Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Deneysel Kornea Neovaskülarizasyonunda Subkonjonktival Siklosporin-A'nın Tedavideki Rolü
Role of Subconjonctival Cyclosporin-A in Treatmeant of Experimental Corneal Neovascularization
Harun YÜKSELa, Murat TUNÇb, Ümran YILDIRIMc, İbrahim ÖNDERd, Çağrı KILIÇa
aGöz Hastalıkları Kliniği, Diyarbakır Eğitim ve Araştırma Hastanesi, Diyarbakır bGöz Hastalıkları AD, cPatoloji AD, Düzce Üniversitesi Tıp Fakültesi, Düzce dGöz Kliniği, Şarkışla Devlet Hastanesi, Sivas
Turkiye Klinikleri J Ophthalmol. 2010;19(4):226-33
Article Language: TR
Full Text
ÖZET
 Amaç: Kornea neovaskülarizasyonu, korneanın şeffaflığının azalmasına ve görme kayıplarına neden olabilen ciddi bir halk sağlığı problemidir. Çalışmamızda termal koterizasyon ile deneysel kornea neovaskülarizasyonu oluşturulmuş ve siklosporin-Anın subkonjonktival enjeksiyon ile uygulanmasının kornea neovaskülarizasyonu gelişimine etkisi araştırılmıştır. Gereç ve Yöntemler: Çalışmaya 24 adet Wistar ratın sağ gözleri alındı. Ratlar uygulanan tedaviye göre 4 gruba ayrıldı. 22 rat ile deneyler tamamlandı: Grup 1: 0.5 mg/0.01 cc subkonjonktival siklosporin-A enjeksiyon grubu (n= 6): grup 2: 0.25 mg/0.01 cc subkonjonktival siklosporin-A enjeksiyon grubu (n= 5); grup 3: 0.125 mg/0.01 cc subkonjonktival siklosporin-A enjeksiyon grubu (n= 6); grup 4 (kontrol grubu): Tedavisiz bırakılan grup (n= 5). Korneaya limbustan 1 mm uzaklıkta saat 3, 6, 9 ve 12 hizasında termal koterizasyon tamamlandıktan sonra temporal bulber konjonktiva altına grup 1, 2 ve 3te belirtilen dozlarda siklosporin-A 0,01 cc volüm içinde enjekte edildi. Altı hafta sonra ameliyat mikroskobu ile kornealar muayene edildi. Neovasküler alanın oranı ve ana damar sayısı tespit edildi. Muayeneden sonra ratlara enükleasyon yapıldı. Parafin blok ve Hematoksilen-eozin boyama ile histopatolojik inceleme yapılarak kornea kesitlerinde damar sayımı yapıldı. Bulgular: Çalışmamızda subkonjonktival siklosporin-A enjeksiyonlarının her 3 grupta da, oluşan yeni damar sayısını istatistiksel olarak anlamlı azalttığı hem histopatolojik incelemede, hem de kornea muayenelerinde gösterildi. Ayrıca grup 1?de neovasküler alan yüzdesi, kontrol grubuna göre istatistiksel olarak anlamlı düşük bulundu. Farklı siklosporin-A doz uygulanmaları arasında anlamlı fark saptanmadı. Sonuç: Subkonjonktival siklosporin-A enjeksiyonu, deneysel kornea neovaskülarizasyonunda yeni damar sayısını anlamlı düzeyde azaltmıştır.

Anahtar Kelimeler: Korneal yenidamarlanma; siklosporin; koter
ABSTRACT
 Objective: Corneal neovascularization is a serious public health problem which causes the loss of transparency of cornea and finally vision loss. In this study we generated experimental corneal neovascularization by using thermal cauterization and investigated the effect of subconjounctival Cyclosporine-A to new vessel generation. Material and Methods: Right eyes of 24 wistar rats were included to study. They divided into 4 groups according to treatment regime. 22 rats completed the experiments. Group 1: 0.5 mg/0.01 cc subconjunctival cyclosporine-A injection group (n= 6); group 2: 0.25 mg/0.01 cc subconjunctival Cyclosporine-A injection group (n= 5); group 3: 0.125 mg/0.01 cc subconjunctival cyclosporine-A injection group (n= 6); group 4 (control group): the group without treatment (n= 5). Thermal cauterizations were applied to corneas 1 mm away from limbus at hour 3, 6, 9, 12. Subconjounctival Cyclosporine-A injections were applied to temporal bulber conjounctivas according to the treatment regime in group 1, 2 and 3. Six weeks later we examined the rat corneas with operation microscope. Ratio of the neovascular region, number of major blood vessels were determinated. After the examination, enucleation was performed. Histopathologic examinations were made with paraffin block and Hematoxilen-Eosin staining. Blood vessels were counted in the histopathologic cornea sections. Results: In our study, we showed that subconjounctival cyclosporine-A injections reduce the number of blood vessels in corneal examinations and hystopatological sections, according to control group in experimental corneal neovascularization. We did not found any difference among the different cyclosporine-A doses. Also we showed that 0.5 mg subconjounctival cyclosporine-A injections (Group 1) reduces the neovascular region ratio according to control group. Conclusion: Subconjunctival cyclosporine-A injection, decreased the number of new blood vessels significantly in experimental corneal neovascularization.

Keywords: Corneal neovascularization; cyclosporine; cautery

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