Basic and clinical approach for analysis and treatment of the age related neovascular maculopathy

年龄相关性新生血管性黄斑病分析和治疗的基础和临床方法

• 批准号: 03404050
• 负责人: TAMAI Makoto
• 金额: $ 19.46万
• 依托单位: TOHOKU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (A)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-03404050/
• 关键词: Age related macular degeneration; Neovascularization; Transplantation of retin at pigment epithelial cells; Vitreous surgery; Sampling of vitreous; Experimental damage of retinal pigment epithelium; Regeneration of retinal pigment epithelium; Histo

According to the informations obtained from clinical observation of the patients with age telated macular degeneration, experimental models using animal eyes were made. An artificial damage of retinal pigment epithlium (RPE) was established and the transplantation of RPE to the rabbit eyes with such artificially damaged retina was perfgomed with vitreous surgery. The functional recovery in vison was histochemically shown in both models. Regeneration of RPE was proved in the retina with artificially damaged RPE and was stimulated by the administration of basic fibroblast growth factor into the vitreous cavity.Vitreous surgery has been introduced to the treatment of the age related macular degeneration with massive subretinal lesion as well as treatment with laser photocoagulation. By means of analysis of the removed subretinal lisions, the manner of extention of this disease was revealed and the contents of lesion were also revealed. Each specimen mainly consists of fibrovascular tissue with fresh and old hematomas. The damaged retinal pigment epithelium (RPE) cells were also found in all specimens. Several cases showed remarkable improvement in visual acuity although those cases have no RPE at macular area after the surgery. New supplemental treatments using growth factor or retinal transplantation may be necessary in order to obtain further improvement in the visual function.

根据对老年性黄斑变性患者的临床观察资料，制作动物眼实验模型。建立了视网膜色素上皮(RPE)的人工损伤模型，并用玻璃体手术的方法将RPE移植到人工损伤的兔眼。组织化学显示两种模型均显示粘液功能恢复。在人工损伤RPE的视网膜中证实了RPE的再生，并通过向玻璃体腔内注射碱性成纤维细胞生长因子来刺激RPE的再生。玻璃体手术已被引入到治疗伴有大量视网膜下病变的老年性黄斑变性以及激光光凝治疗。通过对摘除的视网膜下病变的分析，揭示了该病的扩散方式和病变内容。每个标本以纤维血管组织为主，有新鲜血肿和陈旧血肿。所有标本均见受损的视网膜色素上皮(RPE)细胞。几例术后黄斑区无RPE，但视力有明显提高。为了进一步改善视功能，可能需要使用生长因子或视网膜移植进行新的补充治疗。

项目成果

山田 孝彦,菅野 俊雄,君塚 佳宏,玉井 信: "老人性円板状黄斑変性症の網膜下線維血管病巣についての組織学的検索" 臨床眼科. (1993)

Takahiko Yamada、Toshio Kanno、Yoshihiro Kimizuka、Makoto Tamai：“老年盘状黄斑变性视网膜下纤维血管病变的组织学搜索”临床眼科（1993）。

Takahiko Yamada,Makoto Tamai et al: "Changes and recovery in the interphotoreceptor matrix and rod outer segments of the reattached retina after artificial retinal detachment and abrasion of RPE" Investigative Ophthalmology and Visual Science(Suppl). (199

Takahiko Yamada、Makoto Tamai 等人：“人工视网膜脱离和 RPE 磨损后，光感受器间基质和重新附着的视网膜杆状外节的变化和恢复”调查眼科和视觉科学（增刊）。

山口 慶子,山口 克宏: "老化網膜に対する網膜色素上皮移植の試み" 厚生省特定疾患 網膜脈絡膜萎縮症調査研究班平成3年度研究報告書. (1992)

Keiko Yamaguchi、Katsuhiro Yamaguchi：“针对老化视网膜的视网膜色素上皮移植的尝试”厚生省特定疾病视网膜脉络膜萎缩调查研究小组 1991 年研究报告（1992 年）。

Makoto Tamai,Takahiko Yamada et al: "Histological and histochemical analysis of the artificially damaged rabbit retina with transplanted retinal pigment epithelium" Invest.Ophthalmol & Vis Sci. 34. 1112 (1993)

Makoto Tamai、Takahiko Yamada 等人：“移植视网膜色素上皮的人工损伤兔视网膜的组织学和组织化学分析” Invest.Ophasemol

君塚佳宏、山田孝彦、玉井信他: "加齢黄斑変性において網膜下血腫増殖組織除去を行った症例の網膜色素上皮の動態" 臨床眼科. 47. 290-293 (1993)

Yoshihiro Kimizuka、Takahiko Yamada、Shin Tamai 等人：“去除视网膜下血肿增殖组织的年龄相关性黄斑变性病例中视网膜色素上皮的动态”《临床眼科》47. 290-293 (1993)。