目的:从玻璃体视网膜界面角度探讨玻璃体出血后玻璃体的变化及其预后。
方法:对32只新西兰兔(64只眼)进行实验,体重2500-3000克4个月和无限性别,将0.2mL自体血注入玻璃体腔中心-研究组(右眼),和对照组以相同的方式用等体积的盐水处理。根据观察天数,将兔随机并等分为以下四批:注射后第3、7、14和30天。在行兔和眼球摘除前评估眼压和严重程度分级。分离眼前段自然流出玻璃体以检测液化程度和粘度。然后,电解质的化学成分,通过比色法和酶联免疫吸附测定(ELISA)测定PCT和bFGF。最后,玻璃体取样后观察到玻璃体后脱离(PVD)的发生率。这些研究是双盲的。
结果:注射后,玻璃体混浊程度和凝块大小随时间减少。在不同的时间点,两组之间的液化程度和丝束长度均存在显着差异(均p<0.001)。从第14天开始,研究组的液化程度明显上升,粘度在初始时间显着下降。生化标志物暂时波动,除了碱性成纤维细胞生长因子(bFGF),继续上升,与液化程度相关(r=0.658,p<0.001)。此外,PVD的发生率从第14天开始增加(p<0.05),与巨噬细胞数量呈高度正相关(r=0.934;p<0.001)。
结论:玻璃体出血后,玻璃体的变化较早(2-4周)相对较小,但后来不可逆转。具体来说,液化程度随着粘度的降低而增加,巨噬细胞和bFGF的趋化性诱导不完全的PVD。
To explore the changes in vitreous body after vitreous hemorrhage and assess its prognosis from the perspective of vitreoretinal interface.
The experiment was performed on 32 New Zealand rabbits (64 eyes), weighing 2500-3000 g for 4 months and unlimited gender, which was injected with 0.2 mL of autologous blood into the center of vitreous cavity-the
study group (right eyes), and the control one was treated in the same manner with equal volumes of saline. The rabbits were randomly and equally divided into the following four batches according to the days of observation: Days 3, 7, 14, and 30 after injection. IOP and severity grading were evaluated before rabbits\' execution and eyeballs were enucleated. The anterior segment was separated to flow out the vitreous body naturally to detect the liquefaction degree and viscosity. Then, chemical composition of electrolytes, PCT and bFGF were determined by colorimetry and enzyme-linked immunosorbent assay (ELISA). Finally, the incidence of posterior vitreous detachment (PVD) was observed after vitreous sampled. The studies were double-blind.
After injection, the extent of vitreous opacity and coagulum size decreased over time. Both the degree of liquefaction and the length of tow differed significantly between two groups at different time points (all p < 0.001). The liquefaction degree in the
study group rose obviously from the Day 14, which the viscosity declined significantly on the initial time. Biochemical markers fluctuated temporarily, except for basic fibroblast growth factor (bFGF), which continued to rise and was correlated with the liquefaction degree (r = 0.658, p < 0.001). Besides, the incidence of PVD increased from the 14th day (p < 0.05), and it was highly positively correlated with the number of macrophages (r = 0.934; p < 0.001).
After vitreous hemorrhage, the changes of the vitreous body are relatively minor earlier (2-4 weeks), but irreversible later. Specifically, the degree of liquefaction increases with a decrease in viscosity, and the chemotaxis of macrophages and bFGF induce incomplete PVD.