Eftekhari Kian, Vagefi M Reza, Lee Vivian, Hui James Z, Zhu Menglong, Dine Kimberly, Anderson Richard L, Koeberlein Brigitte, Sulaimankutty Reas, Shindler Kenneth S
Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
FM Kirby Center for Molecular Ophthalmology, Stellar-Chance Laboratories, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Ophthalmic Plast Reconstr Surg. 2018 May/Jun;34(3):201-204. doi: 10.1097/IOP.0000000000000907.
Recent publications have reported the adverse effects of prostaglandin analogues on the periocular tissues. These medications may cause periorbital lipodystrophy, enophthalmos, and deepening of the superior sulcus deformity. While these effects may have adverse consequences for some patients, the atrophy of the periorbital fat may have a useful role in diseases that lead to orbital and periorbital fat hypertrophy such as thyroid eye disease. In this pilot study, the authors investigated the effects of retrobulbar bimatoprost injection on the intraocular pressure and orbital fat in a rat animal model.
Three rats were sedated and intraocular pressure was measured. A 0.1 ml aliquot of bimatoprost was injected into the right orbit of all rats. In the left orbit, 0.1 ml of phosphate-buffered saline was injected as a control. Three weeks later, all rats were sedated and intraocular pressure was measured before euthanizing. Routine histologic staining was performed and thin sections through the intraconal orbital fat were obtained. Density of intraconal adipocytes was measured and adipocyte heterogeneity was determined using a computer image analysis algorithm.
The specimens injected with bimatoprost demonstrated atrophy of orbital fat with significantly increased adipocyte density (p = 0.009) and heterogeneity (p = 0.008) when compared with control. Intraocular pressure was not significantly decreased at 3 weeks after injection of retrobulbar bimatoprost.
In this pilot study, orbital injection of bimatoprost demonstrated atrophy of intraconal adipocytes when compared with control orbits injected with saline. The orbits injected with bimatoprost were noted to have smaller, more heterogeneous adipocytes that were densely packed in the intraconal space. The study limitations include the small sample size, which limited the ability for us to make conclusions about the effect on intraocular pressure. Nevertheless, the findings presented suggest that retrobulbar bimatoprost may present a nonsurgical alternative to induce atrophy of the orbital fat without inducing inflammation or hypotony.
近期的出版物报道了前列腺素类似物对眼周组织的不良影响。这些药物可能导致眶周脂肪营养不良、眼球内陷以及上睑沟畸形加深。虽然这些影响可能对某些患者产生不良后果，但眶周脂肪萎缩在导致眼眶和眶周脂肪肥大的疾病（如甲状腺眼病）中可能具有有益作用。在这项初步研究中，作者在大鼠动物模型中研究了球后注射比马前列素对眼压和眼眶脂肪的影响。
对三只大鼠进行麻醉并测量眼压。将0.1毫升比马前列素等分试样注射到所有大鼠的右眼眶中。在左眼眶中，注射0.1毫升磷酸盐缓冲盐水作为对照。三周后，对所有大鼠进行麻醉并在安乐死之前测量眼压。进行常规组织学染色，并获取穿过锥内眶脂肪的薄片。测量锥内脂肪细胞的密度，并使用计算机图像分析算法确定脂肪细胞的异质性。
与对照组相比，注射比马前列素的标本显示眶脂肪萎缩，脂肪细胞密度（p = 0.009）和异质性（p = 0.008）显著增加。球后注射比马前列素后3周眼压没有显著降低。
在这项初步研究中，与注射盐水的对照眼眶相比，眼眶注射比马前列素显示锥内脂肪细胞萎缩。注射比马前列素的眼眶中脂肪细胞较小、异质性更高，并且密集地堆积在锥内间隙中。研究的局限性包括样本量小，这限制了我们对眼压影响得出结论的能力。然而，所呈现的研究结果表明，球后注射比马前列素可能是一种非手术替代方法，可诱导眼眶脂肪萎缩而不引起炎症或低眼压。
