自體血清點眼劑於兔角膜上皮缺損之效果評估

Efficacy of Topical Autologous Serum in Treatment of Corneal Epithelial Wound in Rabbits

林荀龍(Shiun-Long Lin) ； 張麗君(Li-Jun Zhang) ； 劉邦成(Pan-Chen Liu) ； 王渭賢(Way-Shyan Wang)

《臺灣獸醫學雜誌》 35卷1期 (2009/03) Pp. 49-57

https://doi.org/10.7009/TVJ.200903.0049

摘要

Corneal disease is a common ophthalmic disease in small animals. It can cause varying degrees of opacity. Vision may be gradually impaired and lost. The corneal epithelium is important in the control of water content of the stroma and in preventing microbial invasion. Serum has been used in human ophthalmology, especially in dry eye syndrome and persistent epithelial defect (PED). Serum has similar physiological, biochemical and nutritional properties to tears. In this study we evaluated the efficacy of autologous serum application in treatment of corneal epithial wounds in rabbits. Twenty rabbits (40 eyes) were used in this study. The rabbit corneas were de-epithelialized by the application of ethanol (20%) for 40 seconds. Experiment 1 (26 eyes) comprised 3 groups: control (12 eyes), 50% autologous serum (6 eyes), and 20% autologous serum (6 eyes). Experiment 2 (14 eyes) comprised 2 groups: control (6 eyes), and 50% autologous serum (6 eyes). The lacrimal gland, nictitating membrane, and Harderian gland were removed before chemical debridement in experiment 2. The control groups did not receive any eye-drops during the study period. The autologous serum groups received 50% or 20% autologous serum eye-drops five times a day until the wound had completely healed, starting immediately after debridement. The epithelial defects were stained with fluorescein dye and photographed immediately following debridement and at 3, 6, 10, 14, 21, 25, 29, 33, 37, 41, 48, 52, and 56 hours after debridement. One rabbit from each group was killed with CO2 gas immediately following debridement and one from each group was killed after the wound had completely healed. The corneas of the killed rabbits were excised and fixed for histopathologic examination. All autologous serum eye-drops were cultured on blood agar. The defective corneal area was not significantly different among the 3 groups in Experiment 1. In Experiment 2, the corneal defect area in the 50% autologous serum group was significantly different from that of the control group at each time interval after 6 hours (p＜0.05). The percentage of complete healing in the 50% autologous serum group was significantly higher than that in the 25% autologous serum group and control group at 41 hours and 48 hours after debridement. In conclusion, autologous serum eye-drops resulted in a significantly greater area of corneal epithelial healing in rabbits compared with controls (Experiment 1) and rabbits with aqueous tear deficiency (Experiment 2). These results demonstrated that autologous serum eye-drops may be appropriate for treatment of dry eye syndrome and persistent epithelial defect (PED) in small animals and dogs.

關鍵字

角膜 ； 自體血清 ； 兔

並列摘要

Corneal disease is a common ophthalmic disease in small animals. It can cause varying degrees of opacity. Vision may be gradually impaired and lost. The corneal epithelium is important in the control of water content of the stroma and in preventing microbial invasion. Serum has been used in human ophthalmology, especially in dry eye syndrome and persistent epithelial defect (PED). Serum has similar physiological, biochemical and nutritional properties to tears. In this study we evaluated the efficacy of autologous serum application in treatment of corneal epithial wounds in rabbits. Twenty rabbits (40 eyes) were used in this study. The rabbit corneas were de-epithelialized by the application of ethanol (20%) for 40 seconds. Experiment 1 (26 eyes) comprised 3 groups: control (12 eyes), 50% autologous serum (6 eyes), and 20% autologous serum (6 eyes). Experiment 2 (14 eyes) comprised 2 groups: control (6 eyes), and 50% autologous serum (6 eyes). The lacrimal gland, nictitating membrane, and Harderian gland were removed before chemical debridement in experiment 2. The control groups did not receive any eye-drops during the study period. The autologous serum groups received 50% or 20% autologous serum eye-drops five times a day until the wound had completely healed, starting immediately after debridement. The epithelial defects were stained with fluorescein dye and photographed immediately following debridement and at 3, 6, 10, 14, 21, 25, 29, 33, 37, 41, 48, 52, and 56 hours after debridement. One rabbit from each group was killed with CO2 gas immediately following debridement and one from each group was killed after the wound had completely healed. The corneas of the killed rabbits were excised and fixed for histopathologic examination. All autologous serum eye-drops were cultured on blood agar. The defective corneal area was not significantly different among the 3 groups in Experiment 1. In Experiment 2, the corneal defect area in the 50% autologous serum group was significantly different from that of the control group at each time interval after 6 hours (p＜0.05). The percentage of complete healing in the 50% autologous serum group was significantly higher than that in the 25% autologous serum group and control group at 41 hours and 48 hours after debridement. In conclusion, autologous serum eye-drops resulted in a significantly greater area of corneal epithelial healing in rabbits compared with controls (Experiment 1) and rabbits with aqueous tear deficiency (Experiment 2). These results demonstrated that autologous serum eye-drops may be appropriate for treatment of dry eye syndrome and persistent epithelial defect (PED) in small animals and dogs.

並列關鍵字

corneal epithelial defect ； autologous serum eye-drops ； rabbit