Lin S C, Lin C P, Feld J R, Duker J S, Puliafito C A
Tufts University School of Medicine, Department of Ophthalmology, Boston, MA 02111.
Curr Eye Res. 1994 Jul;13(7):513-22. doi: 10.3109/02713689408999883.
We used benzoporphyrin derivative-monoacid (BPD-MA), a new photosensitizing agent, in photodynamic therapy (PDT) to occlude choroidal vessels in the rabbit. Using BPD-MA, seven dutch-belted rabbit eyes were photodynamically treated to achieve acute choroidal vessel closure. Fundoscopy, fluorescein angiography (FA), and histology were performed 1 hour, 1 day, 3 days, 7 days, 14 days, 21 days, and 28 days after PDT. On FA, PDT-treated spots remained nonperfused until day 3 when gradual reperfusion from the periphery began to appear. By day 28 the area of PDT appeared completely reperfused. Histology of lesions showed acute damage to choroidal vascular endothelial cells and retinal pigment epithelial (RPE) cells. Over subsequent days, recovery of RPE cells and regeneration of large choroidal vascular endothelial cells occurred. In addition, retinal degeneration occurred gradually over the 28 days of follow-up. Since current argon laser therapy of retinal neovascularization causes immediate retinal damage, the ability to occlude choroidal vessels without inducing acute thermal damage holds promise for treating clinical pathologic conditions that feature abnormal neovascularization, such as age-related macular degeneration and diabetic retinopathy.
我们使用新型光敏剂苯并卟啉衍生物单酸（BPD-MA）对兔脉络膜血管进行光动力疗法（PDT）闭塞治疗。使用BPD-MA对7只荷兰带兔眼进行光动力治疗以实现急性脉络膜血管闭塞。在光动力治疗后1小时、1天、3天、7天、14天、21天和28天进行眼底镜检查、荧光素血管造影（FA）和组织学检查。在荧光素血管造影上，光动力治疗的部位在第3天之前一直无灌注，之后从周边开始逐渐出现再灌注。到第28天时，光动力治疗区域似乎完全再灌注。病变的组织学检查显示脉络膜血管内皮细胞和视网膜色素上皮（RPE）细胞受到急性损伤。在随后的几天里，RPE细胞恢复，脉络膜大血管内皮细胞再生。此外，在28天的随访期间视网膜逐渐发生变性。由于目前氩激光治疗视网膜新生血管会立即造成视网膜损伤，在不引起急性热损伤的情况下闭塞脉络膜血管的能力有望用于治疗以异常新生血管形成为特征的临床病理状况，如年龄相关性黄斑变性和糖尿病性视网膜病变。
