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Woo, Lee, Choi, and Choi: The Effect of Subconjunctival Injection of Bevacizumab After Resection of Muscle in Rabbit Models
Original Article

J Korean Ophthalmol Soc 2010;51(3):423-429.

Published online: 25 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.3.423

The Effect of Subconjunctival Injection of Bevacizumab After Resection of Muscle in Rabbit Models

Kyeong Jin Woo, MD1, Kyoungsook Lee, MD1, Dong Gyu Choi, MD2, Mi Young Choi, MD1,

1Department of Ophthalmology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Korea

2Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Address reprint requests to Mi Young Choi, MD Department of Ophthalmology, Chungbuk National University Hospital #410 Sungbong-ro, Heungduk-ku, Cheongju 361-711, Korea TEL: 82-43-269-6335, FAX: 82-43-264-5263, E-Mail: mychoi@chungbuk.ac.kr

Received 5 August 2009       Accepted 17 February 2010

Copyright © 2010 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To study the effects of subconjunctival injection on the conjunctiva and muscles after muscle resection in a rabbit model.

Methods

Resection surgery of 5 mm was performed on both the superior rectus muscle (SR) and the inferior rectus muscle (IR) in five white rabbits. As such, 2.5 mg bevacizumab was subconjunctivally injected around the right SR and IR in the experimental group. The left eyes were not injected and were instead used as the control group. The degrees of injection and edema of conjunctiva were classified on a scale from 0 to 4 via gross examination by five examiners at two and four weeks after surgery. The strength of the muscle attachment was assessed, and the degrees of conjunctival inflammation and inflammation and fibrosis of the muscle were classified on a scale from 0 to 4 at four weeks after surgery via histologic examination.

Results

The results of gross examination at two and four weeks after surgery showed positive correlation among the five examiners (k=0.52, k=0.4), although there was no statistically significant difference between the experimental and control groups (p =0.285, p=0.364). There was also no significant difference between the two groups with regard to tensile strength of the attachment (p=0.414), inflammation of the conjunctiva and muscle, or fibrosis of the muscle in histologic examination (p =0.698, p =0.702, p =0.232, respectively).

Conclusions

There were no significant effects on the inflammation and fibrosis of the conjunctiva or muscles due to subconjunctival injection of 2.5 mg of bevacizumab after muscle resection in a rabbit model.

Keywords: Bevacizumab, Fibrosis, Inflammation, Subconjunctival injection

References

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Figure 1.
(A) Photograph before resection of the right superior rectus muscle of rabbit's eye. (B) Photograph after subconjunctival injection of Bevacizumab (2.5 mg) at the operative site.
jkos-51-423f1.tif
Figure 2.
Photographs of rabbit's eye at 2 weeks after surgery. (A) Superior rectus muscle of experimental group, Grade 1. (B) Superior rectus muscle of control group, Grade 2. (C) Superior rectus muscle of control group, Grade 3.
jkos-51-423f2.tif
Figure 3.
Photographs of rabbit's eye at 4 weeks after surgery. (A) Inferior rectus muscle of experimental group, Grade 0. (B) Superior rectus muscle of experimental group, Grade 1. (C) Inferior rectus muscle of experimental group, Grade 2.
jkos-51-423f3.tif
Figure 4.
Inflammation of the conjunctiva on histologic finding at 2 weeks after surgery (Hematoxylin-eosin stain, ×100). (A) SR* of experimental group, Grade 1: A few inflammatory infiltrates (arrow). (B) IR† of control group, Grade 3: Mild infiltration (arrow) and neutrophils (star) in the epithelium. * SR=superior rectus muscle, † IR=inferior rectus muscle.
jkos-51-423f4.tif
Figure 5.
Inflammation of the muscle on histologic finding at 4 weeks after surgery (Hematoxylin-eosin stain,×100). (A) IR* of experimental group, Grade 0: No evidence of inflammation. (B) SR† of experimental group, Grade 3: Numerous inflammatory infiltrats (arrow). * IR=inferior rectus muscle; † SR=superior rectus muscle.
jkos-51-423f5.tif
Figure 6.
Fibrosis of the muscle on histologic finding at 4 weeks after surgery (Hematoxylin-eosin stain, ×100). (A) IR* of control group, Grade 0: No evidence of fibrosis. (B) SR† of experimental group, Grade 2: Thick fibrotic bands (arrow). * IR=inferior rectus muscle; † SR=superior rectus muscle.
jkos-51-423f6.tif
Table 1.
The grading score of conjunctival injection and edema
Score Injection and edema
0 None
1 Injection only
2 A few blood vessels and mild edema
3 Moderate injection and edema
4 Severe injection and gross edema
Table 2.
The grading score for inflammation
Score Grade of inflammation
0 No inflammation
1 A few lymphocyte and plasma cell
2 Mild inflammatory infiltrate composed of
  lymphocytes, plasma cells, and polymorphonuclear
  leukocytes beneath the epithelium
3 Grade 2 + neutrophils in the epithelium
4 High concentrations of lymphocytes, plasma cells,
  polymorphonuclear leukocytes, and histiocytes
Table 3.
The grading score for fibrosis
Score Grade of fibrosis
0 No fibrosis
1 Mild perimuscular fibrotic reaction
2 Easily detected thick bands
3 Well-developed dense bands of collagen
4 A severe fibrotic response replacing large areas
Table 4.
The comparison of conjunctival injection and edema at 2 and 4 weeks after surgery
    Experimental group Control group P value*
Grade of injection & edema 2 weeks 1.9±0.6 2.2±0.4 0.285
  4 weeks 1.3±0.7 1.4±0.5 0.364

* Mann-Whitney test.

Table 5.
The comparison of muscular attachment power at 4 weeks after surgery
  Experimental group Control group P value*
Power (g) 209±109 180±59 0.414

* Mann-Whitney test.

Table 6.
The comparison of inflammation and fibrosis on histologic findings at 4 weeks after surgery
    Experimental group Control group P value*
Grade of inflammation Conjunctiva 2.3±0.7 2.0±0.7 0.698
  Muscle 1.5±0.8 1.4±0.8 0.702
Grade of fibrosis Muscle 0.6±0.9 0.7±0.7 0.232

* Chi-square test.

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