Scleral cross-linking by riboflavin and blue light application in young rabbits: damage threshold and eye growth inhibition
Scleral cross-linking by riboflavin and blue light application in young rabbits: damage threshold and eye growth inhibition
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DOI：
10.1007/s00417-015-3213-x
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发表时间：
2016-01-01
影响因子：
2.7
通讯作者：
Francke, Mike
中科院分区：
文献类型：
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作者：
Iseli, Hans Peter;Koerber, Nicole;Francke, Mike
背景通过核黄素和光照射的巩膜交联术(SXL)已经被引入作为一种可能的治疗方法来增加高度近视眼的巩膜组织硬度和抑制过度的轴向伸长。方法用不同蓝光强度(450+/-50 nm)和核黄素对3周龄白兔和39只色素兔的巩膜进行照射。通过光镜和免疫组织化学方法检测眼组织的改变和损伤阈值。观察SXL对21只幼兔眼部生长的影响，并用A超、千分尺和磁共振成像对其进行测量。结果在400 mW/cm2以上的蓝光照射下，光镜下可见眼组织发生变性改变。因此，该光强度被定义为损伤阈值。150 mW/cm和200 mW/cm(2)蓝光可较早地观察到视网膜、脉络膜和巩膜的组织改变以及视网膜小胶质细胞和Muller细胞的激活。白兔对SXL治疗的敏感性较低。最小有效蓝光强度为15 mW/cm(2)的SXL对幼兔眼生长有明显的抑制作用，并可维持24周。结论核黄素和蓝光强度低于一定损伤阈值的SXL对幼兔眼有较长时间的生长抑制作用。因此，SXL可能是一种现实的方法来抑制高度近视眼睛的眼球延长。
Background Scleral cross-linking (SXL) by riboflavin and light application has been introduced as a possible treatment to increase scleral tissue stiffness and to inhibit excessive axial elongation of highly myopic eyes. We evaluated an ocular tissue damage threshold for blue light irradiation, and used SXL treatment to induce eye growth inhibition.Methods The sclera of 3-week-old rabbits (39 pigmented and 15 albino rabbits) were treated with different blue light intensities (450 +/- 50 nm) and riboflavin. Alterations and a damage threshold were detected in ocular tissues by means of light microscopy and immunohistochemistry. The influence of SXL on the eye growth was examined in 21 young rabbits and was measured by using A-scan ultrasonography, micrometer caliper, and for selected eyes additionally by MR imaging.Results Light microscopic examinations demonstrated degenerative changes in ocular tissue after irradiation with blue light intensities above 400 mW/cm(2) (with and without riboflavin application). Therefore, that light intensity was defined as the damage threshold. Tissue alteration in retina, choroid, and sclera and activation of retinal microglia cells and Muller cells could be earlier observed at blue light intensities of 150 and 200 mW/cm(2). Albino rabbits were less sensitive to this SXL treatment. A significant reduction of the eye growth could be detected by SXL treatment with the minimal efficient blue light intensity of 15 mW/cm(2) and maintained stable for 24 weeks.Conclusions SXL with riboflavin and blue light intensities below a defined damage threshold can induce a long lasting growth inhibitory effect on young rabbit eyes. Therefore, SXL might be a realistic approach to inhibit eye elongation in highly myopic eyes.