Immediate Break-Down of Blood Retinal Barrier by Infusion of Triolein Emulsion Observed by Fluorescein Angiography

Abstract

Purpose: The purpose of this study is to investigate immediate changes in the blood retinal barrier (BRB) after the infusion of triolein emulsion.

Materials and Methods: Triolein emulsion was infused into the carotid artery of 12 cats to induce experimental fat embolism. The injection of fluorescein dye into the carotid artery followed immediately. Early retinal vascular flow was recorded by a fluorescein angiography (FA) video, and then a FA photograph was obtained up to 30 min after the injection. Leakage of the dye in the choroidal or retinal vessels was evaluated.

Results: In the early phase, multifocal non-perfuse areas were noted in all cats due to embolism by triolein emulsion, which was released by blood perfusion in the late phase. Perfusion defects persisted in the retina of five cats and in the choroid of four cats. Leakage of the dye through the retinal vessels was seen in five cats (42%) in the early phase and in nine cats (75%) in the late phase. In the choroid, leakage of the dye was seen in seven cats (58%) in the early phase and in all cats (100%) in the late phase.

Conclusions: The inner and outer BRB was opened immediately after infusion of triolein emulsion into the carotid artery. Embolism by triolein emulsion was readily resolved due to the liquid nature of triolein.

KEYWORDS::

• Blood-retinal barrier
• Fat embolism
• Fluorescein angiography
• Scanning laser ophthalmoscope
• Triolein

ACKNOWLEDGMENTS

This study was supported by a Medical Research Institute Grant (2009-16), Pusan National University Hospital.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.