales. The data substantiate a segmental lymph drainage from the eye: vitreous body and retrobulbar space for the most part into the Lymphonoduli cervicales profundi, anterior chamber and subconjunctival space for the most part into the Lymphonoduli cervicales superficiales been studied. In albino-rabbits indiaink has been injected into the vitreous body and afterwards its drainage has been controlled histologically (frozen sections). In some animals the investigation has been combined with a bilateral dissection of the cervical lymph nodes. The lymph node dissection causes a massive deceleration of the India-ink's outflow; the perivascular connective tissue shows a clear edematous relaxation. The histological evidence suggests that 1. the vitreous body 2. the interstice between the glia cells of the papilla 3. the pial tissue between the neurone bundles of the optic nerve 4. the perivascular space around the central vessels of the retina 5. the subarachnoid sheath of the optic nerve may be interpreted as prelymphatic pathway.
到目前为止,尚未发现眼部存在淋巴管。眼部不存在淋巴引流。福尔迪通过手术阻断动物颈部淋巴管成功实验性地诱发了“淋巴性脑病和眼病”综合征。在本文的第一部分,给出了关于“眼与淋巴系统”这一主题的历史观点。第二部分详细阐述了我们自己的实验研究。就我们自己的研究而言,已将99m锝 - 硫胶体、99m锝 - 微胶体、99m锝 - 白蛋白和198金胶体注入兔的一只眼睛的球后间隙、前房、玻璃体和结膜下间隙。用安格型相机(pho - Gamma - IV Hp,塞尔核芝加哥公司)在活体上测量了活性分布,并在切片后用碘化钠晶体井型计数器(Clinimat - 200,皮克公司)在体外进行了测量。在一些动物中,该研究与双侧颈淋巴结解剖相结合。在球后间隙注射后,大部分活性可在同侧颈深淋巴结中观察到显著聚集。通过颈淋巴阻断,球后间隙中淋巴异位物质的清除在很大程度上受到抑制。在前房注射后,大部分活性可在同侧颈浅淋巴结中观察到显著聚集。玻璃体腔内注射后,可观察到向双侧颈深淋巴结的引流。在结膜下间隙注射后,在同侧下颌下淋巴结和颈浅淋巴结中可记录到活性的显著积聚。这些数据证实了眼部存在节段性淋巴引流:玻璃体和球后间隙大部分引流至颈深淋巴结,前房和结膜下间隙大部分引流至颈浅淋巴结。在白化兔中,已将印度墨汁注入玻璃体,随后通过组织学(冰冻切片)控制其引流。在一些动物中,该研究与双侧颈淋巴结解剖相结合。淋巴结解剖导致印度墨汁流出大量减缓;血管周围结缔组织呈现明显的水肿性松弛。组织学证据表明:1. 玻璃体;2. 乳头神经胶质细胞之间的间隙;3. 视神经神经元束之间的软膜组织;4. 视网膜中央血管周围的血管周围间隙;5. 视神经的蛛网膜鞘可被解释为淋巴前途径。