Romano Mario R, Ilardi Gennaro, Ferrara Mariantonia, Cennamo Gilda, Parolini Barbara, Mariotti Cesare, Staibano Stefania, Cennamo Giovanni
Department of Biomedical Sciences, Humanitas University, Via Manzoni 113, Rozzano, 20089, Milan, Italy.
Department of Neuroscience, Reproductive and Odontostomatological Science, University Federico II, Naples, Italy.
Graefes Arch Clin Exp Ophthalmol. 2018 Sep;256(9):1573-1580. doi: 10.1007/s00417-018-4029-2. Epub 2018 Jun 8.
To describe functional and histopathological findings after macular peeling using different dyes.
Prospective, randomized, comparative, interventional, and immunohistochemical study. Forty-five eyes from 45 patients with idiopathic epiretinal membrane (ERM) underwent pars plana chromovitrectomy with ERM and inner limiting membrane (ILM) using trypan blue 0.15% + brilliant blue 0.05% + lutein 2% in group 1 (15 eyes), trypan blue 0.15% + brilliant blue 0.025% + polyethylene glycol 3350 4% in group 2 (15 eyes), and indocyanine green 0.05% in group 3 (15 eyes). We evaluated visual acuity (VA) and macular sensitivity (MS) preoperatively, 1, 3, and 6 months after surgery. The expression of glial fibrillary acidic protein (GFAP) and neurofilament protein (NF) was assessed immunohistochemically on the ILMs peeled as markers of glial and neuronal cells.
In group 1, both mean VA and MS were significantly better at 1 and 3 months after surgery (P < 0.05), whereas no significant difference was found after 6 months. GFAP and NF expression was significantly lower in group 1 (P < 0.05).
The ERM/ILM peeling is thought to rip off the intraretinal tissue, based on the amounts of GFAP and NF in the specimens. The use of lutein dyes reduces iatrogenic stress to the retinal tissue and allows a faster functional recovery in the first 3 months after surgery, suggesting a less iatrogenic adhesion to the retinal tissue.
描述使用不同染料进行黄斑剥脱术后的功能和组织病理学结果。
前瞻性、随机、对比、干预性和免疫组织化学研究。45例特发性视网膜前膜（ERM）患者的45只眼接受了玻璃体视网膜切除术，术中在第1组（15只眼）使用0.15%台盼蓝+0.05%亮蓝+2%叶黄素，第2组（15只眼）使用0.15%台盼蓝+0.025%亮蓝+4%聚乙二醇3350，第3组（15只眼）使用0.05%吲哚青绿，同时剥除ERM和内界膜（ILM）。我们评估了术前、术后1个月、3个月和6个月的视力（VA）和黄斑敏感度（MS）。通过免疫组织化学方法评估剥除的ILM上胶质纤维酸性蛋白（GFAP）和神经丝蛋白（NF）的表达，作为胶质细胞和神经元细胞的标志物。
在第1组中，术后1个月和3个月时平均VA和MS均显著改善（P<0.05），而6个月后未发现显著差异。第1组中GFAP和NF表达显著降低（P<0.05）。
根据标本中GFAP和NF的含量，认为ERM/ILM剥脱会撕脱视网膜内组织。叶黄素染料的使用减少了对视网膜组织的医源性损伤，并使术后前3个月功能恢复更快，提示对视网膜组织的医源性粘连更少。
