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目的:探讨新型光敏剂ZnPcS_4-BSA(四磺酸酞菁锌与牛血清白蛋白的配合物)介导的光动力疗法对脉络膜新生血管的疗效及应用前景。方法:每只BN大鼠一眼作为实验眼,另一眼作为对照眼,在间接检眼镜下用氩激光光凝视网膜,于光凝后14、21、28天时行眼底光学相干断层扫描(OCT)和荧光血管造影(FFA)等检查。光凝21天后,进行光动力治疗(PDT),照射能量密度为50J/cm~2,PDT1和PDT2两组分别以ZnPcS_4-BSA和ZnPcS_4为光敏剂,于治疗后24小时和7天进行眼底镜,OCT和FFA等检查,检查后作组织病理学光镜和电镜的观察。结果:光凝后14天时,OCT检查见光凝斑视网膜变薄,脉络膜反射被遮蔽,FFA见少量荧光素渗漏,光镜检查见视网膜神经层变薄。光凝21天后,OCT检查见光凝斑视网膜色素上皮(RPE)层和脉络膜毛细血管层反射光带增厚,光凝后21和28天时,FFA检查分别有55%和35%的光斑有点状荧光素渗漏,光镜检查有脉络膜新生血管形成。PDT1和PDT2组治疗后24h FFA检查CNV各有30%和25%被封闭,7天后各有60%和45%,两组间总的有效封闭率有显著性差异。光镜和电镜检查,PDT2组比PDT1组视网膜色素上皮细胞损伤更为严重。结论:ZnPcS_4-BSA介导的光动力治疗一周后能有效地封闭脉络膜新生血管,比用ZnPcS_4介导的光动力治疗效果更好。
OBJECTIVE: To investigate the curative effect and application prospect of cholinergic neovascularization by photodynamic therapy mediated by a novel photosensitizer ZnPcS_4-BSA (complex of zinc tetraborate phthalocyanine and bovine serum albumin). Methods: One eye of each BN rats was used as the experimental eye and the other eye was used as the control eye. The retina was photocoagulated with argon laser in the indirect ophthalmoscope. Fundus optical coherence tomography (OCT) was performed 14, 21, and 28 days after photocoagulation Fluorescent angiography (FFA) and other tests. After 21 days of photocoagulation, photodynamic therapy (PDT) was performed with an energy density of 50 J / cm ~ 2. PDT1 and PDT2 groups were treated with ZnPcS_4-BSA and ZnPcS_4 as photosensitizers, and ophthalmoscopy was performed at 24 and 7 days after treatment , OCT and FFA and other tests, examination for histopathological light microscopy and electron microscopy. Results: At 14 days after photocoagulation, retinal thinning of photocoagulation spot, shadowing of choroidal membrane and leakage of fluorescein in FFA were observed by OCT. Thinning of retina was observed by light microscopy. After 21 days of photocoagulation, OCT showed thickening of the light reflection band of RPE and choriocapillaris layers. After 21 and 28 days of photocoagulation, 55% of FFA and 35% of spots were slightly punctate Fluorescein leakage, light microscopy with choroidal neovascularization. In the PDT1 and PDT2 groups, 30% and 25% of the CNVs were blocked after 24 hours of treatment and 60% and 45% after 7 days respectively. There was a significant difference in the total effective occlusion rate between the two groups. Light and electron microscopy, PDT2 group than the PDT1 group of retinal pigment epithelial cells more serious damage. CONCLUSION: ZnPcS_4-BSA-mediated photodynamic therapy can effectively block choroidal neovascularization one week later than ZnPcS_4-mediated photodynamic therapy.