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Objective: With visual function and Imageology of detection means retinitis pigmentosa (retinitis pigmentosa, RP) patients testing, evaluation and screening for the detection indicators, initially established in the evaluation of visual function in patients with retinitis pigmentosa; During the inspection, normal rabbits and RCS rats (royal college of surgeon rat, Royal College of Surgeons rats) the preclinical safety on the basis of intravitreal injection of nerve growth factor (Nerve growth factor, NGF), preliminary study in patients with advanced retinitis pigmentosa intravitreal injection of NGF security, to lay the foundation for further topical ocular application of NGF treatment of retinitis pigmentosa. Methods: The normal eye control 224 of the 112 cases of various types of patients with retinitis pigmentosa visual acuity, color vision, stereo vision, contrast sensitivity, vision, flash ERG, multifocal electroretinography, EOG detect combined with fundus autofluorescence fundus fluorescein angiography, optical coherence tomography imaging examination results, the analysis for the detection indicators, the use of statistical methods for investigating the relationship between visual function OUTCOME MEASURES screened initially established retinitis pigmentosa visual function in patients evaluation index. Rabbit vitreous cavity injection NGF20μg/0.2ml of, observe different time rabbit eye response and the behavioral changes and retinal histopathological changes; the RCS rats intravitreal injection NGF5μg/5μl, local reactions observed at different times of the eye, the nerve was measured before and after surgery changes in the physiological evaluation, HE staining pathological changes of the retinal tissue. Selected eight cases of late eight patients with retinitis pigmentosa intravitreal injection NGF20μg/0.2ml control conjunctival injection of saline 0.2ml, respectively after 1 day, 3 days, 1 week, in January, March, June months and 12 months, 18 months, 24 months follow-up observation, evaluation of NGF intravitreal injection safety. Results: 1, patients with retinitis pigmentosa visual function evaluation including psychophysics, neurophysiology evaluation Imageology evaluation of three parts, the results are as follows: (1) psychophysical evaluation: selected patients with retinitis pigmentosa, accounting for less than the low vision 80.3% Age was negatively correlated with the correlation coefficient r = -0.3323, P = 0.0000,91% have varying degrees of color vision disorder, 89% no stereo vision, visual field mean sensitivity was significantly lower than the mean normal contrast sensitivity curve significantly left, the space frequency contrast sensitivity values ??lower than normal, and the vision was a positive correlation, the correlation coefficient r = 0.5163, P = 0.0166. (2) neurophysiological evaluation: flash ERG Figure scotopic rod reaction the largest mixed reaction, cone response b-wave amplitude, 30Hz flicker light N1-P1 amplitude multifocal ERG 1-6 ring P1 reaction density was significantly lower than normal EOG 15 patients 30 peak of 35.41 ± 12.11 (microvolts) light, dark valley 21.47 ± 11.0 (microvolts). B wave and a maximum reaction a reaction rod, the b-wave amplitude, cones reaction to a N1-P1 amplitude of the b-wave amplitude and 30Hz reaction between two two related relationship exists, P <0.01. Exception ③ 78 eyes of patients with RP fundus autofluorescence accounted for 91%, and the vision was a positive correlation. Normal rabbit vitreous cavity injection of NGF, observed at different time points of the cornea, crystal, vitreous and retina were no abnormal changes in rabbit eyes histopathological observation retina cells normally distributed. The RCS rat intravitreal injection of NGF, the observed the multifocal electroretinography P1 wave amplitude density and flash ERG Figure rods reaction at different points in time, the reaction of the cone, the largest mixed reaction b-wave amplitude were no significant changes, and with the significantly longer observation times, the amplitude of the wave. 3 patients with retinitis pigmentosa intravitreal injection of NGF, one had transient intraocular pressure, a vitreous opacity, considering the tendency of endophthalmitis, were cured after two timely processing of all eyes treated with short-term follow-up was not vitreous hemorrhage, retinal vascular occlusion, retinal hemorrhage, edema, exudation, clear congestion and edema of the anterior segment and other adverse reactions and complications after 12-24 months follow-up, patients subjective feeling good, high-contrast visual acuity improved after 2 weeks , preoperative and postoperative imaging studies and electrophysiological various evaluation index no significant statistical difference. Conclusion: 1, patients with retinitis pigmentosa psychophysical evaluation of visual acuity, contrast sensitivity; the neurophysiological evaluation rod reaction b-wave maximum reaction a, b-wave, the reaction of a, b-wave and 30Hz reaction cone N1- P1 mean amplitude density the P1 and multifocal ERG, EOG peak, dark valley; images OUTCOME MEASURES fundus autofluorescence. 2, normal rabbit intravitreal injection of NGF is security, while the RCS rat intravitreal injection of NGF on visual function needs to be a large sample of observation. 3 intravitreal injection of NGF treatment of patients with advanced retinitis pigmentosa is safe in the short term to stabilize the residual visual function.
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