与Tenon囊下泡相比，结膜下泡的猪相关淋巴引流更多。
Bleb-related Porcine Lymphatic Outflow is Greater from Subconjunctival compared to Subtenon Blebs.
作者信息
Lee Jong Yeon, Strohmaier Clemens Adolf, Akiyama Goichi, Saraswathy Sindhu, Yoo Chungkwon, Kim Yong Yeon, Hong Young-Kwon, Huang Alex S
机构信息
Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, USA; Department of Ophthalmology, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea.
Department of Ophthalmology, Johannes Kepler University, Linz, Austria; The Viterbi Family Department of Ophthalmology, Shiley Eye Institute, Hamilton Glaucoma Center, University of California, San Diego, California.
出版信息
J Curr Glaucoma Pract. 2022 Sep-Dec;16(3):144-151. doi: 10.5005/jp-journals-10078-1382.
AIM
Understanding the mechanism of fluid outflow by comparing the subconjunctival and subtenon spaces can lead to improved ocular therapeutics. The purpose of the current study is to evaluate subconjunctival vs subtenon lymphatic outflow by creating tracer-filled blebs in each location.
METHODS
Porcine ( = 20) eyes received subconjunctival or subtenon injection(s) of fixable and fluorescent dextrans. Blebs were angiographically imaged using a Heidelberg Spectralis ([Heidelberg Retina Angiograph] HRA + OCT; Heidelberg Engineering) and bleb-related lymphatic outflow pathways were counted. Optical coherence tomography (OCT) imaging of these pathways was used to assess structural lumens and the presence of valve-like structures. Furthermore, a comparison between tracer injection locations (superior/inferior/temporal/nasal) was made. Histologic analyses for subconjunctival and subtenon outflow pathways were performed, to confirm tracer co-localization with molecular lymphatic markers.
RESULTS
Subconjunctival blebs demonstrated a greater number of lymphatic outflow pathways compared to subtenon blebs in every quadrant [superior: 6.10 ± 1.18 (subconjunctival) vs 0.50 ± 0.27 (subtenon); temporal: 2.30 ± 0.40 vs 0.10 ± 0.10; nasal: 5.30 ± 0.60 vs 0.30 ± 0.21; inferior: 6.00 ±1.29 vs 0.1 ± 0.1; all comparisons < 0.001]. For subconjunctival blebs, the temporal quadrant showed fewer lymphatic outflow pathways compared to the nasal side ( = 0.005).
DISCUSSION
Subconjunctival blebs accessed greater lymphatic outflow compared to subtenon blebs. Furthermore, regional differences existed, with fewer lymphatic vessels temporal than at the other locations.
CLINICAL SIGNIFICANCE
Aqueous humor drainage after glaucoma surgery is incompletely understood. The present manuscript adds to our understanding of how lymphatics might influence filtration bleb function.
HOW TO CITE THIS ARTICLE
Lee JY, Strohmaier CA, Akiyama G, Bleb-related Porcine Lymphatic Outflow Is Greater from Subconjunctival compared to Subtenon Blebs. J Curr Glaucoma Pract 2022;16(3):144-151.
目的
通过比较结膜下间隙和Tenon囊下间隙来了解房水流出机制，有助于改进眼部治疗方法。本研究的目的是通过在每个部位制造充满示踪剂的水泡，评估结膜下与Tenon囊下的淋巴引流情况。
方法
20只猪眼接受结膜下或Tenon囊下注射可固定的荧光葡聚糖。使用海德堡Spectralis（[海德堡视网膜血管造影仪]HRA + OCT；海德堡工程公司）对水泡进行血管造影成像，并计算与水泡相关的淋巴引流途径。利用这些途径的光学相干断层扫描（OCT）成像来评估结构管腔和瓣膜样结构的存在。此外，还对示踪剂注射部位（上方/下方/颞侧/鼻侧）进行了比较。对结膜下和Tenon囊下引流途径进行组织学分析，以确认示踪剂与分子淋巴标记物的共定位。
结果
在每个象限中，结膜下水泡显示出的淋巴引流途径数量均多于Tenon囊下水泡[上方：6.10±1.18（结膜下）对0.50±0.27（Tenon囊下）；颞侧：2.30±0.40对0.10±0.10；鼻侧：5.30±0.60对0.30±0.21；下方：6.00±1.29对0.1±0.1；所有比较P<0.001]。对于结膜下水泡，颞侧象限的淋巴引流途径比鼻侧少（P = 0.005）。
讨论
与Tenon囊下水泡相比，结膜下水泡的淋巴引流更多。此外，存在区域差异，颞侧的淋巴管比其他部位少。
临床意义
青光眼手术后房水引流情况尚不完全清楚。本手稿增加了我们对淋巴管如何影响滤过泡功能的理解。
如何引用本文
Lee JY, Strohmaier CA, Akiyama G, 结膜下与Tenon囊下滤过泡相关的猪淋巴引流情况比较。《当代青光眼实践杂志》2022；16(3):144 - 151。
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