Albrecht v. Graefes Arch. klin. exp. Ophthal. 201, 111-115 (1976)
Graefes Archiv far klinische und experimentelle
Ophthalmologie 9 by Springer-Verlag 1976
Electroretinographic Evaluation of a Treatment Based on Retina Phosphatides in Patients with Various Types of Retinochoroid Degeneration P. Steindler and B. Piccinelli* Istituto di Clinica oculistica della Universitd di Padova (Director: Prof. F. D'Ermo), I-35100 Padova, Italy
Summary. The authors treated 16 patients with various types of retinochoroid degeneration with a preparation containing phospholipids extracted from pig retina. The evaluation of the efficiency of the preparation was carried out using adaptoelectroretinography. Exogenous phospholipids caused a statistically significant increase at the level of the scotopic components of the ERG.
! ntroduction
The importance of phospholipids as components of the cellular membranes and activators of several fundamental enzymes becomes more and more evident and clear from the results of many researches carried out on cellular and subcellular biochemistry [5]. Several studies of growing importance have recently been carried out regarding the possible therapeutic effects of exogenous phospholipids [2] or drugs incorporated in phospholipid vesicles [4]. It has been shown that there is better utilization of enzymes, antibiotics, and cytostatic antimetabolites when these are administered incorporated in lysosomes rather than in a watery solution. The administration of exogenous phospholipids, too, has led to the normalization of hematic lipids in subjects with hyperlipidemia of various origin [2]. The administration of exogenous phospholipids induces significant functional variations on the nervous system, too. For example, the administration of ox-brain phospholipids causes the release of acetylcholine from the cerebral cortex [4]. More recently, Bruni et al. [1] have found that the administration of phosphatidylserine liposomes of cerebral origin very significantly increase blood glucose and, to an even greater extent, that of the brain cortex [1]. In the past it has been observed that the The authors would like to express their thanks to Prof. Noris Siliprandi, Director of the Institute of Biochemistry of the University of Padova, for his precious advises and to Etapharm of Vienna and Aesculapius of Milan for having kindly supplied their products
112
P. Steindler and B. Piecinelli
incubation of the retina in the presence of exogenous phospholipids stimulated an increase in respiration [3] and that, in vivo, the administration of retina-extracted phospholipids brought about significant modifications to the visual field altered by glaucoma [9] or other causes [7]. In these researches Robolotti [7] used visual acuity and the luminous sense as parameters; Weiss [9] used the visual field with colored spots, taking into account the photochromatic interval. As is known, these methods are influenced by the subjective component both of the patient being examined, and that of the experimenter. With the aim of evaluating more objectively the possible therapeutic efficiency of exogenous phospholipids in retinal pathology, we subjected patients with lesions of the retina to treatment with an extract of pig-retina phospholipids. The effects of this treatment were evaluated by using dynamic electroretinography [8]. This type of evaluation, although it allows only partial evaluation of the functionality of the retina based exclusively on bioelectrie data, has the advantage of being absolutely objective.
Methods and Results The pig-retina phospholipids extract was administered to 16 patients with retinopathies of various types (high myopia, detachment of the retina both operated and stabilized, results of disseminated chorioretinites) (see Table 1). The product showed no toxicity. Before and after treatment with two ampules of extract pro die (equal to 10 nag of retinic phospholipids) for 10 consecutive days, the patients were given an adaptoelectroretinographic examination carried out after a preadaptation period of 5 rain at 950 lux. Stimulation was carried out with a Vescovini 3-Joule photostimulator, with a Wratten 92 red filter placed in front (dominant wavelength 642.2 mu). The ERG (electroretinograms) were recorded at 1, 5, and 12 rain; the latency of the electroretinographic alpha point was also considered: i.e., the moment in which the photopic b and the scotopic b showed the same width. Each track was composed of an average of eight stimulations obtained using a Hewlett-Packard Average Signal Analyser. rood. 2480A. Table 1. Clinical cases examined and type of eye disease Name
Sex
Age
Disease
1) Z. Cesira 2) C. Valeria 3) P. Giampaolo 4) R. Giuseppe 5) L. Fabiola 6) O. Egidio 7) S. Antonietta 8) D. Claudio 9) O. Caterina 10) B. Beniamino 11) S. Guerrion 12) P. Clelia 13) N. Elena 14) B. Elisabetta 15) M. Gastone 16) T. Angelo
F F M M F M F M F M M F F F M M
40 8 34 46 13 42 63 8 36 43 23 43 44 32 32 11
Results of retinal detachment Degenerative myopia Degenerative myopia Degenerative myopia Degenerative myopia Results of retinal detachment Results of retinal detachment Degenerative myopia Degenerative myopia Results of retinal detachment Degenerative myopia Results of disseminated chorioretinites Results of disseminated chorioretinites High myopia High myopia High myopia
39,69
Average Diff. t Prob.
30 50 50 50 50 25 45 45 45 50 30 50 40 50 40 25
42.19
120.94
60 210 130 180 160 80 100 110 120 100 65 200 1OO 100 130 90
0 160 60 90 120 60 70 80 100 60 25 100 30 40 60 10
66.56
14.36 2.58 < 0.05
52.19
0 140 65 90 60 O 60 70 100 55 25 50 40 30 50 0
Wave b 2 1st min Before After
44.06
30 50 45 50 50 35 50 55 45 50 30 50 40 50 50 25
P
Graefes Archiv far klinische und experimentelle
Ophthalmologie 9 by Springer-Verlag 1976
Electroretinographic Evaluation of a Treatment Based on Retina Phosphatides in Patients with Various Types of Retinochoroid Degeneration P. Steindler and B. Piccinelli* Istituto di Clinica oculistica della Universitd di Padova (Director: Prof. F. D'Ermo), I-35100 Padova, Italy
Summary. The authors treated 16 patients with various types of retinochoroid degeneration with a preparation containing phospholipids extracted from pig retina. The evaluation of the efficiency of the preparation was carried out using adaptoelectroretinography. Exogenous phospholipids caused a statistically significant increase at the level of the scotopic components of the ERG.
! ntroduction
The importance of phospholipids as components of the cellular membranes and activators of several fundamental enzymes becomes more and more evident and clear from the results of many researches carried out on cellular and subcellular biochemistry [5]. Several studies of growing importance have recently been carried out regarding the possible therapeutic effects of exogenous phospholipids [2] or drugs incorporated in phospholipid vesicles [4]. It has been shown that there is better utilization of enzymes, antibiotics, and cytostatic antimetabolites when these are administered incorporated in lysosomes rather than in a watery solution. The administration of exogenous phospholipids, too, has led to the normalization of hematic lipids in subjects with hyperlipidemia of various origin [2]. The administration of exogenous phospholipids induces significant functional variations on the nervous system, too. For example, the administration of ox-brain phospholipids causes the release of acetylcholine from the cerebral cortex [4]. More recently, Bruni et al. [1] have found that the administration of phosphatidylserine liposomes of cerebral origin very significantly increase blood glucose and, to an even greater extent, that of the brain cortex [1]. In the past it has been observed that the The authors would like to express their thanks to Prof. Noris Siliprandi, Director of the Institute of Biochemistry of the University of Padova, for his precious advises and to Etapharm of Vienna and Aesculapius of Milan for having kindly supplied their products
112
P. Steindler and B. Piecinelli
incubation of the retina in the presence of exogenous phospholipids stimulated an increase in respiration [3] and that, in vivo, the administration of retina-extracted phospholipids brought about significant modifications to the visual field altered by glaucoma [9] or other causes [7]. In these researches Robolotti [7] used visual acuity and the luminous sense as parameters; Weiss [9] used the visual field with colored spots, taking into account the photochromatic interval. As is known, these methods are influenced by the subjective component both of the patient being examined, and that of the experimenter. With the aim of evaluating more objectively the possible therapeutic efficiency of exogenous phospholipids in retinal pathology, we subjected patients with lesions of the retina to treatment with an extract of pig-retina phospholipids. The effects of this treatment were evaluated by using dynamic electroretinography [8]. This type of evaluation, although it allows only partial evaluation of the functionality of the retina based exclusively on bioelectrie data, has the advantage of being absolutely objective.
Methods and Results The pig-retina phospholipids extract was administered to 16 patients with retinopathies of various types (high myopia, detachment of the retina both operated and stabilized, results of disseminated chorioretinites) (see Table 1). The product showed no toxicity. Before and after treatment with two ampules of extract pro die (equal to 10 nag of retinic phospholipids) for 10 consecutive days, the patients were given an adaptoelectroretinographic examination carried out after a preadaptation period of 5 rain at 950 lux. Stimulation was carried out with a Vescovini 3-Joule photostimulator, with a Wratten 92 red filter placed in front (dominant wavelength 642.2 mu). The ERG (electroretinograms) were recorded at 1, 5, and 12 rain; the latency of the electroretinographic alpha point was also considered: i.e., the moment in which the photopic b and the scotopic b showed the same width. Each track was composed of an average of eight stimulations obtained using a Hewlett-Packard Average Signal Analyser. rood. 2480A. Table 1. Clinical cases examined and type of eye disease Name
Sex
Age
Disease
1) Z. Cesira 2) C. Valeria 3) P. Giampaolo 4) R. Giuseppe 5) L. Fabiola 6) O. Egidio 7) S. Antonietta 8) D. Claudio 9) O. Caterina 10) B. Beniamino 11) S. Guerrion 12) P. Clelia 13) N. Elena 14) B. Elisabetta 15) M. Gastone 16) T. Angelo
F F M M F M F M F M M F F F M M
40 8 34 46 13 42 63 8 36 43 23 43 44 32 32 11
Results of retinal detachment Degenerative myopia Degenerative myopia Degenerative myopia Degenerative myopia Results of retinal detachment Results of retinal detachment Degenerative myopia Degenerative myopia Results of retinal detachment Degenerative myopia Results of disseminated chorioretinites Results of disseminated chorioretinites High myopia High myopia High myopia
39,69
Average Diff. t Prob.
30 50 50 50 50 25 45 45 45 50 30 50 40 50 40 25
42.19
120.94
60 210 130 180 160 80 100 110 120 100 65 200 1OO 100 130 90
0 160 60 90 120 60 70 80 100 60 25 100 30 40 60 10
66.56
14.36 2.58 < 0.05
52.19
0 140 65 90 60 O 60 70 100 55 25 50 40 30 50 0
Wave b 2 1st min Before After
44.06
30 50 45 50 50 35 50 55 45 50 30 50 40 50 50 25
P
