| Purpose:Preliminary analysis of the changes in retinal vascular caliber aftervitrectomy and to observe whether retinal vascular caliber and the macular thicknessresponse to epinephrine in intraocular irrigation with retinal caliber measuringsoftware. And with gas compression vitrectomy in rabbit eye, to investigate thechanges of histopathology and function of retina during exposed to same doseepinephrine solution in different duration.Methods:For the first part, prospective data from a randomized clinical trial wereused. Experiment group include epinephrine and control group not includeEpinephrine in intraocular irrigation. The effects of experiment group versus controlgroup in patients with macular hole were evaluated in a randomized clinical trialinvolving32eyes of32patients. Slit lamp biomicroscopy, indirect ophthalmoscopyand intraocular pressure (IOP) measurement were performed at regular intervals in alleyes pre-and postoperatively. All eyes (16epinephrine versus and16notEpinephrine) of32patients had retinal photographs at the baseline and1,3-monthfollow-up visit for analysis in the present study. And all eyes of32patients had OCT(Optical Coherence Tomography) before surgery and1month after surgery. Retinalvascular caliber was measured from digital fundus photographs and summarized ascentral retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline andat the1,3-month follow-up visit. All the vitrectomy was performed by same operatorin the same way. The thickness of macular regions was measured with OCT beforesurgery and1month follow-up visit. For the second part, ten rabbits were randomizedinto experiment group and control group,5rabbits in each group. The right eyes wereused for experiment and the left served as controls. All eyes received injections of0.4ml C3F8into mid-vitreous cavity for gas compression Vitrectomy. At the time ofmaximum gas expansion (72hours of gas compression), the mid-vitreous cavity of right eyes in experiment group were injected with0.1ml1:1000epinephrine. The right eyes in control group were injected with0.1ml Saline in the same way. Slit lamp biomicroscopy, indirect ophthalmoscopy and IOP measurement were performed at regular intervals in all eyes pre-and postoperatively. Electroretinogram (ERG) was performed pre-and1,2,3weeks postoperatively in all eyes and recorded the amplitude of a wave and b wave value. The eyes were enucleated3weeks postoperatively and processed for light microscopy (LM) and TUNEL stain to observe retinal apoptosis.Results:For the first part, the measures of CRAE (170.88μm±5.17vs.182.84μm±46.63) and the measures of CRVE (231.26μm±19.37vs.231.59μm±52.23) of experimental and control eyes were no significant different Pre-and1,3months postoperatively16eyes. The thickness of inner macular regions (292.11μm±29.96vs.273.25μm±13.82) experimental and control eyes were no significant different post1months postoperatively16eyes, P=0.063, The visual after vitrectomy be improved greatly in experimental and control eyes (P<0.001). The visual of experimental and control eyes was no significant different3months postoperatively16eyes. For the second part, the amplitude of a wave and b wave value of ERG of experimental and control eyes were no significant different Pre-and1,2,3weeks postoperatively in all eyes (P>0.05). The value of OCT of experimental and control eyes were no different Pre-and1,2,3weeks postoperatively in all eyes (P>0.05). But the value retinal thickness of experimental eyes a little increased than control eyes. The superior and inferior architectures of all layers of retina were well preserved compared to the controls3weeks postoperatively in all eyes. No histological damage was detected.Conclusions:Effect of epinephrine (1:1000) in intraocular irrigation to retinal vascular caliber and the thickness of macular was no signicant different in experimental and control eyes. Epinephrine (1:1000) in intraocular irrigation did not increase the risk for function of retinal. |
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