目的:研究实验性视网膜脱离(retinal detachment,RD)及脱离复位后神经感觉层细胞凋亡情况,探讨RD后视功能损害的机制为临床治疗提供理论基础。方法:健康成年无眼部疾病青紫兰兔40只,采用计算机随机数字表法分为RD后1,3h;1,3,7,14,28d组及正常对照组,共8组,每组5只,选取右眼为致伤眼,视网膜下注射透明质酸钠建立RD模型;分别于建立模型后按时获取兔眼标本,以TUNEL法观察视网膜神经感觉层细胞的凋亡情况。结果:视网膜脱离复位后存在着神经感觉层细胞凋亡现象,正常对照组、14d和28d组几乎不见凋亡细胞,脱离后1,3h;3,7d组在视网膜各细胞层均出现较多的、具有凋亡形态学与生化改变特征的凋亡细胞,其中在3d组视网膜感觉层细胞凋亡细胞数量达到高峰。视网膜神经感觉层凋亡细胞数目在1,3h;3,7d组之间两两比较均有显著性差异(P<0.01);1,3h;3,7d组与正常对照组、1h;1,28d组之间两两比较均有显著性差异(P<0.01);正常对照组、1h;14,28d组之间两两比较无显著性差异。结论:RD复位后,神经感觉层细胞发生凋亡。

·AIM:To observe the phenomenon of sensory layer apoptosis in detached retina,and further to study the apoptosis mechanisms providing the rationale for clinical treatment.·METHODS:Completely random design was applied.Forty healthy pigment rabbits without oculopathy were divided into 8 groups,1 hour,3 hours,1 day,3,7,14,28 days after retinal detachment(RD)and normal control,5 rabbits in each group.Right eye of each rabbit was treated with infusing sodium hyaluronate under retinal neuro-epithelium layer.The eyeballs were enucleated at different times after RD.The morphologic changes of the retina were observed by electron microscopes.Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)technique was used to assess apoptosis.·RESULTS:There was cell apoptosis in sensory layer after detachment of retina,but almost not observed in retinas from control,14 days and 28 days eyes.They were abundant at 1 hour,3 hours,3 days,7 days after RD,peaked at 3 days,and dropped precipitously at 7 days after detachment.Every multiple comparison among the groups of 1 hour,3 hours,1 day,3 days and 7 days after RD showed significant difference in comparing of apoptotic cells(P<0.01).An obvious change of cell number was found comparing each of 1 hour,3 hours;3 days and 7 days with each of normal control,1 hour,1 day and 28 days(P<0.01).But there was no significant difference of multiple comparison among control group,1 hour,14 days and 28 days group after RD.·CONCLUSION:Apoptosis is an important mechanism of sensory layer cell degeneration after RD.·

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