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核黃素—紫外線A鞏膜交聯對實驗性近視的影響研究

發(fā)布時間:2018-11-17 19:25
【摘要】:目的近視是發(fā)病率最高的眼病之一,近視發(fā)病率在全球范圍內居高不下,并且呈現快速增長的趨勢。近視程度越深,與高度近視相關的眼部并發(fā)癥如視網膜脫離、視網膜下新生血管、白內障和青光眼等的風險也隨之顯著上升,這些并發(fā)癥可引起嚴重視力下降和不可逆性視力損傷。近視眼鞏膜結構發(fā)生改變,鞏膜干重減少,膠原排列紊亂,直徑變細,鞏膜抗張力變差。鞏膜膠原交聯可以使鞏膜組織的膠原之間發(fā)生共價鍵重新結合,從而增強鞏膜組織的機械性能,增強鞏膜的抗牽拉能力,進而阻止眼軸的進一步延長。本研究采用面罩法形覺剝奪制作豚鼠近視模型,并通過核黃素-紫外線A誘導后極部鞏膜膠原交聯,觀察后極部鞏膜交聯對豚鼠實驗性近視的影響研究,有望為臨床上近視的根本治療提供新的可靠方法。方法1.選取3周齡三色豚鼠9只,隨機分為正常對照組(NOR組,n=4)和形覺剝奪近視組(FDM組,n=5),FDM組配戴氣球制作的面罩,暴露左眼、雙耳及口鼻,遮蓋右眼,NOR組不做任何處理,右眼為實驗眼,分別于遮蓋前、遮蓋1周、2周進行生物學檢測,包括屈光度和眼軸長度。2.選取出生3周的三色豚鼠9只,右眼為實驗眼,左眼為自身對照。進行右眼單眼核黃素-紫外線A后極部鞏膜膠原交聯手術,1周后處死豚鼠,取鞏膜做成條帶,行鞏膜生物力學檢測。3.選取出生3周的三色豚鼠25只,由丹陽市呂城鎮(zhèn)奧臣實驗動物養(yǎng)殖場提供(批號:SCXk(京2013-0007)),屈光度范圍在0~+8.00D之間,雙眼屈光參差小于2.5D,隨機分為空白對照組NOR(n=7)、形覺剝奪組FDM(n=7)、單純交聯組NOR+CL(n=5)和近視交聯組FDM+CL(n=6),選取右眼為實驗眼,左眼為自身對照眼。NOR組不做任何處理,FDM組進行右眼單眼面罩法形覺剝奪,NOR+CL組只進行右眼單眼核黃素-紫外線A后極部鞏膜膠原交聯,FDM+CL組先進行右眼單眼核黃素-紫外線A后極部鞏膜膠原交聯,后進行右眼單眼面罩法形覺剝奪。分別于實驗前、遮蓋1周、2周、3周、4周進行豚鼠眼球光學生物測量,包括屈光度、眼軸長度和角膜曲率,4周測量結束后,處死豚鼠,每組選取2只行組織病理學檢測,其余取鞏膜條帶行生物力學檢測。結果1.面罩法形覺剝奪可以成功制作豚鼠實驗性近視模型。形覺剝奪2周可以誘導約-2.50D的近視,眼軸延長約0.2mm,FDM組實驗眼(OD)與對照眼(OS)相比,更趨近于近視,雙眼屈光參差向近視方向發(fā)展,NOR組雙眼間無明顯差異,FDM組與NOR組相比,雙眼屈光參差具有明顯差異,有統計學意義。2.核黃素-紫外線A誘導的后極部鞏膜膠原交聯可以成功誘導鞏膜膠原交聯,有效增強鞏膜的機械性能,鞏膜的極限應力和彈性模量增大,極限應變減小。3.核黃素-紫外線A誘導的后極部鞏膜膠原交聯可以延緩豚鼠實驗性近視的進展速度。核黃素-紫外線A交聯可以延緩近視屈光度增長約35%。FDM組與其他3組相比,實驗眼的眼軸較對側眼明顯延長,差異有統計學意義,而FDM+CL組與NOR組相比,眼軸幾乎無明顯增長。4組組織病理學檢測結果顯示,視網膜和RPE細胞未見明顯損傷。結論核黃素-紫外線A誘導的后極部鞏膜膠原交聯可以通過增強鞏膜的機械性質進而延緩豚鼠實驗性近視的進展速度,且對視網膜和RPE細胞無明顯損傷。
[Abstract]:Objective Myopia is one of the highest incidence of eye diseases. The incidence of myopia is high in the world, and the trend of rapid growth is presented. The deeper the degree of myopia, the risk of ocular complications associated with high myopia, such as retinal detachment, new blood vessels in the retina, cataracts and glaucoma, has also increased significantly, which can cause severe visual deterioration and irreversible vision damage. The changes of the scleral structure of the myopia, the decrease of the dry weight of the sclera, the disorder of the alignment of the collagen, the diameter of the sclera, and the deterioration of the tensile force of the sclera. The crosslinking of the scleral collagen can reintegrate the collagen between the scleral tissues, thereby enhancing the mechanical properties of the scleral tissue, enhancing the anti-pulling ability of the sclera, and further preventing further extension of the eye axis. In this study, the model of the guinea pig myopia was made by the mask method, and the collagen cross-linking of the sclera was induced by riboflavin-ultraviolet A, and the effect of the post-pole scleral cross-linking on the experimental myopia in the guinea pigs was studied, and a new and reliable method was expected to be provided for the fundamental treatment of myopia. Method 1. The three-week-old three-color guinea pigs were randomly divided into the normal control group (NOR group, n = 4) and the group (FDM group, n = 5), the FDM group wearing the mask made of the balloon, exposed the left eye, the ears and the mouth nose, covering the right eye, the NOR group did not do any treatment, the right eye was the experimental eye, The biological tests were performed for 1 week and 2 weeks, respectively, prior to the covering, including the power and the eye-axis length. 9 of the three-color guinea pigs at 3 weeks of birth were selected, and the right eye was the experimental eye and the left eye was the self-control. Right-eye single-eye riboflavin-UV-A post-scleral collagen cross-linking operation was performed, and the guinea pig was sacrificed after 1 week, and the sclera was made into a band, and the biomechanical testing of the sclera was performed. 25 guinea pigs were selected to be born for 3 weeks, and the three-color guinea pigs were provided (batch number: SCXk (Beijing 2013-0007)) from the laboratory animal farm in Lutown, Danyang City, and the diopters ranged from 0 to + 8. 00D. The refractive index of the two eyes was less than 2.5D, and was randomly divided into the blank control group (NOR (n = 7) and the group FDM (n = 7). In the simple cross-linked group, NOR + CL (n = 5) and short-term cross-linked group FDM + CL (n = 6), the right eye was selected as the experimental eye and the left eye was the self-control eye. The NOR group did not do any treatment, and the FDM group was deprived of the right-eye single-eye mask method. In the NOR + CL group, only the right-eye single-eye riboflavin-ultraviolet A was cross-linked with the sclera collagen, and the FDM + CL group was first subjected to right-eye single-eye riboflavin-ultraviolet-A posterior-pole scleral collagen cross-linking, and the right eye and the single-eye mask method of the right eye are subjected to the right-eye single-eye mask method. The optical measurements of the guinea pig's eye were performed for 1 week, 2 weeks, 3 weeks and 4 weeks before the experiment, including the diopter, the length of the eye and the curvature of the cornea, and after the end of the 4-week measurement, the guinea pigs were sacrificed. Results 1. The experimental myopia model of the guinea pig can be successfully produced by the mask method. The myopia of about-2.50D can be induced in the 2-week-deprivation, the eye-axis is extended by about 0.2mm, and the experimental eye (OD) of the FDM group is more close to the myopia than the control eye (OS), and the refractive index of the two eyes is developed in the near-sighted direction, and there is no significant difference between the two eyes of the NOR group, and the FDM group is compared with the NOR group, There was a significant difference in the refractive index of the two eyes, and it was of statistical significance. The cross-linking of the scleral collagen induced by riboflavin-ultraviolet A can successfully induce the cross-linking of the sclera, effectively enhance the mechanical properties of the sclera, increase the limit stress and the elastic modulus of the sclera, and decrease the limit strain. The cross-linking of the posterior pole and the sclera induced by riboflavin-ultraviolet A can delay the progression of experimental myopia in the guinea pig. Riboflavin-UV-A cross-linking can delay the growth of myopia by about 35%. Compared with the other three groups, the eye-axis of the experimental eye is significantly longer than that of the other three groups, the difference is of statistical significance, and the group of FDM + CL has no significant increase in the eye axis compared with the NOR group. No significant injury was seen in the retina and RPE cells. Conclusion The cross-linking of the scleral collagen induced by riboflavin-ultraviolet A can delay the progress of experimental myopia in the guinea pig by enhancing the mechanical properties of the sclera, and no obvious damage to the retina and RPE cells.
【學位授予單位】:天津醫(yī)科大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R778.11

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