Experimental Study on the Destruction and Recovery of the Blood Retinal Barrier after Photocoagulation and Cryotherapy in the Rabbits

Kwak, Hyung Woo; Chang, Bong Leen

Abstract

The primary purpose of the study is to investigate the destruction and recovery of the blood retinal barrier after photocoagulation and cryotherapy in the rabbits. The 110 pigmented rabbits were used in this experiment. After photocagulation and cryotherapy we injected intravenousely a dose of 25 mg/kg of fluorescein sodium, and then sampled blood and vitreous and measured the concentration of fluorescein sodium by means of High Performance Liquid Chromatography. The calculated penetration ratio which indicates the destruction of the blood retinal barrier is obtained by dividing fluorescein sodium concentration of vitreous by integral of fluorescein sodium concentration of the plasma from 3 min to 60 min. Subsequently, fundus photography and enucleation for flat preparation were performed in each experimental rabbit. The fluorescein concentration of vitreous of the normal rabbit is 3.60 +/- 4.75 X 10(-9)gm/ml and its penetration ratio is 0.20 +/- 0.23 X 10(-6) min. After measuring the correlation between the frequency of photocoagulation and penetration ratio and between the frequency of cryotherapy and penetration ratio, we found out that the correlation coefficient was 0.885 and 0.909 respectively. And this experiment showed that penetration ratio was higher in cryotherapy group than in photocoagulation group. In addition, we divided these experimental animals into 4 groups, mild and severe cryotherapy groups and lighter and heaver photocoagulation groups, and assessed the penetration ratio of these four groups at 1,3,7,14,28, and 42 days after treatment. As a result, penetration ratio was highest at 3 days after treatment and was almost back to normal by 42 days in all experimental groups except in severe cryotherapy group. Compared with photocagulation groups, cryotherapy groups showed more extensive destruction and delayed recovery of the blood retinal barrier. In fundus photography, in the photocoagulation groups white patch was developed after treatment, at 7 days white patches disappeared and were replaced by pigmented and scarred tissue; by 42 days the margin of these lesions was indistinct and the lesions were changed into relatively small scarred patches. On the other hand, in the cryotherapy groups the thick round white patch wasdeveloped after treament, at 7 days large round white patches disappeared and were replaced by pigmented and scarred tissue; by 42 days the lesions were replaced by large scarred patches with pigmentation and depigmentation. In flat preparation, in the photocoagulation groups central necrotic zone and intermediate zone with hyperpigmentation and peripheral zone with hypopigmentation was presented at 1 day. In the cryotherapy groups the diminished density, in the center and white ring at the margin was revealed at 1 day. From 7 days in photocogulation groups and from 14 days in the cryotherapy groups, retinal pigment epithelium began to show proliferation and by 42 days, retinal pigment epithelial layer of both groups except severe cryotherapy group was replaced by relatively normal retinal pigment epithelium.