Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ophthalmic Res. 2023;66(1):48-56. doi: 10.1159/000525745. Epub 2022 Jun 30.
The purpose of this study was to evaluate the effect of intravitreal injection of tissue plasminogen activator (tPA) on proliferative vitreoretinopathy (PVR).
PVR was induced in a rabbit model by intraocular injection of dispase (0.05 U/0.1 mL). Progression of PVR was followed by indirect ophthalmic examination. Following 6 weeks, 5 animals received intravitreal injection of 25 µg/0.1 mL tPA and four were injected with balanced salt solution (BSS). Animals were euthanized at 48 h following tPA/BSS injection, and eyes were enucleated for histological evaluation and staining with α-smooth muscle actin (αSMA) and Sirius Red.
Following tPA injection, one eye had a reduction in PVR from grade 2 to 1 and three eyes remained stable. Following BSS, PVR grade was unchanged in three eyes. In one eye in each group, the severity of PVR could not be assessed due to limited view. Staining with αSMA showed reduced presence of fibroblasts in eyes injected with tPA compared with those injected with BSS. Collagen type I and III, demonstrated by Sirius Red staining, was reduced in the tPA group in comparison with controls.
Our results suggest that intravitreally injected tPA may show an inhibitory effect on PVR progression. Further exploration in clinical trials is desired.
本研究旨在评估玻璃体内注射组织型纤溶酶原激活剂（tPA）对增生性玻璃体视网膜病变（PVR）的影响。
通过向兔眼内注射Dispase（0.05 U/0.1 mL）建立 PVR 模型。通过间接检眼镜检查来监测 PVR 的进展。6 周后，5 只动物接受了 25 µg/0.1 mL tPA 的玻璃体内注射，4 只接受了平衡盐溶液（BSS）的注射。在 tPA/BSS 注射后 48 小时处死动物，眼球被取出进行组织学评估，并进行α-平滑肌肌动蛋白（αSMA）和天狼猩红染色。
在 tPA 注射后，一只眼的 PVR 从 2 级降至 1 级，3 只眼保持稳定。在 BSS 注射后，3 只眼的 PVR 分级没有变化。在每组的一只眼中，由于视野有限，无法评估 PVR 的严重程度。与 BSS 注射组相比，用 αSMA 染色显示 tPA 注射眼的成纤维细胞数量减少。与对照组相比，天狼猩红染色显示 tPA 组的 I 型和 III 型胶原减少。
我们的结果表明，玻璃体内注射的 tPA 可能对 PVR 进展有抑制作用。需要进一步在临床试验中进行探索。
