백색토끼에서 수술 현미경에 노출 후 망막의 변화
Retinal Changes in White Rabbits after Exposure to the Light of an Operating Microscope
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목적: 수술현미경에 노출이 백색토끼의 망막에 어떠한 영향을 미치는지 알아보고자 하였다. 대상과 방법: 백색토끼 18마리를 대상으로 수술현미경에 60분간 노출시켰으며, 노출되기 전 및 노출 후 1시간, 1일, 7일, 14일째 각각 안저검사, 형광안저조영 및 망막전위도 검사를 반복 시행하여 결과를 비교하였다. 광학현미경과 투과 전자현미경을 이용하여 망막의 조직병리검사를 시행하였으며 시간의 경과에 따른 망막의 변화를 관찰하였다. 결과: 수술현미경에 노출되기 전후로 안저검사 및 형광안저조영에서는 이상이 관찰되지 않았다. 망막전위도 검사에서 노출 1시간 뒤부 터 암순응 시 막대세포반응의 진폭의 감소를 관찰할 수 있었다. 노출 1일 뒤에는 막대세포반응 감소 및 최대복합반응의 a파와 b파도 감소되었으며 이후 점차 상승하여 2주째는 노출 이전과 유사한 수준으로 회복되었다. 투과전자현미경에 의한 조직병리검사상 광수용 체 바깥분절과 망막상피세포의 이상이 관찰되었으며 2주째 노출 이전과 유사한 수준으로 회복되었다. 결론: 수술현미경에 노출 후 안저소견이 정상이라 할지라도 초기에 망막의 손상이 발생할 수 있다는 사실을 유의해야 할 것으로 생각 한다.
Abstract
Purpose: This study was performed to investigate the potential damage to white rabbit retinas caused by an operating microscope light. Methods: A total of 18 white rabbits were exposed to the light of an operating microscope for 60 minutes. Fundus examination, fluorescein angiography (FAG), and electroretinogram (ERG) were performed before exposure and 1 hr, 1 day, 7 days and 14 days afterward to allow for serial comparisons. Light and electron microscopic examinations were performed to evaluate the changes in the rabbit retinas over time. Results: Signs of retinal damage upon fundus examination and FAG were not found before or after exposure to the light of an operating microscopy. ERG, however, showed significant reduction in the dark-adapted rod response 1 hour after light exposure, and significant decline in the amplitude of the maximal combined response a- and b-wave 1 day after light exposure in the rabbit retinas. ERG findings returned to the pre-exposure level after 2 weeks. Ultrastructural injury to the photoreceptor outer segments and the retinal pigmented epithelium, observed using transmission electron microscopy, recovered to the pre-exposure state after 2 weeks. Conclusions: The risk of retinal damage should be considered as an early result of exposure to the light of an operating microscope, even in normal retinal findings.
참고문헌 (34)
- Sadun AC, "A biophysical analysis", Arch Ophthalmol, 102, pp.1510~1512 (1984)
- Kim SH, "The effects of repeated prolonged indirect ophthalmoscopy on rabbit retina", J Korean Ophthalmol Soc, 25, pp.189~200 (1984)
- Jaffe GJ, "Retinal phototoxicity from the operating microscope", Ophthalmology, 95, pp.1130~1141 (1988)
- Michels M, "Macular phototoxicity caused by fiberoptic endoillumination during pars plana vitrectomy", Am J Ophthalmol, 114, pp.287~296 (1992)
- Noell WK, "Retinal damage by light in rats", Invest Ophthalmol, 5, pp.450~473 (1966)
- McDonald HR, "Light induced maculopathy from the operating microscope in extracapsular cataract extraction and intraocular lens implantation", Ophthalmology, 90, pp.945~951 (1983)
- Ham WT Jr, "The nature of retinal radiation damage dependence on wavelength, power level and exposure time", Vision Res, 20, pp.1105~1111 (1980)
- Jeon SW, "Experimental model of solar retinopathy", J Korean Ophthalmol Soc, 32, pp.458~466 (1991)
- Sliney DH, "Eye protective techniques for bright light", Ophthalmology, 90, pp.937~944 (1983)
- Boettner EA, "Transmission of the ocular media", Invest Ophthalmol Vis Sci, 1, pp.776~783 (1962)
- Lerman S, "Chemical and physical properties of the normal and aging lens spectroscopic (UV, fluorescence, phosphorescence, and NMR) analyses", Am J Optom Physiol Opt, 64, pp.11~22 (1987)
- Arafat AF, "Subclinical operating microscope retinopathy the use of static perimetry in its detection", Eye, 8, pp.467~472 (1994)
- Yoon HM, "An ultrastructural study of recovery of photoreceptor layer from visible light induced damage", J Korean Ophthalmol Soc, 34, pp.678~686 (1993)
- Ramirez J, "Electrophysiological and morphological changes in rabbit retina after exposure to the light of the operating microscope", Graefes Arch Clin Exp Ophthalmol, 230, pp.380~384 (1992)
- 신준우, "햇빛과 수술현미경 조명에 의한 광독성 망막증 2예", 대한안과학회지, 42(9), pp.1362~1366 (2001), 대한안과학회
- Khwarg SG, "Incidence, risk factors, and morphology in operating microscope light retinopathy", Am J Ophthalmol, 103, pp.225~263 (1987)
- Byrnes GA, "Prospective incidence of photic maculopathy after cataract surgery", Am J Ophthalmol, 119, pp.231~232 (1995)
- Michels M, "Operating microscope-induced retinal phototoxicity: pathophysiology, clinical manifestations and prevention", Surv Ophthalmol, 34, pp.237~252 (1990)
- Hochheimer BF, "Retinal damage from light", Am J Ophthalmol, 88, pp.1039~1044 (1979)
- Lawwill T, "Three major pathologic processes caused by light in the primate retina: a search for mechanisms", Trans Am Ophthalmol Soc, 80, pp.517~579 (1982)
- Wiegand RD, "Evidence for rod outer segment lipid peroxidation following constant illumination of the rat retina", Invest Ophthalmol Vis Sci, 24, pp.1433~1435 (1983)
- Glickman RD, "The origin of photo oxidative stress in the aging eye", Prog Brain Res, 131, pp.699~712 (2001)
- Kremers JJ, "Retinal damage in macaque after white light exposures lasting ten minutes to twelve hours", Invest Ophthalmol Vis Sci, 30, pp.1032~1040 (1989)
- Rapp LM, "Separate mechanisms for retinal damage by ultraviolet A and mid visible light", Invest Ophthalmol Vis Sci, 31, pp.1186~1190 (1990)
- Hansson HA, "Ultrastructural studies on rat retina damaged by visibl light", Virchows Arch B Cell Pathol, 6, pp.247~262 (1970)
- Lanum J, "The damaging effects of light on the retina. Empirical findings, theoretical and practical implications", Surv Ophthalmol, 22, pp.221~249 (1978)
- O’Steen WK, "Retinal damage after prolonged exposure to visible light", Am J Anat, 134, pp.5~21 (1972)
- Borsje RA, "Oosterhuis JA", Exp Eye Res, 50, pp.297~304 (1990)
- Wu J, "Photochemical damage of the retina", Surv Ophthalmol, 51, pp.461~481 (2006)
- Abe T, "Protection of photoreceptor cells from phototoxicity by transplanted retinal pigment epithelial cells expressing different neurotrophic factors", Cell Transplant, 14, pp.799~808 (2005)
- Calkins JL, "Retinal light exposure from ophthalmoscopes, slit lamps, and overhead surgical lamps", Invest Ophthalmol Vis Sci, 19, pp.1009~1015 (1980)
- Ham WT Jr, "Retinal sensitivity to damage from short wavelength light", Nature, 260, pp.153~155 (1976)
- Calkins JL, "Retinal light exposure from operation microscopes", Arch Ophthalmol, 97, pp.2363~2367 (1979)
- Sliney DH, "Quantifying retinal irradiance levels in light damage experiments", Curr Eye Res, 3, pp.175~179 (1984)