Boone D E, Boldt H C, Ross R D, Folk J C, Kimura A E
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Retina. 1996;16(6):518-24. doi: 10.1097/00006982-199616060-00009.
To clinically and surgically evaluate clot lysis in an animal model of subretinal hemorrhage after intravitreal injection of tissue plasminogen activator.
Autologous subretinal hemorrhages were created via a transvitreal approach in 18 pigs. The next day (day 1) animals were randomly selected to receive either an intravitreal injection of 0.1 mL balanced salt solution or 0.1 mL tissue plasminogen activator (25 micrograms) followed by observation or vitrectomy a day later. On day 2, six pigs (all treated with tissue plasminogen activator) underwent a vitrectomy in which aspiration of the subretinal hemorrhage was attempted. The other eyes were evaluated for clot lysis by ophthalmoscopy at days 3, 10, and 30. All eyes were examined histopathologically.
The eyes that had been treated with tissue plasminogen activator demonstrated a color change at the peripheral margin, which suggested that clot lysis had occurred. At the time of the vitrectomy, the clots were liquefied partially; removal by aspiration alone, however, was not possible. Photoreceptor damage was moderate to severe by day 10 in all eyes, whether they were treated with tissue plasminogen activator or balanced salt solution. All eyes that underwent vitrectomy had moderate to severe photoreceptor damage.
In this animal model, intravitreal tissue plasminogen activator was associated with features that suggested partial clot lysis; tissue plasminogen activator did not produce sufficient lysis to allow surgical removal by aspiration alone, however.
通过玻璃体腔内注射组织型纤溶酶原激活剂，在视网膜下出血的动物模型中对凝块溶解进行临床和手术评估。
通过经玻璃体途径在18头猪中制造自体视网膜下出血。第二天（第1天），随机选择动物接受0.1 mL平衡盐溶液或0.1 mL组织型纤溶酶原激活剂（25微克）的玻璃体腔内注射，随后在一天后进行观察或玻璃体切除术。在第2天，6头猪（均接受组织型纤溶酶原激活剂治疗）接受了玻璃体切除术，术中尝试抽吸视网膜下出血。在第3天、第10天和第30天，通过检眼镜检查评估其他眼睛的凝块溶解情况。对所有眼睛进行组织病理学检查。
接受组织型纤溶酶原激活剂治疗的眼睛在外围边缘出现颜色变化，这表明发生了凝块溶解。在玻璃体切除术时，凝块部分液化；然而，仅通过抽吸无法清除。到第10天时，无论是否接受组织型纤溶酶原激活剂或平衡盐溶液治疗，所有眼睛的光感受器损伤均为中度至重度。所有接受玻璃体切除术的眼睛均有中度至重度光感受器损伤。
在该动物模型中，玻璃体腔内注射组织型纤溶酶原激活剂出现了提示部分凝块溶解的特征；然而，组织型纤溶酶原激活剂并未产生足够的溶解以使仅通过抽吸进行手术清除成为可能。
