Four year''s experience with quality assurance in anesthesiology in Hamburg

50 eyes of 30 Sprague-Dawley rats were subjected to 60 minutes of pressure-induced ischemia, then fixed for light and electron microscopy with no reperfusion, or reperfusion after 30 minutes, 1, 2 or 4 hours, and 1 or 3 days from the time ocular ischemia was relaxed. The TdT-mediated dUTP-biotin nick end labeling (TUNEL) method revealed apoptotic signs at the inner retina as early as 1 hour after reperfusion. However, the incidence of apoptotic signs with the TUNEL method did not accord with the results of electron microscopic examination. During the time after the reperfusion started, especially after more than 4 hours, apoptotic signs became obvious and extended from the inner to the outer retina. These apoptotic findings could be seen with both the TUNEL method and electron microscopy. By 3 days after the reperfusion, necrotic cells in the ganglion cell layer, and the inner and outer nuclear layer became more prominent than apoptotic cells. These results may provide a baseline for therapeutic strategy and the prognosis of ischemia-reperfusion injury in the retina.