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首页> 外文会议>Conference on Laser and Noncoherent Light Ocular Effects: Epidemiology, Prevention, and Treatment III Jan 26-27, 2003 San Jose, California, USA >Significance of retinal laser lesion location and subretinal hemorrhage in bridging choroidal neovascular complexes
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Significance of retinal laser lesion location and subretinal hemorrhage in bridging choroidal neovascular complexes

机译：视网膜激光损伤部位和视网膜下出血在桥接脉络膜新生血管复合物中的意义

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Purpose: To determine funduscopic criteria that will help predict when bridging choroidal neovascular (CNV) complexes will develop after laser retinal trauma and to define early preventive treatment targets. Methods: Ten rhesus monkeys were used and retinal lesions were produced by Nd:YAG exposures (20ns, 1-2mJ, 1064nm, min. spot size) simulating human accidental laser trauma to the central fundus. Funduscopy, fluorescein/ICG angiography, and optical coherence tomography (OCT) were conducted at day 1, 4, and 14, and at 2 and 4 months, after which animals were terminated for histologic evaluation. Predisposition for bridging fibrovascular complexes was evaluated for single hemorrhagic lesions, two small lesions showing coalescing hemorrhages, and multiple lesions involved with large field subretinal and vitreous hemorrhages. Results: All single lesions with confined subretinal hemorrhages showed elevated CNVs. All lesion sets that showed small coalescing subretinal hemorrhages formed bridging CNV scars. No bridging CNVs occurred in lesion sets involving a vitreous hemorrhage adjacent to a confined but small subretinal hemorrhage. Complex CNV formation occurred in large field subretinal hemorrhages involving multiple laser lesions. Extensive secondary photoreceptor losses occurred in large and confined hemorrhage and CNV zones. Conclusions: Trauma presenting with evidence of coalescing and confined subretinal hemorrhages between two adjacent lesions has a high chance of forming choroidal neovascular bridge complexes between the involved lesions. Release of subretinal blood through a vitreous hemorrhage reduced the chances of cross-bridging CNV formation, except for large-field subretinal hemorrhages. CNV formation may be related to the long residence time, break down products, and clearance processes of extravasated blood. Retinal detachment complications produced by the hemorrhage may further contribute to CNVs. Removal of trapped blood and curtailing angiogenesis and cellular proliferation may be helpful treatment strategies.
机译：目的：确定眼底镜检查标准，以帮助预测激光视网膜损伤后何时会形成脉络膜新生血管（CNV）复合物，并确定早期预防性治疗目标。方法：使用十只恒河猴，通过Nd：YAG照射（20ns，1-2mJ，1064nm，最小光斑尺寸）模拟人的意外激光对中央眼底的损伤，产生视网膜损伤。在第1、4和14天以及第2和4个月进行眼底镜检查，荧光素/ ICG血管造影和光学相干断层扫描（OCT），之后将动物处死以进行组织学评估。对于单个出血性病变，两个显示合并性出血的小病变以及涉及大视野视网膜下和玻璃体出血的多个病变，评估了桥接纤维血管复合物的易感性。结果：所有局限性视网膜下出血的单个病变均显示CNV升高。所有显示小的合并视网膜下出血的病变组均形成桥接CNV疤痕。在涉及玻璃体出血的局限性但较小的视网膜下出血的病变组中，未发生桥接CNV。复杂的CNV形成发生在涉及多个激光损伤的大视野视网膜下出血中。广泛的继发性光感受器丧失发生在大而狭窄的出血区和CNV区。结论：在两个相邻病灶之间出现合并和局限性视网膜下出血的创伤很有可能在受累病灶之间形成脉络膜新生血管桥复合体。除大视野视网膜下出血外，通过玻璃体出血释放视网膜下血液减少了交叉桥接CNV形成的机会。 CNV的形成可能与停留时间长，产品分解和渗出血液的清除过程有关。出血引起的视网膜脱离并发症可能进一步导致CNV。清除滞留的血液并减少血管生成和细胞增殖可能是有用的治疗策略。

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