Matsumoto Hidetaka, Miller Joan W, Vavvas Demetrios G
Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
J Vis Exp. 2013 Sep 11(79):50660. doi: 10.3791/50660.
Subretinal injection of sodium hyaluronate is a widely accepted method of inducing retinal detachment (RD). However, the height and duration of RD or the occurrence of subretinal hemorrhage can affect photoreceptor cell death in the detached retina. Hence, it is advantageous to create reproducible RDs without subretinal hemorrhage for evaluating photoreceptor cell death. We modified a previously reported method to create bullous and persistent RDs in a reproducible location with rare occurrence of subretinal hemorrhage. The critical step of this modified method is the creation of a self-sealing scleral incision, which can prevent leakage of sodium hyaluronate after injection into the subretinal space. To make the self-sealing scleral incision, a scleral tunnel is created, followed by scleral penetration into the choroid with a 30 G needle. Although choroidal hemorrhage may occur during this step, astriction with a surgical spear reduces the rate of choroidal hemorrhage. This method allows a more reproducible and reliable model of photoreceptor death in diseases that involve RD such as rhegmatogenous RD, retinopathy of prematurity, diabetic retinopathy, central serous chorioretinopathy, and age-related macular degeneration (AMD). [corrected].
玻璃酸钠视网膜下注射是诱导视网膜脱离(RD)的一种广泛接受的方法。然而,RD的高度和持续时间或视网膜下出血的发生会影响脱离视网膜中的光感受器细胞死亡。因此,创建可重复的无视网膜下出血的RD对于评估光感受器细胞死亡是有利的。我们改进了先前报道的方法,在可重复的位置创建大泡性和持续性RD,且视网膜下出血发生率低。这种改进方法的关键步骤是创建一个自封闭巩膜切口,这可以防止玻璃酸钠注射到视网膜下间隙后渗漏。为了制作自封闭巩膜切口,先创建一个巩膜隧道,然后用30G针头穿透巩膜进入脉络膜。尽管在此步骤中可能会发生脉络膜出血,但用手术矛头压迫可降低脉络膜出血的发生率。这种方法可以为涉及RD的疾病(如孔源性视网膜脱离、早产儿视网膜病变、糖尿病视网膜病变、中心性浆液性脉络膜视网膜病变和年龄相关性黄斑变性(AMD))提供更可重复和可靠的光感受器死亡模型。[已校正]