Jaffe G J, Irvine A R, Wood I S, Severinghaus J W, Pino G R, Haugen C
Department of Ophthalmology, University of California, San Francisco 94143.
Ophthalmology. 1988 Aug;95(8):1130-41. doi: 10.1016/s0161-6420(88)33065-4.
The effect of the inspired oxygen concentration (FIO2) on the production of retinal phototoxicity by the operating microscope was studied in phakic rhesus monkeys. One eye of each monkey was exposed to light under conditions of 99% FIO2, and the other eye was exposed under 21% oxygen (O2). Three of four locations on each retina were exposed to light for durations varying from 1 1/2 to 20 minutes per exposure. Fundus photographs and fluorescein angiograms were obtained 24 to 72 hours after exposure. Animals were euthanatized for analysis of retinal histopathology at intervals from 2 weeks to 8 months after light exposure. Retinal phototoxic lesions were produced after an average of 5 minutes of light exposure under both 21 and 99% O2. O2 potentiated the light damage both clinically and histologically. Under both conditions, lesion size was directly related to the duration of light exposure (P less than 0.005). Lesions near threshold produced with 99% FIO2 were 1.6 to 6.9 (mean, 2.9) times larger than the corresponding lesions formed with 21% FIO2. Histologic damage was likewise more severe in lesions produced under high O2 conditions. Retinal repair occurred in lesions produced under high and low O2 conditions. Photoreceptor regeneration was nearly complete by 18 weeks, whereas retinal pigment epithelial (RPE) recovery lagged up to 1 1/2 months. The results of this study have important implications for clinical practice: the operating microscope can produce retinal phototoxicity rapidly, and O2 administered during ophthalmic procedures may potentiate the damage if appropriate precautions are not taken.
在有晶状体的恒河猴中研究了吸入氧浓度（FIO2）对手术显微镜产生视网膜光毒性的影响。每只猴子的一只眼睛在FIO2为99%的条件下暴露于光线下，另一只眼睛在21%氧气（O2）条件下暴露。每个视网膜上四个位置中的三个位置每次暴露于光线下的持续时间从1.5分钟到20分钟不等。在暴露后24至72小时拍摄眼底照片和荧光素血管造影。在光照后2周-8个月的不同时间间隔对动物实施安乐死以分析视网膜组织病理学。在21%和99%的O2条件下，平均光照5分钟后均产生了视网膜光毒性损伤。O2在临床和组织学上均增强了光损伤。在两种条件下，损伤大小均与光照持续时间直接相关（P<0.005）。在99%FIO2条件下产生的接近阈值的损伤比在21%FIO2条件下形成的相应损伤大1.6至6.9倍（平均为2.9倍）。在高O2条件下产生的损伤组织学损伤同样更严重。在高O2和低O2条件下产生的损伤中均发生了视网膜修复。光感受器再生在18周时几乎完成，而视网膜色素上皮（RPE）恢复滞后长达1.5个月。本研究结果对临床实践具有重要意义：手术显微镜可迅速产生视网膜光毒性，如果不采取适当预防措施，眼科手术期间给予的O2可能会加重损伤。
