| ObjectiveThrough observing different theropies of traditional Chinese medicine,just to use xi jiao di huang tang which can clear away pathogenic heat and remove pathogenic heat from blood,tao hong si wu tang which can activate the blood circulation,huang lian jie du tang which can clear away pathogenic heat and toxic material and zhi bai di huang tang which can nourish yin and clear away pathogenic heat,study the protective effects to rabbits' retina especially vasculars by intravitreal gentamicin,and investigate the toxic effect and its mechanism,thereby to identify Chinese medicinal herbs which may be valuable as therapeutic agents for retinal vascular diseases especially retinal vasculitis. MethodIntravitreal inject of 500ug of gentamicin in Dutch Belted rabbit eyes, after 24 hours ,treat them with saline,xi jiao di huang tang,tao hong si wu tang,huang lian jie du tang and zhi bai di huang tang,examine changes in clinical findings, fluorescein angiography, retinal vascular digestion, histopathologic finding, electron microscopy, histochemical changes and computerized image amalysis when the treating was got for 7 and 14 days. Result1 Ophthalmoscopic studies of the retina after intravitreal injection of gentamicin demonstrated that retinal hemorrhage, edema, optic disc swelling, ocular pigmentation changes and so on.Prominent vascular nonperfusion throughout the retina, small foci of leakage from some retinal blood vessels, narked hyperfluorescence of the optic disc chould be seen on fluorescein angiography. Light and electron microscopy showed that retinal pigment epithelium had changes firstly, it ranked mussily, melanin content changed, mitochondrial swelling, and nuclear pyknosis. Photoreceptors showed cytoplasmic vacuolization, mitochondrial, then the nerve fiber layer swelled, its mitochondria was also swollen. There was a prominent inflammatory response on the surface of the intemal limiting membrane, with infiltration of the retina by polymorphonuclear neutrophils and monocytes.Retinal vasculas had obviously inflammatory action, mainly caused by leukocytic plugging.2 The middle dosage of tao hong si wu tang was more effective to this animal model, it can reduce retina ICAM-1 obviously and its action was better than the middle dosage of xi jiao di huang tang ,the effect of reduce retinal von Willebrand factor was not obvious, possibility is through reduction of retinal ICAM-1 expression to reduce scorchingness cell adhere,so it can alleviate inflammation reaction; the middle dosage of huang lian jie du tang could reduce retinal bleeding obviously in early stage,possibly because the damage of gentanmicin to rabbit retina is acute toxicity reaction, major expression is the embolism bleeding of blood vessels, and it have the effect of clearing away pathogenic heat and removing pathogenic heat from blood, it can prolong apparently to congeal for blood enzyme time and restrain the changing from fibrin original to fibrin, having obvious fight thrombus role concerning;the protective effect of zhi bai di huang tang may show after 14 days, which is the stage of late period of pathological changes, because the retinal vasculitis in later stage often show deficience of yin,we should nourish yin,clear away pathogenic heat right away and activate the blood circulation at the same time.3 The retina digestion flat technology of blood vessels is a good method of researching retinal vasculitis, it can not only observe the structure of blood capillary,circulation and distribution clearly, but also see the bleeding area of retina and inflamation cells soaking of vascular wall and its around visually and so on.All of this can not be replaced by histopathologic finding and electron microscopy exactly. Conclusion1 The model of intravitreal gentamin had many common clinical signs and histophthologic changes with other ocular diseases, especially the retinal vasculity,so it may be a better model, that is deserve to make further elucidation.2 The middle dosage of huang lian jie du tang could reduce retinal bleeding obviously in early stage .As a classical formula herb of activating the blood circulation, The middle dosage of tao hong si wu tang covild partly protect the retinal and vasculars from the toxicity of gentamicin, improving retinal tiny circulation obviously. It will be of great value of clinical practices of these similar diseases with Traditional Chinese Medicine.3 The retina digestion flat of blood vessels is more direct for the observation of retinal vessels and cells, and this is very worthy of trying in our experimental research of retinal vascular diseases continuously in the future. |
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