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[玻璃体内注射类固醇对兔眼的影响]

[Effects of intravitreal steroid injection on rabbit eye].

作者信息

Shimada H, Matsui M

出版信息

Nippon Ganka Gakkai Zasshi. 1989 Apr;93(4):501-10.

PMID:2801353
Abstract

In a previous study by the authors, it was determined that irrigation solutions containing an anti-prostaglandin agent had the capability of preventing the occurrence of blood-ocular barrier disruptions, retinal edema and post-operative inflammation following vitrectomy. However, not only prostaglandins but also leukotrienes, noted for their migratory effect on leukocytes, have cell migratory effect on the retinal pigment epithelial cells. Therefore, irrigation solutions containing an anti-prostaglandin agent and a steroid are expected to have the capability of preventing the occurrence of proliferative vitreoretinopathy and post-operative inflammation after vitrectomy. In this experiment, two kinds of steroids were injected into rabbit vitreous cavities in order to evaluate toxicity and to establish the toxic intravitreal dose of steroids on intraocular tissue. After paracentesis, 36 eyes of 18 rabbits were injected with dexamethasone sodium phosphate or betamethasone sodium phosphate, suspended in 0.3 ml of distilled water. Each steroid has the same molecular weight and almost the same clinical effects. The four eyes of two rabbits received 0.3 ml of physiologic saline as a control. All eyes were observed histologically seven days after the injection. It was proved that each steroid had almost the same toxicity for the same concentration and all steroids at dose less than five mg did not show toxicity on intraocular tissue. With all steroids, 10mg produced localized retinal degeneration at the inferior region of the posterior fundus. Twenty mg caused more extensive retinal degeneration. At a dose of 80 mg each steroid caused corneal edema, degeneration of ciliary bodies, fibrin formation in the vitreous body and degeneration of retinal cells throughout the retina. Considering the osmolarity and pH of each steroid solution, it was concluded that less than five mg of each of the steroids did not cause retinotoxicity, whereas more than 10 mg of any steroid did cause retinotoxicity.

摘要

在作者先前的一项研究中,已确定含有抗前列腺素药物的灌注液有能力预防玻璃体切除术后血眼屏障破坏、视网膜水肿及术后炎症的发生。然而,不仅前列腺素,而且以对白细胞的迁移作用而闻名的白三烯,对视网膜色素上皮细胞也有细胞迁移作用。因此,含有抗前列腺素药物和类固醇的灌注液有望有能力预防玻璃体切除术后增殖性玻璃体视网膜病变及术后炎症的发生。在本实验中,为评估毒性并确定类固醇在眼内组织中的毒性玻璃体内剂量,将两种类固醇注入兔玻璃体腔。穿刺放液后,给18只兔的36只眼注射磷酸地塞米松或磷酸倍他米松,悬浮于0.3 ml蒸馏水中。每种类固醇具有相同的分子量且临床效果几乎相同。两只兔的四只眼接受0.3 ml生理盐水作为对照。注射后七天对所有眼睛进行组织学观察。结果证明,相同浓度下每种类固醇的毒性几乎相同,且剂量小于5 mg时所有类固醇对眼内组织均无毒性。使用所有类固醇时,10 mg会在眼底后部下方区域引起局限性视网膜变性。20 mg会导致更广泛的视网膜变性。每种类固醇剂量为80 mg时,会引起角膜水肿、睫状体变性、玻璃体内纤维蛋白形成以及整个视网膜的视网膜细胞变性。考虑到每种类固醇溶液的渗透压和pH值,得出结论:每种类固醇剂量小于5 mg不会引起视网膜毒性,而任何一种类固醇剂量超过10 mg都会引起视网膜毒性。

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