Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, No. 69 Yongding Road, Haidian District, Beijing, 100039, China.
Medical School of Chinese PLA, Beijing, China.
Aesthetic Plast Surg. 2024 Jun;48(11):2190-2196. doi: 10.1007/s00266-024-03891-9. Epub 2024 Mar 1.
There are serious complications associated with hyaluronic acid (HA) facial injections, including vision impairment due to retinal artery ischemia. In this study, we put forth a clinically relevant model of retinal ischemia and reperfusion in rabbit. We used this to verify the efficacy of hyaluronidase intra-artery thrombolysis in the treatment of hyaluronic acid-induced retinal artery occlusion.
Retinal artery ischemia was induced by injecting HA into the ophthalmic artery (OA) of adult chinchilla rabbit, and reperfusion was achieved by intra-artery thrombolysis therapy with hyaluronidase following 60 min and 4 h of occlusion. Digital subtraction angiography (DSA) and fundus fluorescein angiography (FFA) were used to evaluate blood flow in the retina. Electroretinogram (ERG), hematoxylin and eosin staining and transmission electron microscope were used to evaluate the structure and function of the retina after ischemia and reperfusion following 60 min and 4 h of occlusion.
DSA and FFA images confirmed occlusion of the ophthalmic and central retinal arteries, as well as reperfusion after hyaluronidase thrombolysis. ERG indicated retinal dysfunction following ischemia, and thrombolysis partially rescued its impairment following 4 h of occlusion. Hematoxylin and eosin staining and TUNEL staining revealed ischemia-induced histological damages in the retina at different time windows, and hyaluronidase thrombolysis partially mitigated these damages.
We report a method to establish a HA-induced retinal artery occlusion animal model. Hyaluronidase intra-artery thrombolysis was used to recanalize the embolized OA at different time points. Using our method, we achieved retinal reperfusion, and an improvement was observed in the visual function of rabbits after hyaluronidase thrombolysis following 4 h of occlusion. We believe that hyaluronidase intra-artery thrombolysis is an effective method to treat HA-induced retinal artery occlusion in clinic.
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透明质酸（HA）面部注射会引起严重并发症，包括视网膜动脉缺血导致的视力损害。在这项研究中，我们提出了一种兔视网膜缺血再灌注的临床相关模型。我们用这种模型来验证玻璃酸酶动脉内溶栓治疗 HA 诱导的视网膜动脉阻塞的疗效。
通过向成年南美大耳兔的眼动脉（OA）注射 HA 来诱导视网膜动脉缺血，在 60 分钟和 4 小时闭塞后，通过玻璃酸酶动脉内溶栓治疗来实现再灌注。数字减影血管造影（DSA）和眼底荧光血管造影（FFA）用于评估视网膜血流。视网膜电图（ERG）、苏木精和伊红染色以及透射电子显微镜用于评估缺血和再灌注后 60 分钟和 4 小时闭塞后视网膜的结构和功能。
DSA 和 FFA 图像证实了眼动脉和中央视网膜动脉的闭塞以及玻璃酸酶溶栓后的再灌注。ERG 表明缺血后视网膜功能障碍，4 小时闭塞后溶栓部分挽救了其损伤。苏木精和伊红染色和 TUNEL 染色显示不同时间窗内缺血引起的视网膜组织损伤，玻璃酸酶溶栓部分减轻了这些损伤。
我们报告了一种建立 HA 诱导的视网膜动脉阻塞动物模型的方法。玻璃酸酶动脉内溶栓用于在不同时间点再通栓塞的 OA。使用我们的方法，我们实现了视网膜再灌注，并且在 4 小时闭塞后，玻璃酸酶溶栓后观察到兔子的视觉功能有所改善。我们认为，玻璃酸酶动脉内溶栓是治疗 HA 诱导的视网膜动脉阻塞的一种有效方法。
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