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Correia Barão R, Santos M, Marques RE, Quintas AM, Guerra P. Keratoconus tomographic indices in osteogenesis imperfecta. Graefes Arch Clin Exp Ophthalmol 2023; 261:2585-2592. [PMID: 37074408 PMCID: PMC10432331 DOI: 10.1007/s00417-023-06059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/28/2023] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Osteogenesis imperfecta (OI) is a rare inherited disease affecting collagen-rich tissues. Ocular complications have been reported such as thin corneas, low ocular rigidity, keratoconus, among others. The purpose of this study is to characterize corneal tomographic features in OI patients compared to unaffected patients, with particular focus on commonly studied keratoconus indices. METHODS Cross-sectional case-control study including 37 OI patients and 37 age-matched controls. Patients and controls underwent comprehensive ophthalmological examination including corneal Scheimpflug tomography with a Pentacam HR device (Oculus Optikgeräte GmbH, Wetzlar, Germany) to analyse and compare topometric, tomographic, pachymetric and Belin-Ambrósio Enhanced Ectasia Display III (BAD-D) data of both eyes of each patient. RESULTS Most OI patients had type I disease (n = 24; 65%) but type III-VII patients were also included. Two patients had clinically overt bilateral keratoconus. OI patients had significantly higher maximum keratometry (45.2 ± 2.1 vs. 43.7 ± 1.2; p = 0.0416), front and back elevation (3.0 ± 3.3 vs. 2.1 ± 1.3, p = 0.0201; 11.1 ± 8.2 vs. 5.0 ± 3.7, p < 0.0001), index of surface variance (25.5 ± 13 vs. 17.4 ± 8.3; p = 0.0016), index of vertical asymmetry (0.21 ± 0.14 vs. 0.15 ± 0.06; p = 0.0215), index of height asymmetry (9.2 ± 14 vs. 6.0 ± 4.5; p = 0.0421), index of height decentration (0.02 ± 0.01 vs. 0.01 ± 0.01; p < 0.0001) and average pachymetric progression (1.01 ± 0.19 vs. 0.88 ± 0.14; p < 0.0001) readings. Thinnest corneal thickness and maximum Ambrósio relational thickness were significantly lower (477 ± 52 vs. 543 ± 26; 387 ± 95 vs. 509 ± 49; p < 0.0001). Two-thirds of OI patients had corneas with a minimum thickness < 500 µm. BAD-D value was significantly higher in OI patients (2.1 ± 1.4 vs. 0.9 ± 0.2; p < 0.0001). CONCLUSION OI patients showed significant changes in corneal profiles compared with healthy subjects. A high proportion of patients had tomographically suspect corneas when using keratoconus diagnostic indices. Further studies are warranted to assess the true risk of corneal ectasia in OI patients.
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Affiliation(s)
- Rafael Correia Barão
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal.
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
| | - Miguel Santos
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | - Raquel Esteves Marques
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Miguel Quintas
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Paulo Guerra
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Monavarfeshani A, Yan W, Pappas C, Odenigbo KA, He Z, Segrè AV, van Zyl T, Hageman GS, Sanes JR. Transcriptomic analysis of the ocular posterior segment completes a cell atlas of the human eye. Proc Natl Acad Sci U S A 2023; 120:e2306153120. [PMID: 37566633 PMCID: PMC10450437 DOI: 10.1073/pnas.2306153120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/29/2023] [Indexed: 08/13/2023] Open
Abstract
Although the visual system extends through the brain, most vision loss originates from defects in the eye. Its central element is the neural retina, which senses light, processes visual signals, and transmits them to the rest of the brain through the optic nerve (ON). Surrounding the retina are numerous other structures, conventionally divided into anterior and posterior segments. Here, we used high-throughput single-nucleus RNA sequencing (snRNA-seq) to classify and characterize cells in six extraretinal components of the posterior segment: ON, optic nerve head (ONH), peripheral sclera, peripapillary sclera (PPS), choroid, and retinal pigment epithelium (RPE). Defects in each of these tissues are associated with blinding diseases-for example, glaucoma (ONH and PPS), optic neuritis (ON), retinitis pigmentosa (RPE), and age-related macular degeneration (RPE and choroid). From ~151,000 single nuclei, we identified 37 transcriptomically distinct cell types, including multiple types of astrocytes, oligodendrocytes, fibroblasts, and vascular endothelial cells. Our analyses revealed a differential distribution of many cell types among distinct structures. Together with our previous analyses of the anterior segment and retina, the data presented here complete a "Version 1" cell atlas of the human eye. We used this atlas to map the expression of >180 genes associated with the risk of developing glaucoma, which is known to involve ocular tissues in both anterior and posterior segments as well as the neural retina. Similar methods can be used to investigate numerous additional ocular diseases, many of which are currently untreatable.
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Affiliation(s)
- Aboozar Monavarfeshani
- Center for Brain Science, Harvard University, Cambridge, MA02138
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA02115
| | - Wenjun Yan
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
| | - Christian Pappas
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT84132
- Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT84132
| | - Kenechukwu A. Odenigbo
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
| | - Zhigang He
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA02115
| | - Ayellet V. Segrè
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA02114
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA02142
| | - Tavé van Zyl
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA02114
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT065101
| | - Gregory S. Hageman
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT84132
- Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT84132
| | - Joshua R. Sanes
- Center for Brain Science, Harvard University, Cambridge, MA02138
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA02138
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Hannay V, Czerpak CA, Quigley HA, Nguyen TD. A noninvasive clinical method to measure in vivo mechanical strains of the lamina cribrosa by optical coherence tomography. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.14.23294082. [PMID: 37645852 PMCID: PMC10462204 DOI: 10.1101/2023.08.14.23294082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Objective To measure mechanical strain of the lamina cribrosa (LC) after intraocular pressure (IOP) change produced one week after a change in glaucoma medication. Design Cohort study. Participants Adult glaucoma patients (23 eyes, 15 patients) prescribed a change in IOP-lowering medication. Intervention Non-invasive optical coherence tomography (OCT) imaging of the eye. Main Outcomes Deformation calculated by digital volume correlation of OCT scans of the LC before and after IOP lowering by medication. Results Among 23 eyes, 17 eyes of 12 persons had IOP lowering ≥ 3 mmHg (reduced IOP group) with tensile anterior-posterior E zz strain = 1.0% ± 1.1% (p = 0.003) and compressive radial strain ( E rr ) = -0.3% ± 0.5% (p=0.012; random effects models accounting inclusion of both eyes in some persons). Maximum in-plane principal (tensile) strain and maximum shear strain in the reduced IOP group were: E max = 1.7% ± 1.0% and Γ max = 1.4% ± 0.7%, respectively (both p<0.0001 versus zero). Reduced IOP group strains E max and Γ max were significantly larger with greater %IOP decrease (<0.0001, <0.0001). The compliance of the E zz , E max , and Γ max strain response, defined as strain normalized by the IOP decrease, were larger with more abnormal perimetric mean deviation or visual field index values (all p≥0.02). Strains were unrelated to age (all p≥0.088). In reduced IOP eyes, mean LC anterior border posterior movement was only 2.05 μm posteriorly (p=0.052) and not related to % IOP change (p=0.94, random effects models). Only E rr was significantly related to ALD change, becoming more negative with greater posterior LC border change (p=0.015). Conclusion LC mechanical strains can be effectively measured by changes in eye drop medication using OCT and are related to degree of visual function loss in glaucoma. Trial Registration ClinicalTrials.gov Identifier: NCT03267849.
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Huang T, Wang Y, Wang Z, Long Q, Li Y, Chen D. Complement-mediated inflammation and mitochondrial energy metabolism in the proteomic profile of myopic human corneas. J Proteomics 2023; 285:104949. [PMID: 37331426 DOI: 10.1016/j.jprot.2023.104949] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023]
Abstract
Myopia is one of the most common causes of visual impairment worldwide. To identify proteins related to myopiagenesis, data-independent acquisition proteomic analysis was performed using corneal lenticules of myopic patients who underwent small incision lenticule extraction surgery. A total of 19 lenticules from 19 age and sex-matched patients were analyzed, 10 in high refractive error (HR, spherical equivalent over -6.00 D) group and 9 in low refractive error (LR, spherical equivalent between -3.00 and - 1.00 D) group. Differentially expressed proteins (DEPs) were identified by comparing the corneal proteome between the two groups. Functional analyses were performed to explore the biological pathways and interactions of the DEPs. 107 DEPs (67 upregulated and 40 downregulated in HR group, compared to LR) were identified from 2138 quantified proteins. Functional analyses indicated that upregulated proteins were primarily involved in the complement pathways and extracellular matrix (ECM) remodeling, while downregulated proteins were involved in mitochondrial energy metabolism. Western blot analysis confirmed increased complement C3a and apolipoprotein E in HR samples, further supporting the proteomics data. In conclusion, this proteomic study reveals that proteins associated with the complement system, ECM remodeling, and mitochondrial energy metabolism might be key effectors in myopiagenesis. SIGNIFICANCE: Myopia has become one of the most prevalent causes of visual impairment, especially in Asia. The underlying mechanism of myopia development is still up for debate. This study compares the proteomic profiles of high and low myopic corneas, identifying differentially expressed proteins associated with the complement system, ECM remodeling, and mitochondrial energy metabolism. The findings of this study could provide novel insights into the pathogenesis of myopia. The complement system and mitochondrial energy metabolism may provide potential therapeutic targets in the treatment and prevention of myopia.
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Affiliation(s)
- Tianze Huang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Yuchen Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Zhonghai Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Qin Long
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
| | - Di Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China.
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Chuangsuwanich T, Tun TA, Braeu FA, Yeoh CHY, Chong RS, Wang X, Aung T, Hoang QV, Girard MJA. How Myopia and Glaucoma Influence the Biomechanical Susceptibility of the Optic Nerve Head. Invest Ophthalmol Vis Sci 2023; 64:12. [PMID: 37552032 PMCID: PMC10411647 DOI: 10.1167/iovs.64.11.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/06/2023] [Indexed: 08/09/2023] Open
Abstract
PURPOSE The purpose of this study was to assess optic nerve head (ONH) deformations following acute intraocular pressure (IOP) elevations and horizontal eye movements in control eyes, highly myopic (HM) eyes, HM eyes with glaucoma (HMG), and eyes with pathologic myopia (PM) alone or PM with staphyloma (PM + S). METHODS We studied 282 eyes, comprising of 99 controls (between +2.75 and -2.75 diopters), 51 HM (< -5 diopters), 35 HMG, 21 PM, and 75 PM + S eyes. For each eye, we imaged the ONH using spectral-domain optical coherence tomography (OCT) under the following conditions: (1) primary gaze, (2) 20 degrees adduction, (3) 20 degrees abduction, and (4) primary gaze with acute IOP elevation (to ∼35 mm Hg) achieved through ophthalmodynamometry. We then computed IOP- and gaze-induced ONH displacements and effective strains. Effective strains were compared across groups. RESULTS Under IOP elevation, we found that HM eyes exhibited significantly lower strains (3.9 ± 2.4%) than PM eyes (6.9 ± 5.0%, P < 0.001), HMG eyes (4.7 ± 1.8%, P = 0.04), and PM + S eyes (7.0 ± 5.2%, P < 0.001). Under adduction, we found that HM eyes exhibited significantly lower strains (4.8% ± 2.7%) than PM + S eyes (6.0 ± 3.1%, P = 0.02). We also found that eyes with higher axial length were associated with higher strains. CONCLUSIONS Our study revealed that eyes with HMG experienced significantly greater strains under IOP compared to eyes with HM. Furthermore, eyes with PM + S had the highest strains on the ONH of all groups.
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Affiliation(s)
- Thanadet Chuangsuwanich
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tin A. Tun
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Fabian A. Braeu
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Clarice H. Y. Yeoh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rachel S. Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Xiaofei Wang
- Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
| | - Tin Aung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Quan V. Hoang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Columbia University, New York, New York, United States
| | - Michaël J. A. Girard
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
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Luo N, Wang Y, Alimu S, Zhao L, Huang Y, Guo Z, Zhao X, Liu B, Chen S, Lu L. Assessment of Ocular Deformation in Pathologic Myopia Using 3-Dimensional Magnetic Resonance Imaging. JAMA Ophthalmol 2023; 141:768-774. [PMID: 37440241 PMCID: PMC10346513 DOI: 10.1001/jamaophthalmol.2023.2869] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/16/2023] [Indexed: 07/14/2023]
Abstract
IMPORTANCE Ocular deformation in pathologic myopia can affect the entire globe. However, few studies have investigated the equatorial pattern of ocular shape. In addition, the correlation between equatorial and posterior morphology needs to be further explored. OBJECTIVE To assess global ocular deformation in pathologic myopia. DESIGN, SETTING, AND PARTICIPANTS This hospital-based, cross-sectional study included 180 pathologic myopic eyes with atrophic maculopathy grading C2 (diffuse chorioretinal atrophy) or more from 180 participants who underwent comprehensive ophthalmic examination, including high-resolution 3-dimensional magnetic resonance imaging. In addition, 10 nonpathologic myopic eyes of 10 participants were set as the control group. Main Outcomes and Measures According to the cross-sectional view of equator, equatorial shape was classified as round, rectangular, pyriform (noncircular and more protruded in 1 direction), vertical-elliptical, or horizontal-elliptical; according to the nasal and inferior views, the posterior shape was categorized as spheroidal, conical, bulb-shaped, ellipsoidal, multidistorted, and barrel-shaped. Equatorial circularity and ocular sphericity were used to quantitatively assess the morphological variability of the equatorial and posterior regions, respectively. The association between ocular morphology and ocular parameters and myopic maculopathy was also investigated. Results The mean (SD) age of 180 participants with pathologic myopia was 55.14 (10.74) years, 127 were female (70.6%), and the mean (SD) axial length of studied eyes was 30.22 (2.25) mm. The predominant equatorial shape was pyriform (66 eyes [36.7%]), followed by round (45 eyes [25.0%]). The predominant posterior shape was bulb-shaped (97 eyes [52.2%]), followed by multidistorted (46 eyes [24.7%]). Equatorial circularity and equatorial shapes were correlated (r = -0.469; 95% CI, -0.584 to -0.346; P < .001) and ocular sphericity was correlated with posterior shapes (r = -0.533; 95% CI, -0.627 to -0.427; P < .001). In eyes with a vertical-elliptical equator, equatorial circularity and ocular sphericity were positively linearly correlated (R2 = 0.246; 95% CI, 0.050-0.496; P = .002) and the prevalence of inferior staphyloma was higher (27.8%; P = .04). Eyes with a horizontal-elliptical equator have the most horizontally oriented axis of corneal flat keratometry (median, 43.55 [interquartile range, 43.84] degrees; P = .01) and tended to present with multidistorted posterior shape (21.7%; P = .04). Conclusions and Relevance These findings suggest ocular deformation is common in pathologic myopia and can affect the entire eye, including the equatorial and posterior regions. The morphological classification may enhance the understanding of the diverse patterns of ocular shape in pathologic myopia.
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Affiliation(s)
- Nan Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yanbing Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Subinuer Alimu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Liyi Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yanqiao Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ziyi Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiujuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Bingqian Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Liu X, Jiang L, Ke M, Sigal IA, Chua J, Hoang QV, Chia AW, Najjar RP, Tan B, Cheong J, Bellemo V, Chong RS, Girard MJA, Ang M, Liu M, Garhöfer G, Barathi VA, Saw SM, Villiger M, Schmetterer L. Posterior scleral birefringence measured by triple-input polarization-sensitive imaging as a biomarker of myopia progression. Nat Biomed Eng 2023; 7:986-1000. [PMID: 37365268 PMCID: PMC10427432 DOI: 10.1038/s41551-023-01062-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
In myopic eyes, pathological remodelling of collagen in the posterior sclera has mostly been observed ex vivo. Here we report the development of triple-input polarization-sensitive optical coherence tomography (OCT) for measuring posterior scleral birefringence. In guinea pigs and humans, the technique offers superior imaging sensitivities and accuracies than dual-input polarization-sensitive OCT. In 8-week-long studies with young guinea pigs, scleral birefringence was positively correlated with spherical equivalent refractive errors and predicted the onset of myopia. In a cross-sectional study involving adult individuals, scleral birefringence was associated with myopia status and negatively correlated with refractive errors. Triple-input polarization-sensitive OCT may help establish posterior scleral birefringence as a non-invasive biomarker for assessing the progression of myopia.
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Affiliation(s)
- Xinyu Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
| | - Liqin Jiang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Mengyuan Ke
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Ian A Sigal
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
- Department of Ophthalmology, Columbia University, New York, NY, USA
| | - Audrey Wi Chia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Raymond P Najjar
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore, Singapore
| | - Jocelyn Cheong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Valentina Bellemo
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rachel S Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Michaël J A Girard
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Mengyang Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Veluchamy A Barathi
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
- Translational Pre-Clinical Model Platform, Singapore Eye Research Institute, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, ,National University of Singapore, National University Health System, Singapore, Singapore
| | - Martin Villiger
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- SERI-NTU Advanced Ocular Engineering (STANCE) programme, Singapore, Singapore.
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
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Chen L, Huang Y, Zhang X, Shi Y, Gao Z, Sun B, Shen Y, Sun L, Cao Y, Zhang Q, Guo J, Li F, Chen W, Li X, Zhou X. Corneal Biomechanical Properties Demonstrate Anisotropy and Correlate With Axial Length in Myopic Eyes. Invest Ophthalmol Vis Sci 2023; 64:27. [PMID: 37477932 PMCID: PMC10365135 DOI: 10.1167/iovs.64.10.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/12/2023] [Indexed: 07/22/2023] Open
Abstract
Purpose The purpose of this study was to investigate the ex vivo and in vivo biomechanical characteristic of cornea in myopic eyes. Methods Fifty-one corneal stromal lenticules were obtained from myopic eyes during the SMILE procedure and were tested by a biaxial tensile system within 24 hours postoperatively. The material properties of the lenticules were described using stress-strain curves and were compared among axial length (AL) <26 mm and AL ≥ 26 mm group. Pre-operative stress-strain index (SSI) parameters were used to evaluate the biomechanical properties of the cornea in vivo. Results Compared with AL < 26 mm, the tangent modulus significantly decreased in horizontal and vertical directions when AL ≥ 26 mm (P < 0.05); SSI also significantly decreased when AL ≥ 26 mm (P < 0.05). Anisotropic parameter is positively correlated with AL (r = 0.307, P < 0.05). Compared with AL < 26 mm, anisotropic parameter significantly increased when AL ≥ 26 mm (P < 0.05). SSI was negatively correlated with AL (r = -0.380, P < 0.05) in the AL < 26 mm group but not in the AL ≥ 26 mm group (P > 0.05). Compared with 26 mm ≤ AL < 27 mm group, the tangent modulus significantly decreased in the horizontal direction (P < 0.05) but not in the vertical direction when 27 mm ≤ AL < 28 mm (P > 0.05). Conclusions The biomechanical properties of cornea decreased with the increase of AL. Tangent modulus significantly decreased in the horizontal direction compared with vertical direction. AL should be taken into account during calculation of corneal biomechanical parameters in order to improve validity.
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Affiliation(s)
- Lingfeng Chen
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Yangyi Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xiaoyu Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yike Shi
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Zhipeng Gao
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Bingqing Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Ling Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yifan Cao
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Qianqian Zhang
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- School of Automation and Software Engineering, Shanxi University, Taiyuan, Shanxi, China
| | - Jiqiang Guo
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Fen Li
- College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, Taiyuan, China
- Institute of Applied Mechanics, Taiyuan University of Technology, Taiyuan, China
| | - Weiyi Chen
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Xiaona Li
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
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Ji F, Bansal M, Wang B, Hua Y, Islam MR, Matuschke F, Axer M, Sigal IA. A direct fiber approach to model sclera collagen architecture and biomechanics. Exp Eye Res 2023; 232:109510. [PMID: 37207867 PMCID: PMC10330555 DOI: 10.1016/j.exer.2023.109510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/16/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
Sclera collagen fiber microstructure and mechanical behavior are central to eye physiology and pathology. They are also complex, and are therefore often studied using modeling. Most models of sclera, however, have been built within a conventional continuum framework. In this framework, collagen fibers are incorporated as statistical distributions of fiber characteristics such as the orientation of a family of fibers. The conventional continuum approach, while proven successful for describing the macroscale behavior of the sclera, does not account for the sclera fibers are long, interwoven and interact with one another. Hence, by not considering these potentially crucial characteristics, the conventional approach has only a limited ability to capture and describe sclera structure and mechanics at smaller, fiber-level, scales. Recent advances in the tools for characterizing sclera microarchitecture and mechanics bring to the forefront the need to develop more advanced modeling techniques that can incorporate and take advantage of the newly available highly detailed information. Our goal was to create a new computational modeling approach that can represent the sclera fibrous microstructure more accurately than with the conventional continuum approach, while still capturing its macroscale behavior. In this manuscript we introduce the new modeling approach, that we call direct fiber modeling, in which the collagen architecture is built explicitly by long, continuous, interwoven fibers. The fibers are embedded in a continuum matrix representing the non-fibrous tissue components. We demonstrate the approach by doing direct fiber modeling of a rectangular patch of posterior sclera. The model integrated fiber orientations obtained by polarized light microscopy from coronal and sagittal cryosections of pig and sheep. The fibers were modeled using a Mooney-Rivlin model, and the matrix using a Neo-Hookean model. The fiber parameters were determined by inversely matching experimental equi-biaxial tensile data from the literature. After reconstruction, the direct fiber model orientations agreed well with the microscopy data both in the coronal plane (adjusted R2 = 0.8234) and in the sagittal plane (adjusted R2 = 0.8495) of the sclera. With the estimated fiber properties (C10 = 5746.9 MPa; C01 = -5002.6 MPa, matrix shear modulus 200 kPa), the model's stress-strain curves simultaneously fit the experimental data in radial and circumferential directions (adjusted R2's 0.9971 and 0.9508, respectively). The estimated fiber elastic modulus at 2.16% strain was 5.45 GPa, in reasonable agreement with the literature. During stretch, the model exhibited stresses and strains at sub-fiber level, with interactions among individual fibers which are not accounted for by the conventional continuum methods. Our results demonstrate that direct fiber models can simultaneously describe the macroscale mechanics and microarchitecture of the sclera, and therefore that the approach can provide unique insight into tissue behavior questions inaccessible with continuum approaches.
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Affiliation(s)
- Fengting Ji
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Manik Bansal
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bingrui Wang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yi Hua
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mohammad R Islam
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Felix Matuschke
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich GmbH, Jülich, Germany
| | - Markus Axer
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich GmbH, Jülich, Germany
| | - Ian A Sigal
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
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60
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Moin KA, Yeakle MM, Parrill AM, Garofalo VA, Tsiyer AR, Bishev D, Gala D, Fogel J, Hatsis AJ, Wickas TD, Anand P, Morcos M. Ocular and orbital manifestations of granulomatosis with polyangiitis: a systematic review of published cases. Rom J Ophthalmol 2023; 67:214-221. [PMID: 37876507 PMCID: PMC10591438 DOI: 10.22336/rjo.2023.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/26/2023] Open
Abstract
Objective: Granulomatosis with polyangiitis (GPA) is an autoimmune disorder characterized by necrotizing granulomatous inflammation of small and medium-sized vessels. This systematic review aimed to highlight the most common ophthalmic manifestations and to uncover their associations with antineutrophil cytoplasmic antibody (ANCA) positivity and the presence of granulomas. Methods: A literature search of PubMed, Web of Science, and Scopus electronic databases was performed from journal inception to March 21, 2021, for case reports and a series of ophthalmic GPAs. Cytoplasmic-ANCA (c-ANCA), perinuclear-ANCA (p-ANCA), and granulomas were analyzed against many ophthalmic signs and symptoms. 306 patients with GPA were retrospectively studied. Results: Granulomas were present in 47.7% of our sample, c-ANCA in 59.2%, and p-ANCA in 10.8%. Scleritis was significantly associated with higher odds for c-ANCA positivity. Eye discharge, episcleritis, proptosis, and central nervous system (CNS) involvement were each significantly associated with lower odds for c-ANCA positivity. Orbital mass was significantly associated with lower odds for p-ANCA positivity. CNS involvement was significantly associated with higher odds for p-ANCA positivity (OR:3.08, 95% CI:1.02, 9.36, p=0.047) and orbital mass was significantly associated with lower odds for p-ANCA positivity. Conclusions: We recommend that clinicians should consider ocular or orbital GPA in patients presenting with non-specific eye complaints, such as vision impairment, orbital mass, or proptosis, and obtain further assessments to determine the possible presence of granuloma, c-ANCA, or p-ANCA. Abbreviations: GPA = Granulomatosis with Polyangiitis, ANCA = antineutrophil cytoplasmic antibody, c-ANCA = cytoplasmic-ANCA, p-ANCA = perinuclear-ANCA, CNS = central nervous system, AAVs = ANCA-associated vasculitides, SD = standard deviation, GU = genitourinary, ENT = ear nose and throat, OR = odds ratio, CI = confidence interval.
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Affiliation(s)
- Kayvon Ahmad Moin
- American University of the Caribbean, School of Medicine, Cupecoy, Sint Maarten
| | | | - Allison Margaret Parrill
- Department of Family Medicine, University of South Carolina School of Medicine, Seneca, South Carolina, USA
| | | | | | - Daniel Bishev
- American University of the Caribbean, School of Medicine, Cupecoy, Sint Maarten
| | - Dhir Gala
- American University of the Caribbean, School of Medicine, Cupecoy, Sint Maarten
| | - Joshua Fogel
- Department of Business Management, Brooklyn College, Brooklyn, NY, USA
| | - Alexander James Hatsis
- Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, USA
| | - Tyler Daniel Wickas
- Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, USA
| | - Prachi Anand
- Department of Rheumatology, Nassau University Medical Center, East Meadow, New York, USA
| | - Marcelle Morcos
- Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, USA
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Xu Y, Chen Q, Shao Z, Wei J, Zhu X, Rong A, Chen X, Ni Y, Jiang Y. Evaluation of new robust silk fibroin hydrogels for posterior scleral reinforcement in rabbits. Front Bioeng Biotechnol 2023; 11:1211688. [PMID: 37388765 PMCID: PMC10300450 DOI: 10.3389/fbioe.2023.1211688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/01/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Currently, there is no ideal material available for posterior scleral reinforcement (PSR) to prevent the progression of high myopia. In this study, we investigated robust regenerated silk fibroin (RSF) hydrogels as potential grafts for PSR in animal experiments to evaluate their safety and biological reactions. Methods: PSR surgery was performed on the right eye of twenty-eight adult New Zealand white rabbits, with the left eye serving as a self-control. Ten rabbits were observed for 3 months, while 18 rabbits were observed for 6 months. The rabbits were evaluated using intraocular pressure (IOP), anterior segment and fundus photography, A- and B-ultrasound, optical coherence tomography (OCT), histology, and biomechanical tests. Results: No complications such as significant IOP fluctuation, anterior chamber inflammation, vitreous opacity, retinal lesion, infection, or material exposure were observed. Furthermore, no evidence of pathological changes in the optic nerve and retina, or structural abnormalities on OCT, were found. The RSF grafts were appropriately located at the posterior sclera and enclosed in fibrous capsules. The scleral thickness and collagen fiber content of the treated eyes increased after surgery. The ultimate stress of the reinforced sclera increased by 30.7%, and the elastic modulus increased by 33.0% compared to those of the control eyes at 6 months after surgery. Conclusion: Robust RSF hydrogels exhibited good biocompatibility and promoted the formation of fibrous capsules at the posterior sclera in vivo. The biomechanical properties of the reinforced sclera were strengthened. These findings suggest that RSF hydrogel is a potential material for PSR.
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Affiliation(s)
- Yule Xu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiaolin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laborarory of Advanced Materials, Fudan University, Shanghai, China
| | - Zhengzhong Shao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laborarory of Advanced Materials, Fudan University, Shanghai, China
| | - Jiahong Wei
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuyou Zhu
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ao Rong
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Ophthalmology, Shanghai Xin Shi Jie Eye Hospital, Shanghai, China
| | - Xin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laborarory of Advanced Materials, Fudan University, Shanghai, China
| | - Yusu Ni
- Otology and Skull Base Surgery Department, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine of National Health and Family Planning Commission, Shanghai, China
- Otorhinolaryngology Department of Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Jiang
- Department of Ophthalmology, Shanghai Xin Shi Jie Eye Hospital, Shanghai, China
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Lee PY, Fryc G, Gnalian J, Hua Y, Waxman S, Zhong F, Yang B, Sigal IA. Direct measurements of collagen fiber recruitment in the posterior pole of the eye. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.07.539784. [PMID: 37215028 PMCID: PMC10197604 DOI: 10.1101/2023.05.07.539784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Collagen is the main load-bearing component of the peripapillary sclera (PPS) and lamina cribrosa (LC) in the eye. Whilst it has been shown that uncrimping and recruitment of the PPS and LC collagen fibers underlies the macro-scale nonlinear stiffening of both tissues with increased intraocular pressure (IOP), the uncrimping and recruitment as a function of local stretch have not been directly measured. This knowledge is crucial for the development of constitutive models associating micro and macro scales. In this project we measured local stretch-induced collagen fiber bundle uncrimping and recruitment curves of the PPS and LC. Thin coronal samples of PPS and LC of sheep eyes were mounted and stretched biaxially quasi-statically using a custom system. At each step, we imaged the PPS and LC with instant polarized light microscopy and quantified pixel-level (1.5 μm/pixel) collagen fiber orientations. We used digital image correlation to measure the local stretch and quantified collagen crimp by the circular standard deviation of fiber orientations, or waviness. Local stretch-recruitment curves of PPS and LC approximated sigmoid functions. PPS recruited more fibers than the LC at the low levels of stretch. At 10% stretch the curves crossed with 75% bundles recruited. The PPS had higher uncrimping rate and waviness remaining after recruitment than the LC: 0.9° vs. 0.6° and 3.1° vs. 2.7°. Altogether our findings support describing fiber recruitment of both PPS and LC with sigmoid curves, with the PPS recruiting faster and at lower stretch than the LC, consistent with a stiffer tissue.
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Affiliation(s)
- Po-Yi Lee
- Department of Ophthalmology, University of Pittsburgh School of Medicine
- Department of Bioengineering, Swanson School of Engineering
| | - Gosia Fryc
- Department of Chemistry, Dietrich School of Arts and Sciences University of Pittsburgh, Pittsburgh, PA
| | - John Gnalian
- Department of Ophthalmology, University of Pittsburgh School of Medicine
| | - Yi Hua
- Department of Ophthalmology, University of Pittsburgh School of Medicine
- Department of Biomedical Engineering, University of Mississippi, University, MS
- Department of Mechanical Engineering, University of Mississippi, University, MS
| | - Susannah Waxman
- Department of Ophthalmology, University of Pittsburgh School of Medicine
| | - Fuqiang Zhong
- Department of Ophthalmology, University of Pittsburgh School of Medicine
| | - Bin Yang
- Department of Engineering, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA
| | - Ian A Sigal
- Department of Ophthalmology, University of Pittsburgh School of Medicine
- Department of Bioengineering, Swanson School of Engineering
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63
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Foong TY, Hua Y, Amini R, Sigal IA. Who bears the load? IOP-induced collagen fiber recruitment over the corneoscleral shell. Exp Eye Res 2023; 230:109446. [PMID: 36935071 PMCID: PMC10133210 DOI: 10.1016/j.exer.2023.109446] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/25/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023]
Abstract
Collagen is the main load-bearing component of cornea and sclera. When stretched, both of these tissues exhibit a behavior known as collagen fiber recruitment. In recruitment, as the tissues stretch the constitutive collagen fibers lose their natural waviness, progressively straightening. Recruited, straight, fibers bear substantially more mechanical load than non-recruited, wavy, fibers. As such, the process of recruitment underlies the well-established nonlinear macroscopic behavior of the corneoscleral shell. Recruitment has an interesting implication: when recruitment is incomplete, only a fraction of the collagen fibers is actually contributing to bear the loads, with the rest remaining "in reserve". In other words, at a given intraocular pressure (IOP), it is possible that not all the collagen fibers of the cornea and sclera are actually contributing to bear the loads. To the best of our knowledge, the fraction of corneoscleral shell fibers recruited and contributing to bear the load of IOP has not been reported. Our goal was to obtain regionally-resolved estimates of the fraction of corneoscleral collagen fibers recruited and in reserve. We developed a fiber-based microstructural constitutive model that could account for collagen fiber undulations or crimp via their tortuosity. We used experimentally-measured collagen fiber crimp tortuosity distributions in human eyes to derive region-specific nonlinear hyperelastic mechanical properties. We then built a three-dimensional axisymmetric model of the globe, assigning region-specific mechanical properties and regional anisotropy. The model was used to simulate the IOP-induced shell deformation. The model-predicted tissue stretch was then used to quantify collagen recruitment within each shell region. The calculations showed that, at low IOPs, collagen fibers in the posterior equator were recruited the fastest, such that at a physiologic IOP of 15 mmHg, over 90% of fibers were recruited, compared with only a third in the cornea and the peripapillary sclera. The differences in recruitment between regions, in turn, mean that at a physiologic IOP the posterior equator had a fiber reserve of only 10%, whereas the cornea and peripapillary sclera had two thirds. At an elevated IOP of 50 mmHg, collagen fibers in the limbus and the anterior/posterior equator were almost fully recruited, compared with 90% in the cornea and the posterior sclera, and 70% in the peripapillary sclera and the equator. That even at such an elevated IOP not all the fibers were recruited suggests that there are likely other conditions that challenge the corneoscleral tissues even more than IOP. The fraction of fibers recruited may have other potential implications. For example, fibers that are not bearing loads may be more susceptible to enzymatic digestion or remodeling. Similarly, it may be possible to control tissue stiffness through the fraction of recruited fibers without the need to add or remove collagen.
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Affiliation(s)
- Tian Yong Foong
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yi Hua
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Biomedical Engineering, University of Mississippi, MS, United States; Department of Mechanical Engineering, University of Mississippi, MS, United States
| | - Rouzbeh Amini
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, United States; Department of Bioengineering, Northeastern University, Boston, MA, United States
| | - Ian A Sigal
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States; McGowan Institute for Regenerative Medicine, University of Pittsburgh Medical Center and University of Pittsburgh, Pittsburgh, PA, United States.
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64
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Jan NJ, Lee PY, Wallace J, Iasella M, Gogola A, Wang B, Sigal IA. Stretch-Induced Uncrimping of Equatorial Sclera Collagen Bundles. J Biomech Eng 2023; 145:054503. [PMID: 36459150 PMCID: PMC9791674 DOI: 10.1115/1.4056354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
Stretch-induced collagen uncrimping underlies the nonlinear mechanical behavior of the sclera according to what is often called the process of recruitment. We recently reported experimental measurements of sclera collagen crimp and pressure-induced uncrimping. Our studies, however, were cross-sectional, providing statistical descriptions of crimp with no information on the effects of stretch on specific collagen bundles. Data on bundle-specific uncrimping is necessary to better understand the effects of macroscale input on the collagen microscale and tissue failure. Our goal in this project was to measure bundle-specific stretch-induced collagen uncrimping of sclera. Three goat eyes were cryosectioned sagittally (30 μm). Samples of equatorial sclera were isolated, mounted to a custom uni-axial stretcher and imaged with polarized light microscopy at various levels of clamp-to-clamp stretch until failure. At each stretch level, local strain was measured using image tracking techniques. The level of collagen crimping was determined from the bundle waviness, defined as the circular standard deviation of fiber orientation along a bundle. Eye-specific recruitment curves were then computed using eye-specific waviness at maximum stretch before sample failure to define fibers as recruited. Nonlinear mixed effect models were used to determine the associations of waviness to local strain and recruitment to clamp-to-clamp stretch. Waviness decreased exponentially with local strain (p < 0.001), whereas bundle recruitment followed a sigmoidal curve with clamp-to-clamp stretch (p < 0.001). Individual bundle responses to stretch varied substantially, but recruitment curves were similar across sections and eyes. In conclusion, uni-axial stretch caused measurable bundle-specific uncrimping, with the sigmoidal recruitment pattern characteristic of fiber-reinforced soft tissues.
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Affiliation(s)
- Ning-Jiun Jan
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15213
| | - Po-Yi Lee
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15213
| | - Jacob Wallace
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15213
| | - Michael Iasella
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15213
| | - Alexandra Gogola
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Bingrui Wang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Ian A. Sigal
- Department of Ophthalmology, Laboratory of Ocular Biomechanics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15213
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Brown DM, Yu J, Kumar P, Paulus QM, Kowalski MA, Patel JM, Kane MA, Ethier CR, Pardue MT. Exogenous All-Trans Retinoic Acid Induces Myopia and Alters Scleral Biomechanics in Mice. Invest Ophthalmol Vis Sci 2023; 64:22. [PMID: 37219510 PMCID: PMC10210516 DOI: 10.1167/iovs.64.5.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Ocular all-trans retinoic acid (atRA) levels are influenced by visual cues, and exogenous atRA has been shown to increase eye size in chickens and guinea pigs. However, it is not clear whether atRA induces myopic axial elongation via scleral changes. Here, we test the hypothesis that exogenous atRA will induce myopia and alter scleral biomechanics in the mouse. Methods Male C57BL/6J mice were trained to voluntarily ingest atRA + vehicle (1% atRA in sugar, 25 mg/kg) (RA: n = 16 animals) or vehicle only (Ctrl: n = 14 animals). Refractive error (RE) and ocular biometry were measured at baseline and after 1 and 2 weeks of daily atRA treatment. Eyes were used in ex vivo assays to measure scleral biomechanics (unconfined compression: n = 18), total scleral sulfated glycosaminoglycan (sGAG) content (dimethylmethylene blue: n = 23), and specific sGAGs (immunohistochemistry: n = 18). Results Exogenous atRA caused myopic RE and larger vitreous chamber depth (VCD) to develop by 1 week (RE: -3.7 ± 2.2 diopters [D], P < 0.001; VCD: +20.7 ± 15.1 µm, P < 0.001), becoming more severe by 2 weeks (RE: -5.7 ± 2.2 D, P < 0.001; VCD: +32.3 ± 25.8 µm, P < 0.001). The anterior eye biometry was unaffected. While scleral sGAG content was not measurably affected, scleral biomechanics were significantly altered (tensile stiffness: -30% ± 19.5%, P < 0.001; permeability: +60% ± 95.3%, P < 0.001). Conclusions In mice, atRA treatment results in an axial myopia phenotype. Eyes developed myopic RE and larger VCD without the anterior eye being affected. The decrease in stiffness and increase in permeability of the sclera are consistent with the form-deprivation myopia phenotype.
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Affiliation(s)
- Dillon M. Brown
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
| | - Jianshi Yu
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - Praveen Kumar
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - Quinn M. Paulus
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
| | - Michael A. Kowalski
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Jay M. Patel
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Maureen A. Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - C. Ross Ethier
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Machelle T. Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States
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Monavarfeshani A, Yan W, Pappas C, Odenigbo KA, He Z, Segrè AV, van Zyl T, Hageman GS, Sanes JR. Transcriptomic Analysis of the Ocular Posterior Segment Completes a Cell Atlas of the Human Eye. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.26.538447. [PMID: 37162855 PMCID: PMC10168356 DOI: 10.1101/2023.04.26.538447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Although the visual system extends through the brain, most vision loss originates from defects in the eye. Its central element is the neural retina, which senses light, processes visual signals, and transmits them to the rest of the brain through the optic nerve (ON). Surrounding the retina are numerous other structures, conventionally divided into anterior and posterior segments. Here we used high-throughput single nucleus RNA sequencing (snRNA-seq) to classify and characterize cells in the extraretinal components of the posterior segment: ON, optic nerve head (ONH), peripheral sclera, peripapillary sclera (PPS), choroid, and retinal pigment epithelium (RPE). Defects in each of these tissues are associated with blinding diseases - for example, glaucoma (ONH and PPS), optic neuritis (ON), retinitis pigmentosa (RPE), and age-related macular degeneration (RPE and choroid). From ∼151,000 single nuclei, we identified 37 transcriptomically distinct cell types, including multiple types of astrocytes, oligodendrocytes, fibroblasts, and vascular endothelial cells. Our analyses revealed a differential distribution of many cell types among distinct structures. Together with our previous analyses of the anterior segment and retina, the new data complete a "Version 1" cell atlas of the human eye. We used this atlas to map the expression of >180 genes associated with the risk of developing glaucoma, which is known to involve ocular tissues in both anterior and posterior segments as well as neural retina. Similar methods can be used to investigate numerous additional ocular diseases, many of which are currently untreatable.
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Affiliation(s)
- Aboozar Monavarfeshani
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA, USA
- Equal contributions
| | - Wenjun Yan
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
- Equal contributions
| | - Christian Pappas
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Kenechukwu A. Odenigbo
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
| | - Zhigang He
- F.M. Kirby Neurobiology Center, Boston Children’s Hospital, Boston, MA, USA
| | - Ayellet V. Segrè
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA 02114
- Broad Institute of Harvard and MIT, Cambridge, MA
| | - Tavé van Zyl
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
- Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear, Boston, MA 02114
- Present address: Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT 06510
| | - Gregory S. Hageman
- Sharon Eccles Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Joshua R. Sanes
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138
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Song D, Lim S, Park J, Demer JL. Linear viscoelasticity of human sclera and posterior ocular tissues during tensile creep. J Biomech 2023; 151:111530. [PMID: 36933327 DOI: 10.1016/j.jbiomech.2023.111530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/21/2023] [Accepted: 03/02/2023] [Indexed: 03/13/2023]
Abstract
PURPOSE Despite presumed relevance to ocular diseases, the viscoelastic properties of the posterior human eye have not been evaluated in detail. We performed creep testing to characterize the viscoelastic properties of ocular regions, including the sclera, optic nerve (ON) and ON sheath. METHODS We tested 10 pairs of postmortem human eyes of average age 77 ± 17 years, consisting of 5 males and 5 females. Except for the ON that was tested in native shape, tissues were trimmed into rectangles. With physiologic temperature and constant wetting, tissues were rapidly loaded to tensile stress that was maintained by servo feedback as length was monitored for 1,500 sec. Relaxation modulus was computed using Prony series, and Deborah numbers estimated for times scales of physiological eye movements. RESULTS Correlation between creep rate and applied stress level was negligible for all tissues, permitting description as linear viscoelastic materials characterized by lumped parameter compliance equations for limiting behaviors. The ON was the most compliant, and anterior sclera least compliant, with similar intermediate values for posterior sclera and ON sheath. Sensitivity analysis demonstrated that linear behavior eventually become dominant after long time. For the range of typical pursuit tracking, all tissues exhibit Debora numbers less than 75, and should be regarded as viscoelastic. With a 6.7 Deborah number, this is especially so for the ON during pursuit and convergence. CONCLUSIONS Posterior ocular tissues exhibit creep consistent with linear viscoelasticity necessary for describing biomechanical behavior of the ON, its sheath, and sclera during physiological eye movements and eccentric ocular fixations. Running Head: Tensile Creep of Human Ocular Tissues.
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Affiliation(s)
- Dooseop Song
- Department of Mechanical Engineering, University of California, Los Angeles, United States; Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, United States
| | - Seongjin Lim
- Department of Mechanical Engineering, University of California, Los Angeles, United States; Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, United States
| | - Joseph Park
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, United States
| | - Joseph L Demer
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, United States; Department of Bioengineering, University of California, Los Angeles, United States; Department of Neurology, University of California, Los Angeles, United States.
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68
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Goodman D, Ness S. The Role of Oxidative Stress in the Aging Eye. Life (Basel) 2023; 13:life13030837. [PMID: 36983992 PMCID: PMC10052045 DOI: 10.3390/life13030837] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
Given the expanding elderly population in the United States and the world, it is important to understand the processes underlying both natural and pathological age-related changes in the eye. Both the anterior and posterior segment of the eye undergo changes in biological, chemical, and physical properties driven by oxidative stress. With advancing age, changes in the anterior segment include dermatochalasis, blepharoptosis, thickening of the sclera, loss of corneal endothelial cells, and stiffening of the lens. Changes in the posterior segment include lowered viscoelasticity of the vitreous body, photoreceptor cell loss, and drusen deposition at the macula and fovea. Age-related ocular pathologies including glaucoma, cataracts, and age-related macular degeneration are largely mediated by oxidative stress. The prevalence of these diseases is expected to increase in the coming years, highlighting the need to develop new therapies that address oxidative stress and slow the progression of age-related pathologies.
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Affiliation(s)
- Deniz Goodman
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Steven Ness
- Department of Ophthalmology, Boston Medical Center, Boston, MA 02118, USA
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Bulloch G, Seth I, Sukumar S, Chen Y, Zhu Z. Scleral thinning causes, diagnosis, and management: A narrative review. Cont Lens Anterior Eye 2023; 46:101825. [PMID: 36894372 DOI: 10.1016/j.clae.2023.101825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Sclera forms the outer fibrous coat of the eye and provides structural integrity for the housing of intraocular contents. Scleral thinning is a serious progressive condition which can lead to perforation and worsening visual functioning. This review aims to summarize the anatomical consideration and causes of scleral thinning, diagnosis, and the various surgical approaches available to treat scleral thinning. MATERIALS AND METHODS The narrative literature review was conducted by senior Ophthalmologists and researchers. PubMed, EMBASE, Web of Science, Scopus, and Google Scholar databases were searched for relevant literature from infinity till March 2022. Terms of the search referred to 'sclera' or 'scleral thinning' or 'scleral melting', and were combined with 'treatment', or 'management' or 'causes'. Publications were included in this manuscript if they offered information about the nature of these topics. Reference lists of relevant literature was searched. There were no limits on type of article to be included for this review. RESULTS Scleral thinning arises from diverse congenital, degenerative, immunological, infectious, post-surgical, and traumatic etiologies. It is diagnosed upon slit-lamp examination, indirect ophthalmoscopy, and optical coherence tomography. Conservative pharmacological treatment of scleral thinning may include anti-inflammatory drugs, steroid drops, immunosuppressors, monoclonal antibodies, and surgical treatments including tarsorrhaphy, scleral transplantation, amniotic membrane transplantation, donor corneal graft, conjunctival flaps, tenon's membrane flap, pericardial graft, dermis graft, cadaveric dura mater graft, and other autologous and biological grafts. CONCLUSION Scleral thinning treatments have developed dramatically in recent decades and the rise of alternative grafts for scleral transplantation procedures or use of conjunctival flaps have taken center stage in surgical management. This review adds a comprehensive summary of the scleral thinning with attention to the positive and negative features of new treatments alongside previous mainstay management strategies.
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Affiliation(s)
- Gabriella Bulloch
- Department of Ophthalmology, Royal Victorian Ear and Eye Hospital, Centre for Eye Research Australia, Melbourne, Australia; Faculty of Science, Medicine, and Health, The University of Melbourne, Australia
| | - Ishith Seth
- Department of Ophthalmology, Royal Victorian Ear and Eye Hospital, Centre for Eye Research Australia, Melbourne, Australia; Faculty of Science, Medicine, and Health, The University of Melbourne, Australia; Faculty of Medicine, Central Clinical School, Monash University, Australia.
| | - Sharanya Sukumar
- Department of Ophthalmology, Royal Victorian Ear and Eye Hospital, Centre for Eye Research Australia, Melbourne, Australia
| | - Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Province Key Laboratory of Ophthalmology and Vision Science, Guangzhou, China
| | - Zhuoting Zhu
- Department of Ophthalmology, Royal Victorian Ear and Eye Hospital, Centre for Eye Research Australia, Melbourne, Australia; Faculty of Science, Medicine, and Health, The University of Melbourne, Australia
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Fea A, Sacchi M, Franco F, Laffi GL, Oddone F, Costa G, Serino F, Giansanti F. Effectiveness and Safety of XEN45 in Eyes With High Myopia and Open Angle Glaucoma. J Glaucoma 2023; 32:178-185. [PMID: 36730214 DOI: 10.1097/ijg.0000000000002151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/14/2022] [Indexed: 02/03/2023]
Abstract
PRCIS XEN45 implant was an effective and safe procedure in primary open angle glaucoma (OAG) eyes with high myopia. Although the hypotony incidence rate was relatively high, it resolved with medical therapy and was of short duration. PURPOSE The purpose of this study is to evaluate the effectiveness and safety of the XEN45 stent in eyes with OAG and high myopia. DESIGN Retrospective and multicenter study. METHODS Consecutive OAG patients who underwent a XEN45, either alone or in combination with cataract surgery, and had a refractive error higher than -6 D and an axial length ≥26 mm. The primary endpoint was the mean intraocular pressure (IOP) lowering at the last follow-up visit. RESULTS Thirty-one eyes were included (96.8% with a primary OAG diagnosis). The mean refraction was -13.2±5.6 (range: -6.75 to-23.0) D. In the overall study sample, preoperative mean IOP (95% CI) was significantly lowered from 23.5 (20.5-26.4) mm Hg to 13.0 (12.2-13.8) mm Hg at the last follow-up visit, P <0.0001. At the last follow-up visit, 16 (57.1%) eyes achieved an IOP ≤14 mm Hg, 11 (68.9%) of them without treatment. The number of ocular hypotensive medications was significantly reduced from 3.0±1.1 drugs at preoperatively to 0.6±1.0 drugs at the last follow-up visit, P <0.0001. Median (95% CI) follow-up was 24.0 (12.0-24.0) months. Linear regression analysis showed a significant correlation between the preoperative refraction and the IOP lowering ( r =0.43, P =0.0155). Needling procedure was performed in 11 eyes (39.3%) and hypotony (defined as an IOP <6 mm Hg) was observed in 8 eyes (28.6%) during the first postoperative day and remained for a week. CONCLUSION Although the Xen implant effectively lowered IOP in highly myopic eyes with glaucoma, the incidence of hypotony was high, and in most cases, resolved within the first month with medical management and monitoring.
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Affiliation(s)
- Antonio Fea
- Complex Ophthalmology Structure, City of Health and Science of Turin, Department of Surgical Sciences - University of Turin, Turin
| | - Matteo Sacchi
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan
| | - Fabrizio Franco
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
| | | | | | - Giacomo Costa
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
| | - Federica Serino
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
| | - Fabrizio Giansanti
- Ophthalmology Department, SOD Ophthalmology, AOU Careggi Florence, Florence, Italy
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Nishida S, Takashima Y, Udagawa R, Ibaraki H, Seta Y, Ishihara H. A Multifunctional Hybrid Nanocarrier for Non-Invasive siRNA Delivery to the Retina. Pharmaceutics 2023; 15:pharmaceutics15020611. [PMID: 36839933 PMCID: PMC9962392 DOI: 10.3390/pharmaceutics15020611] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Drug therapy for retinal diseases (e.g., age-related macular degeneration, the leading cause of blindness) is generally performed by invasive intravitreal injection because of poor drug delivery caused by the blood-retinal barrier (BRB). This study aimed to develop a nanocarrier for the non-invasive delivery of small interfering RNA (siRNA) to the posterior segment of the eye (i.e., the retina) by eyedrops. To this end, we prepared a hybrid nanocarrier based on a multifunctional peptide and liposomes, and the composition was optimized. A cytoplasm-responsive stearylated peptide (STR-CH2R4H2C) was used as the multifunctional peptide because of its superior ability to enhance the complexation, cell permeation, and intracellular dynamics of siRNA. By adding STR-CH2R4H2C to the surface of liposomes, intracellular uptake increased regardless of the liposome surface charge. The STR-CH2R4H2C-modified cationic nanocarrier demonstrated significant siRNA transfection efficiency with no cytotoxicity, enhanced siRNA release from endosomes, and effectively suppressed vascular endothelial growth factor expression in rat retinal pigment epithelium cells. The 2.0 mol% STR-CH2R4H2C-modified cationic nanocarrier enhanced intraocular migration into the retina after instillation into rat eyes.
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Machine Learning System for Lung Neoplasms Distinguished Based on Scleral Data. Diagnostics (Basel) 2023; 13:diagnostics13040648. [PMID: 36832135 PMCID: PMC9954858 DOI: 10.3390/diagnostics13040648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Lung cancer remains the most commonly diagnosed cancer and the leading cause of death from cancer. Recent research shows that the human eye can provide useful information about one's health status, but few studies have revealed that the eye's features are associated with the risk of cancer. The aims of this paper are to explore the association between scleral features and lung neoplasms and develop a non-invasive artificial intelligence (AI) method for detecting lung neoplasms based on scleral images. A novel instrument was specially developed to take the reflection-free scleral images. Then, various algorithms and different strategies were applied to find the most effective deep learning algorithm. Ultimately, the detection method based on scleral images and the multi-instance learning (MIL) model was developed to predict benign or malignant lung neoplasms. From March 2017 to January 2019, 3923 subjects were recruited for the experiment. Using the pathological diagnosis of bronchoscopy as the gold standard, 95 participants were enrolled to take scleral image screens, and 950 scleral images were fed to AI analysis. Our non-invasive AI method had an AUC of 0.897 ± 0.041(95% CI), a sensitivity of 0.836 ± 0.048 (95% CI), and a specificity of 0.828 ± 0.095 (95% CI) for distinguishing between benign and malignant lung nodules. This study suggested that scleral features such as blood vessels may be associated with lung cancer, and the non-invasive AI method based on scleral images can assist in lung neoplasm detection. This technique may hold promise for evaluating the risk of lung cancer in an asymptomatic population in areas with a shortage of medical resources and as a cost-effective adjunctive tool for LDCT screening at hospitals.
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73
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Safa BN, Bleeker A, Berdahl JP, Ethier CR. The Effects of Negative Periocular Pressure on Biomechanics of the Optic Nerve Head and Cornea: A Computational Modeling Study. Transl Vis Sci Technol 2023; 12:5. [PMID: 36745441 PMCID: PMC9910383 DOI: 10.1167/tvst.12.2.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the effects of negative periocular pressure (NPP), and concomitant intraocular pressure (IOP) lowering, on the biomechanics of the optic nerve head (ONH) and cornea. Methods We developed a validated finite element (FE) model of the eye to compute tissue biomechanical strains induced in response to NPP delivered using the Multi-Pressure Dial (MPD) system. The model was informed by clinical measurements of IOP lowering and was based on published tissue properties. We also conducted sensitivity analyses by changing pressure loads and tissue properties. Results Application of -7.9 mmHg NPP decreased strain magnitudes in the ONH by c. 50% whereas increasing corneal strain magnitudes by c. 25%. Comparatively, a similar increase in corneal strain was predicted to occur due to an increase in IOP of 4 mmHg. Sensitivity studies indicated that NPP lowers strain in the ONH by reducing IOP and that these effects persisted over a range of tissue stiffnesses and spatial distributions of NPP. Conclusions NPP is predicted to considerably decrease ONH strain magnitudes. It also increases corneal strain but to an extent expected to be clinically insignificant. Thus, using NPP to lower IOP and hence decrease ONH mechanical strain is likely biomechanically beneficial for patients with glaucoma. Translational Relevance This study provides the first description of how NPP affects ONH biomechanics and explains the underlying mechanism of ONH strain reduction. It complements current empirical knowledge about the MPD system and guides future studies of NPP as a treatment for glaucoma.
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Affiliation(s)
- Babak N. Safa
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
| | - Adam Bleeker
- Dean McGee Eye Institute Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - John P. Berdahl
- Equinox Ophthalmic, Newport Beach, CA, USA,Vance Thompson Vision, Sioux Falls, SD, USA
| | - C. Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
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74
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Sayah DN, Lesk MR. Ocular Rigidity and Current Therapy. Curr Eye Res 2023; 48:105-113. [PMID: 35763027 DOI: 10.1080/02713683.2022.2093380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular rigidity (OR) is an important biomechanical parameter of the eye accounting for the material and geometrical properties of the corneoscleral shell.Methods: This study used a literature search to review the role of ocular rigidity and the application of potential therapies targeting this parameter in glaucoma and myopia.Conclusion: Biomechanical modeling and improved understanding of the biochemistry, and molecular arrangement of sclera and its constituents have yielded important insights. Recent developments, including that of a non-invasive and direct OR measurement method and improved ocular imaging techniques are helping to elucidate the role of OR in healthy and diseased eyes by facilitating large scale and longitudinal clinical studies. Improved understanding of OR at the initial stages of disease processes and its alterations with disease progression will undoubtedly propel research in the field. Furthermore, a better understanding of the determinants of OR is helping to refine novel therapeutic approaches which target and alter the biomechanical properties of the sclera in sight-threatening conditions such as glaucoma and myopia.
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Affiliation(s)
- Diane N Sayah
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.,School of Optometry, Université de Montréal, Montreal, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.,Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Canada
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75
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Aging Effects on Optic Nerve Neurodegeneration. Int J Mol Sci 2023; 24:ijms24032573. [PMID: 36768896 PMCID: PMC9917079 DOI: 10.3390/ijms24032573] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
Common risk factors for many ocular pathologies involve non-pathologic, age-related damage to the optic nerve. Understanding the mechanisms of age-related changes can facilitate targeted treatments for ocular pathologies that arise at any point in life. In this review, we examine these age-related, neurodegenerative changes in the optic nerve, contextualize these changes from the anatomic to the molecular level, and appreciate their relationship with ocular pathophysiology. From simple structural and mechanical changes at the optic nerve head (ONH), to epigenetic and biochemical alterations of tissue and the environment, multiple age-dependent mechanisms drive extracellular matrix (ECM) remodeling, retinal ganglion cell (RGC) loss, and lowered regenerative ability of respective axons. In conjunction, aging decreases the ability of myelin to preserve maximal conductivity, even with "successfully" regenerated axons. Glial cells, however, regeneratively overcompensate and result in a microenvironment that promotes RGC axonal death. Better elucidating optic nerve neurodegeneration remains of interest, specifically investigating human ECM, RGCs, axons, oligodendrocytes, and astrocytes; clarifying the exact processes of aged ocular connective tissue alterations and their ultrastructural impacts; and developing novel technologies and pharmacotherapies that target known genetic, biochemical, matrisome, and neuroinflammatory markers. Management models should account for age-related changes when addressing glaucoma, diabetic retinopathy, and other blinding diseases.
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Cheng Y, Ren T, Wang N. Biomechanical homeostasis in ocular diseases: A mini-review. Front Public Health 2023; 11:1106728. [PMID: 36733902 PMCID: PMC9886686 DOI: 10.3389/fpubh.2023.1106728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Diabetes mellitus-induced hyperglycemia is responsible for multiple pathological ocular alternations from vasculopathy to biomechanical dyshomeostasis. Biomechanical homeostasis is crucial to maintain the normal physiological condition of the eyes. Biomechanical features vary in eye tissues regarding different anatomical positions, tissue components, and cellular functions. The disturbance in biomechanical homeostasis may result in different ocular diseases. In this review, we provide a preliminary sketch of the latest evidence on the mechano-environment of the eyeball and its possible influencing factors, thereby underscoring the relationship between the dyshomeostasis of ocular biomechanics and common eye diseases (e.g., diabetic retinopathy, keratoconus, glaucoma, spaceflight-associated neuro-ocular syndrome, retinal vein occlusion and myopia, etc.). Together with the reported evidence, we further discuss and postulate the potential role of biomechanical homeostasis in ophthalmic pathology. Some latest strategies to investigate the biomechanical properties in ocular diseases help unveil the pathological changes at multiple scales, offering references for making new diagnostic and treatment strategies targeting mechanobiology.
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Affiliation(s)
- Ying Cheng
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tianmin Ren
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China,*Correspondence: Ningli Wang ✉
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Chou CC, Shih PJ, Jou TS, Hsu MY, Chen JP, Hsu RH, Lee NC, Chien YH, Hwu WL, Wang IJ. Corneal Biomechanical Characteristics in Osteogenesis Imperfecta With Collagen Defect. Transl Vis Sci Technol 2023; 12:14. [PMID: 36622688 PMCID: PMC9838590 DOI: 10.1167/tvst.12.1.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose To identify the characteristic corneal biomechanical properties of osteogenesis imperfecta (OI), and to compare the corneal biomechanical properties between OI and keratoconus. Methods We included 46 eyes of 23 patients with OI, 188 eyes of 99 keratoconus patients, and 174 eyes of 92 normal controls to compare corneal biomechanical parameters between OI corneas, keratoconus, and normal controls by using Corneal Visualization Scheimpflug Technology (Corvis ST). Results Patients with OI had significantly higher Corvis biomechanical index (CBI) (P < 0.001), higher tomographic and biomechanical index (TBI) (P = 0.040), lower Corvis Biomechanical Factor (CBiF) (P = 0.034), and lower stiffness parameter at first applanation (SP-A1) (P < 0.001) compared with normal controls. In contrast, OI group showed lower CBI (P < 0.001), lower TBI (P < 0.001), higher CBiF (P < 0.001), and higher SP-A1 (P = 0.020) than keratoconus group. Notably, the stress-strain index (SSI) was not significantly different between the OI and normal controls (P = 1.000), whereas keratoconus showed the lowest SSI compared with OI group (P = 0.025) and normal controls (P < 0.001). Conclusions Although the corneal structures of OI patients are less stable and easier to deform as compared to those of the control group, there is no significant difference in material stiffness observed between the OI and normal controls. In contrast, the corneas of keratoconus showed not only lower structural stability and higher deformability but also lower material stiffness compared with those of OI cornea and normal controls. Translational Relevance The biomechanical alterations are different between OI corneas and keratoconus.
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Affiliation(s)
- Chien-Chih Chou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Tzuu-Shuh Jou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,Center of Precision Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Yen Hsu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan,Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - Rai-Hseng Hsu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ni-Chung Lee
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Hsiu Chien
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wuh-Liang Hwu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Jong Wang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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Xia M, Zhang E, Yao F, Xia Z, Zhou M, Ran X, Xia X. Regional differences of the sclera in the ocular hypertensive rat model induced by circumlimbal suture. EYE AND VISION (LONDON, ENGLAND) 2023; 10:2. [PMID: 36597143 PMCID: PMC9811703 DOI: 10.1186/s40662-022-00319-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/15/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE To describe the regional differences of the sclera in ocular hypertension (OHT) models with the inappropriate extension of the ocular axis. METHODS To discover the regional differences of the sclera at the early stage, OHT models were established using circumlimbal suture (CS) or sclerosant injection (SI). Axial length (AL) was measured by ultrasound and magnetic resonance imaging. The glaucoma-associated distinction was determined by intraocular pressure (IOP) and retrograde tracing of retinal ganglion cells (RGCs). The central thickness of the ganglion cell complex (GCC) was measured by optical coherence tomography. RGCs and collagen fibrils were detected using a transmission electron microscope, furthermore, anti-alpha smooth muscle actin (αSMA) was determined in the early stage after the operation. RESULTS Compared with the control group, the eyes in OHT models showed an increased IOP (P < 0.001 in the CS group, P = 0.001 in the SI group), growing AL (P = 0.026 in the CS group, P = 0.043 in the SI group), reduction of central RGCs (P < 0.001 in the CS group, P = 0.017 in the SI group), thinning central GCC (P < 0.001 in the CS group), and a distinctive expression of αSMA in the central sclera in the early 4-week stage after the operation (P = 0.002 in the CS group). Compared with the SI group, the eye in the CS group showed a significantly increased AL (7.1 ± 0.4 mm, P = 0.031), reduction of central RGCs (2121.1 ± 87.2 cells/mm2, P = 0.001), thinning central GCC (71.4 ± 0.8 pixels, P = 0.015), and a distinctive expression of αSMA (P = 0.005). Additionally, ultrastructural changes in RGCs, scleral collagen fibers, and collagen crimp were observed in the different regions. Increased collagen volume fraction in the posterior segment of the eyeball wall (30.2 ± 3.1%, P = 0.022) was observed by MASSON staining in the CS group. CONCLUSION Regional differences of the sclera in the ocular hypertensive rat model induced by CS may provide a reference for further treatment of scleral-related eye disorders.
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Affiliation(s)
- Mingfang Xia
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.469519.60000 0004 1758 070XDepartment of Ophthalmology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750004 Ningxia China
| | - Endong Zhang
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Fei Yao
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Zhaohua Xia
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Mingmin Zhou
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Xufang Ran
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Xiaobo Xia
- grid.216417.70000 0001 0379 7164Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China ,grid.452223.00000 0004 1757 7615Hunan Key Laboratory of Ophthalmology, Changsha, 410008 Hunan China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
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Czerpak CA, Kashaf MS, Zimmerman BK, Quigley HA, Nguyen TD. The Strain Response to Intraocular Pressure Decrease in the Lamina Cribrosa of Patients with Glaucoma. Ophthalmol Glaucoma 2023; 6:11-22. [PMID: 35863747 PMCID: PMC9849479 DOI: 10.1016/j.ogla.2022.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To measure biomechanical strains in the lamina cribrosa (LC) of living human eyes with intraocular pressure (IOP) lowering. DESIGN Cohort study. PARTICIPANTS Patients with glaucoma underwent imaging before and after laser suturelysis after trabeculectomy surgery (29 image pairs; 26 persons). INTERVENTION Noninvasive imaging of the eye. MAIN OUTCOME MEASURES Strains in optic nerve head tissue and changes in depths of the anterior border of the LC. RESULTS Intraocular pressure decreases caused the LC to expand in thickness in the anterior-posterior strain (Ezz = 0.94 ± 1.2%; P = 0.00020) and contract in radius in the radial strain (Err = - 0.19 ± 0.33%; P = 0.0043). The mean LC depth did not significantly change with IOP lowering (1.33 ± 6.26 μm; P = 0.26). A larger IOP decrease produced a larger, more tensile Ezz (P < 0.0001), greater maximum principal strain (Emax; P < 0.0001), and greater maximum shear strain (Γmax; P < 0.0001). The average LC depth change was associated with the Γmax and radial-circumferential shear strain (Erθ; P < 0.02) but was not significantly related to tensile or compressive strains. An analysis by clock hour showed that in temporal clock hours 3 to 6, a more anterior LC movement was associated with a more positive Emax, and in clock hours 3, 5, and 6, it was associated with a more positive Γmax. At 10 o'clock, a more posterior LC movement was related to a more positive Emax (P < 0.004). Greater compliance (strain/ΔIOP) of Emax (P = 0.044), Γmax (P = 0.052), and Erθ (P = 0.018) was associated with a thinner retinal nerve fiber layer. Greater compliance of Emax (P = 0.041), Γmax (P = 0.021), Erθ (P = 0.024), and in-plane shear strain (Erz; P = 0.0069) was associated with more negative mean deviations. Greater compliance of Γmax (P = 0.055), Erθ (P = 0.040), and Erz (P = 0.015) was associated with lower visual field indices. CONCLUSIONS With IOP lowering, the LC moves either into or out of the eye but, on average, expands in thickness and contracts in radius. Shear strains are nearly as substantial as in-plane strains. Biomechanical strains are more compliant in eyes with greater glaucoma damage. This work was registered at ClinicalTrials.gov as NCT03267849.
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Affiliation(s)
- Cameron A Czerpak
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland.
| | - Michael Saheb Kashaf
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Brandon K Zimmerman
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland
| | - Harry A Quigley
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Thao D Nguyen
- Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, Maryland; Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
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Ramm L, Herber R, Lorenz G, Jasper CS, Pillunat LE, Pillunat KR. Evaluation of corneal biomechanical properties using the ocular response analyzer and the dynamic Scheimpflug-Analyzer Corvis ST in high pressure and normal pressure open-angle glaucoma patients. PLoS One 2023; 18:e0281017. [PMID: 36701409 PMCID: PMC9879466 DOI: 10.1371/journal.pone.0281017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To characterize differences in corneal biomechanics in high (HPG) and normal pressure (NPG) primary open-angle glaucoma, and its association to disease severity. METHODS Corneal biomechanical properties were measured using the Ocular Response Analyzer (ORA) and the dynamic Scheimpflug-Analyzer Corvis ST (CST). Disease severity was functionally assessed by automated perimetry (Humphrey field analyzer) and structurally with the Heidelberg Retina Tomograph. To avoid a possible falsification by intraocular pressure, central corneal thickness and age, which strongly influence ORA and CST measurements, group matching was performed. Linear mixed models and generalized estimating equations were used to consider inter-eye correlation. RESULTS Following group matching, 60 eyes of 38 HPG and 103 eyes of 60 NPG patients were included. ORA measurement revealed a higher CRF in HPG than in NPG (P < 0.001). Additionally, the CST parameter integrated radius (P < 0.001) was significantly different between HPG and NPG. The parameter SSI (P < 0.001) representing corneal stiffness was higher in HPG than in NPG. Furthermore, regression analysis revealed associations between biomechanical parameters and indicators of disease severity. In HPG, SSI correlated to RNFL thickness. In NPG, dependencies between biomechanical readings and rim area, MD, and PSD were shown. CONCLUSION Significant differences in corneal biomechanical properties were detectable between HPG and NPG patients which might indicate different pathophysiological mechanisms underlying in both entities. Moreover, biomechanical parameters correlated to functional and structural indices of diseases severity. A reduced corneal deformation measured by dynamic methods was associated to advanced glaucomatous damage.
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Affiliation(s)
- Lisa Ramm
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Robert Herber
- Faculty of Medicine Carl Gustav Carus, Department of Ophthalmology, TU Dresden, Dresden, Germany
- * E-mail:
| | - Georg Lorenz
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Carolin S. Jasper
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Karin R. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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Xu Y, Lai L, Chen Z, Jia Y, Gao D, Lv X, Song Y, Sun M, Li Y, Zhang F. Scleral Remolding-Related Gene Expression After Scleral Collagen Cross-Linking Using Ultraviolet A and Riboflavin in Myopic Guinea Pig Model. Curr Eye Res 2022; 48:392-401. [PMID: 36519626 DOI: 10.1080/02713683.2022.2156549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE This study was conducted to evaluate scleral remolding-related gene expression after scleral collagen cross-linking (SCXL) using ultraviolet A (UVA) and riboflavin in lens-induced myopia (LIM) guinea pigs. METHODS A total of 100 4-week-old pigmented guinea pigs were randomly divided into five groups (n = 20): SCXL + LIM, LIM, SCXL, Sham, and Control. Refraction, anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and axial length (AL) were measured using streak retinoscope and A-scan ultrasonography. SCXL was performed using 0.1% riboflavin solution and 365 nm UVA irradiation. Lens-induced myopia was achieved by wearing -10 D concave lenses. Quantitative real-time PCR (qPCR) and western blot were used to measure mRNA and protein levels, respectively. RESULTS Myopia was successfully induced in the LIM group, while myopic refraction was higher and ACD and AL were shorter in SCXL + LIM compared with LIM, suppressing myopia progression. The scleral COL1A1 mRNA levels were significantly decreased and MMP2 and ACTA2 mRNA levels were significantly increased in LIM compared with other groups, while COL1A1 mRNA levels were increased and MMP2 and ACTA2 mRNA levels were decreased in SCXL + LIM compared with LIM. The scleral COL1A1 protein levels were significantly increased at 1 week and 4 weeks and MMP2 protein levels were significantly decreased at 1 week in SCXL compared with SCXL + LIM, LIM and Control. MMP2 protein levels were significantly decreased in SCXL + LIM and SCXL compared with LIM at 4 weeks. The differences in TGFB1, BMP2, CCN2, ITGA2, and ITGB1 mRNA levels and ACTA2 protein levels between the five groups were not significantly different. CONCLUSION SCXL using UVA and riboflavin could influence the expression of scleral remolding-related genes, including COL1A1, MMP2, TIMP2, and ACTA2, and thus contribute to improving collagen synthesis and reducing collagen degradation and might have an effect on slowing myopia progression.
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Affiliation(s)
- Yushan Xu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lingbo Lai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhe Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuqian Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dengxin Gao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaotong Lv
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yanzheng Song
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mingshen Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yu Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Sun X, Qiao Y, Zhao L, Shi Z, Zhang X, Cao R, Zhou Q, Shi W. Application of Decellularized Porcine Sclera in Repairing Corneal Perforations and Lamellar Injuries. ACS Biomater Sci Eng 2022; 8:5295-5306. [PMID: 36454184 DOI: 10.1021/acsbiomaterials.2c00972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Scleras are mainly used for the treatment of glaucoma, eyelid damage, and scleral ulcers. Given that the sclera and cornea collectively constitute the complete external structure of the eyeball and both have the same tissue and cell origin, we attempted to identify scleral materials to treat lamellar and penetrating corneal injuries. Based on research in our center, antigenic components in decellularized porcine sclera (DPS) were removed using a simplified decellularization method, leaving the collagen structure and active components undamaged. DPS preserved the mechanical properties and did not significantly inhibit the proliferation and replication of human corneal epithelial cells. In vivo, the graft epithelium healed well after lamellar and penetrating scleral grafting, and the graft thickness did not change evidently. DPS can resist suture traction during scleral transplantation and maintain anterior chamber stability until day 28 post-operatively, especially in penetrating repairs. No obvious immune rejection of lamellar or penetrating scleral grafts was found 28 days after DPS transplantation. This study shows that DPS could be used as an alternative material for the emergency repair of corneal perforations and lamellar injuries, representing another application of sclera.
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Affiliation(s)
- Xiuli Sun
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Jingsi Road, Jinan 271000, China
| | - Yujie Qiao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Jingsi Road, Jinan 271000, China
| | - Long Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Jingsi Road, Jinan 271000, China
| | - Zhen Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Jingsi Road, Jinan 271000, China
| | - Xiaoyu Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Jingsi Road, Jinan 271000, China
| | - Rui Cao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Jingsi Road, Jinan 271000, China
| | - Qingjun Zhou
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, 5 Yan'erdao Road, Qingdao 266071, China
| | - Weiyun Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jingsi Road, Jinan 271000, China
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Tang X, Liu L, Liu S, Song S, Li H. MicroRNA-29a inhibits collagen expression and induces apoptosis in human fetal scleral fibroblasts by targeting the Hsp47/Smad3 signaling pathway. Exp Eye Res 2022; 225:109275. [PMID: 36206860 DOI: 10.1016/j.exer.2022.109275] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/06/2022] [Accepted: 10/01/2022] [Indexed: 12/29/2022]
Abstract
Members of the microRNA-29 (miR-29) gene family have been implicated as suppressors of collagen in several human diseases. The present study aimed to explore the function of miR-29a in human fetal scleral fibroblasts (HFSFs) and to investigate potential mechanisms by which the molecule regulates cellular functioning. First, HFSFs were transfected with miR-29a mimic, miR-29a inhibitor, or their corresponding controls. Then, cell proliferation and apoptosis were assessed using a CCK-8 assay and flow cytometry, respectively. Further, using real-time PCR, western blotting, and immunofluorescence staining, levels of miR-29a, heat shock protein 47 (Hsp47), COL1A1, Smad3, P-Smad3, Bax, and Bcl-2 were investigated. Next, empty vectors and SERPINH1-overexpressing vectors were used to transfect HFSFs. Western blotting and flow cytometry were performed to assess changes in levels of HFSF protein expression and apoptosis, respectively. Results indicated that the miR-29a mimic significantly inhibited Hsp47, Smad3, P-Smad3, and COL1A1 expression. Conversely, the miR-29a inhibitor enhanced the expression of the same genes. Furthermore, miR-29a overexpression inhibited HFSFs proliferation and enhanced the rate of HFSFs apoptosis. Consistent with this finding, miR-29a overexpression led to the downregulation of Bcl-2 and upregulation of Bax. In contrast, miR-29a suppression led to the upregulation of Bcl-2 and downregulation of Bax expression and reduced the rate of apoptosis. Additional research revealed that overexpression of Hsp47 prevented HFSFs apoptosis and enhanced collagen production. Findings that miR-29a overexpression reduces collagen expression levels, slows proliferation, and promotes apoptosis in HFSFs highlight the key role of miR-29a in scleral remodeling. The effects of miR-29a on scleral remodeling might mediate by targeting Hsp47 and repressing the Smad3 pathway.
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Affiliation(s)
- Xiaolan Tang
- Department of Ophthalmology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| | - Ling Liu
- Department of Ophthalmology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| | - Shichun Liu
- Department of Ophthalmology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| | - Shengfang Song
- Department of Ophthalmology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
| | - Hua Li
- Department of Ophthalmology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
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Markov P, Zhu H, Boote C, Blain EJ. Delayed reorganisation of F-actin cytoskeleton and reversible chromatin condensation in scleral fibroblasts under simulated pathological strain. Biochem Biophys Rep 2022; 32:101338. [PMID: 36123992 PMCID: PMC9482111 DOI: 10.1016/j.bbrep.2022.101338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 11/06/2022] Open
Abstract
Mechanical loading regulates the functional capabilities of the ocular system, particularly in the sclera (‘white of the eye’) – the principal load-bearing tissue of the ocular globe. Resident fibroblasts of the scleral eye wall are continuously subjected to fluctuating mechanical strains arising from eye movements, cerebrospinal fluid pressure and, most influentially, intra-ocular pressure (IOP). Whilst fibroblasts are hypothesised to actively participate in scleral biomechanics, to date limited information has been reported on how the macroscopic stresses and strains are transmitted via their cytoskeletal networks. In this study, the effect of applying either a ‘physiological load’ (simulating healthy IOP) or a ‘pathological load’ (simulating an elevated glaucomatous IOP) to bovine scleral fibroblasts, as a model of human glaucoma, was conducted to characterise cytoskeletal organisation, chromatin condensation and cell dimensions using immunofluorescence confocal microscopy. Quantification of cell parameters and cytoskeletal element anisotropy were subsequently performed using FibrilTool, and chromatin condensation parameter assessment through a bespoke MATLAB script. The novel findings suggest that physiological load-induced F-actin rearrangement is transient, whereas pathological load, recapitulating in vivo glaucomatous IOP levels, had a reversible and inhibitory influence on remodelling of the cytoskeletal architecture and, further, induction of chromatin condensation. Ultimately, this could compromise cell behaviour. These findings could provide valuable insight into the mechanism(s) used by scleral fibroblasts to mechanically adapt to support biomechanical tissue integrity, and how it could be potentially modified for therapeutic avenues targeting mechanically mediated ocular pathologies such as glaucoma. Physiological strain induced a transient F-actin rearrangement in scleral fibroblasts. In contrast, pathological strain reversibly delayed F-actin rearrangement. Vimentin and β-tubulin networks were largely unaffected by strain regimens. Pathological strain reversibly increased chromatin condensation parameter. Pathological strain may induce ‘inhibition delay’ to confer cytoprotection.
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Brown DM, Kowalski MA, Paulus QM, Yu J, Kumar P, Kane MA, Patel JM, Ethier CR, Pardue MT. Altered Structure and Function of Murine Sclera in Form-Deprivation Myopia. Invest Ophthalmol Vis Sci 2022; 63:13. [PMID: 36512347 PMCID: PMC9753793 DOI: 10.1167/iovs.63.13.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose The sclera is believed to biomechanically influence eye size, facilitating the excessive axial elongation that occurs during myopigenesis. Here, we test the hypothesis that the sclera will be remodeled and exhibit altered biomechanics in the mouse model of form-deprivation (FD) myopia, accompanied by altered retinoid concentrations, a potential signaling molecule involved in the process. Methods Male C57 Bl/6J mice were subjected to unilateral FD (n = 44 eyes), leaving the contralateral eye untreated (contra; n = 44). Refractive error and ocular biometry were measured in vivo prior to and after 1 or 3 weeks of FD. Ex vivo measurements were made of scleral biomechanical properties (unconfined compression: n = 24), scleral sulfated glycosaminoglycan (sGAG) content (dimethylmethylene blue: n = 18, and immunohistochemistry: n = 22), and ocular all-trans retinoic acid (atRA) concentrations (retina and RPE + choroid + sclera, n = 24). Age-matched naïve controls were included for some outcomes (n = 32 eyes). Results Significant myopia developed after 1 (-2.4 ± 1.1 diopters [D], P < 0.001) and 3 weeks of FD (-4.1 ± 0.7 D, P = 0.025; mean ± standard deviation). Scleral tensile stiffness and permeability were significantly altered during myopigenesis (stiffness = -31.4 ± 12.7%, P < 0.001, and permeability = 224.4 ± 205.5%, P < 0.001). Total scleral sGAG content was not measurably altered; however, immunohistochemistry indicated a sustained decrease in chondroitin-4-sulfate and a slower decline in dermatan sulfate. The atRA increased in the retinas of eyes form-deprived for 1 week. Conclusions We report that biomechanics and GAG content of the mouse sclera are altered during myopigenesis. All scleral outcomes generally follow the trends found in other species and support a retina-to-sclera signaling cascade underlying mouse myopigenesis.
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Affiliation(s)
- Dillon M. Brown
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
| | - Michael A. Kowalski
- Department of Orthopedics, Emory University School of Medicine, Atlanta, Georgia, United States
| | - Quinn M. Paulus
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
| | - Jianshi Yu
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - Praveen Kumar
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - Maureen A. Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - Jay M. Patel
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
- Department of Orthopedics, Emory University School of Medicine, Atlanta, Georgia, United States
| | - C. Ross Ethier
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
| | - Machelle T. Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia, United States
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86
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Lysyl oxidase-like 1 deficiency alters ultrastructural and biomechanical properties of the peripapillary sclera in mice. Matrix Biol Plus 2022; 16:100120. [PMID: 36060791 PMCID: PMC9436796 DOI: 10.1016/j.mbplus.2022.100120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 11/30/2022] Open
Abstract
Lysyl oxidate-like 1 knockout (Loxl1-/-) mice have decreased vision without elevated intraocular pressure. Loxl1-/- mice exhibit biometric changes of the anterior segment of the eye. Loxl1-/- mice have altered elastin and collagen structure in peripapillary sclera. Structural alternations of peripapillary sclera correlate with its increased stiffness in Loxl1-/- mice.
Lysyl oxidase-like 1 encoded by the LOXL1 gene is a member of the lysyl oxidase family of enzymes that are important in the maintenance of extracellular matrix (ECM)-rich tissue. LOXL1 is important for proper elastic fiber formation and mice lacking LOXL1 (Loxl1−/−) exhibit systemic elastic fiber disorders, such as pelvic organ prolapse, a phenotype associated with exfoliation syndrome (XFS) in humans. Patients with XFS have a significant risk of developing exfoliation glaucoma (XFG), a severe form of glaucoma, which is a neurodegenerative condition leading to irreversible blindness if not detected and treated in a timely fashion. Although Loxl1−/− mice have been used extensively to investigate mechanisms of pelvic organ prolapse, studies of eyes in those mice are limited and some showed inconsistent ocular phenotypes. In this study we demonstrate that Loxl1−/− mice have significant anterior segment biometric abnormalities which recapitulate some human XFS features. We then focused on the peripapillary sclera (PPS), a critical structure for maintaining optic nerve health. We discovered quantitative and qualitive changes in ultrastructure of PPS, such as reduced elastic fibers, enlarged collagen fibrils, and transformed collagen lamella organization detected by transmission electron microscopy (TEM). Importantly, these changes corelate with altered tissue biomechanics detected by Atomic Force Microscopy (AFM) of PPS in mice. Together, our results support a crucial role for LOXL1 in ocular tissue structure and biomechanics, and Loxl1−/− mice could be a valuable resource for understanding the role of scleral tissue biomechanics in ocular disease.
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87
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Zhao Y, Hu G, Yan Y, Wang Z, Liu X, Shi H. Biomechanical analysis of ocular diseases and its in vitro study methods. Biomed Eng Online 2022; 21:49. [PMID: 35870978 PMCID: PMC9308301 DOI: 10.1186/s12938-022-01019-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/13/2022] [Indexed: 12/25/2022] Open
Abstract
Ocular diseases are closely related to the physiological changes in the eye sphere and its contents. Using biomechanical methods to explore the relationship between the structure and function of ocular tissue is beneficial to reveal the pathological processes. Studying the pathogenesis of various ocular diseases will be helpful for the diagnosis and treatment of ocular diseases. We provide a critical review of recent biomechanical analysis of ocular diseases including glaucoma, high myopia, and diabetes. And try to summarize the research about the biomechanical changes in ocular tissues (e.g., optic nerve head, sclera, cornea, etc.) associated with those diseases. The methods of ocular biomechanics research in vitro in recent years are also reviewed, including the measurement of biomechanics by ophthalmic equipment, finite element modeling, and biomechanical analysis methods. And the preparation and application of microfluidic eye chips that emerged in recent years were summarized. It provides new inspiration and opportunity for the pathogenesis of eye diseases and personalized and precise treatment.
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88
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Wang X, He Q, Zhao X, Li H, Liu L, Wu D, Wei R. Assessment of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with high myopia. BMC Ophthalmol 2022; 22:464. [PMID: 36451140 PMCID: PMC9714010 DOI: 10.1186/s12886-022-02688-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Previous reports have suggested that inflammation levels play a crucial role in the pathogenesis of high myopia (HM). This study aimed to investigate the relationship between HM and systemic inflammation using the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). METHODS Overall, 100 age- and sex-matched participants were recruited for the study, including 50 participants each in the non-HM (NHM) and HM groups. Ocular examinations and blood tests were performed. The NLR and PLR values were calculated from complete blood counts. Receiver operating characteristic (ROC) curves and optimal cut-off values were used to determine the optimal values of the NLR and PLR to distinguish between the HM and NHM groups. RESULTS The values of NLR and PLR were significantly elevated in the HM group compared with those in the NHM group (P < 0.001 and P = 0.010, respectively). Axial length (AL) was significantly correlated with the NLR (r = 0.367, P < 0.001) and PLR (r = 0.262, P = 0.009). In the ROC analysis, the NLR value to distinguish between the HM and NHM groups was 0.728; the best cut-off value was 2.68, with 76% sensitivity and 62% specificity. The PLR value to distinguish between the HM and NHM groups was 0.650; the best cut-off value was 139.69, with 52% sensitivity and 76% specificity. CONCLUSION The findings of this study indicate that the development of HM may be associated with systemic inflammation measured using the NLR and PLR. TRIAL REGISTRATION The study was registered on December 28, 2021 ( http://www.chictr.org.cn ; ChiCTR2100054834).
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Affiliation(s)
- Xin Wang
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China ,grid.411642.40000 0004 0605 3760Beijing Yanqing District Hospital (Peking University Third Hospital Yanqing Hospital), No. 28, East Shuncheng Street, Yanqing District, Beijing, China
| | - Qing He
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China
| | - Xiaoyu Zhao
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China
| | - Haoru Li
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China
| | - Lin Liu
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China
| | - Di Wu
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China
| | - Ruihua Wei
- grid.412729.b0000 0004 1798 646XTianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Centre for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, No. 251, Fukang Road, Nankai District, Tianjin, 300384 China
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Finite element modeling of effects of tissue property variation on human optic nerve tethering during adduction. Sci Rep 2022; 12:18985. [PMID: 36347907 PMCID: PMC9643519 DOI: 10.1038/s41598-022-22899-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
Tractional tethering by the optic nerve (ON) on the eye as it rotates towards the midline in adduction is a significant ocular mechanical load and has been suggested as a cause of ON damage induced by repetitive eye movements. We designed an ocular finite element model (FEM) simulating 6° incremental adduction beyond the initial configuration of 26° adduction that is the observed threshold for ON tethering. This FEM permitted sensitivity analysis of ON tethering using observed material property variations in measured hyperelasticity of the anterior, equatorial, posterior, and peripapillary sclera; and the ON and its sheath. The FEM predicted that adduction beyond the initiation of ON tethering concentrates stress and strain on the temporal side of the optic disc and peripapillary sclera, the ON sheath junction with the sclera, and retrolaminar ON neural tissue. However, some unfavorable combinations of tissue properties within the published ranges imposed higher stresses in these regions. With the least favorable combinations of tissue properties, adduction tethering was predicted to stress the ON junction and peripapillary sclera more than extreme conditions of intraocular and intracranial pressure. These simulations support the concept that ON tethering in adduction could induce mechanical stresses that might contribute to ON damage.
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90
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Subudhi P, Subudhi BNR, Patro S, Sitaram S. Commentary: Endoexpression technique of nucleus delivery in manual small-incision cataract surgery. Indian J Ophthalmol 2022; 70:4064-4065. [PMID: 36308161 PMCID: PMC9907228 DOI: 10.4103/ijo.ijo_2237_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Praveen Subudhi
- Ruby Eye Hospital, Govinda Vihar, Berhampur, Odisha, India,Department of Ophthalmology, Hitech Medical College, Bhubaneswar, Odisha, India,Correspondence to: Dr. Praveen Subudhi, Ruby Eye Hospital, Govinda Vihar, Berhampur, Ganjam, Odisha, India. E-mail:
| | | | - Sweta Patro
- Ruby Eye Hospital, Govinda Vihar, Berhampur, Odisha, India
| | - Silla Sitaram
- Ruby Eye Hospital, Govinda Vihar, Berhampur, Odisha, India
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91
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Association between transforming growth factors-β and matrix metalloproteinases in the aqueous humor and plasma in myopic patients. J Fr Ophtalmol 2022; 45:1177-1183. [DOI: 10.1016/j.jfo.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022]
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92
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Li Y, Lu Y, Du K, Yin Y, Hu T, Fu Q, Zhang Y, Wen D, Wu X, Xia X. RNA-sequencing analysis reveals the long noncoding RNA profile in the mouse myopic retina. Front Genet 2022; 13:1014031. [PMID: 36313450 PMCID: PMC9606684 DOI: 10.3389/fgene.2022.1014031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/28/2022] [Indexed: 11/08/2023] Open
Abstract
Aim: Myopia is a prevalent public health problem. The long noncoding RNA (lncRNA) mechanisms for dysregulated retinal signaling in the myopic eye have remained elusive. The aim of this study was to analyze the expression profiles and possible pathogenic roles of lncRNAs in mouse form-deprived myopia (FDM) retinas. Methods: A mouse FDM model was induced and retinas from the FDM right eyes and the contralateral eyes were collected for RNA sequencing. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, and lncRNA-mRNA coexpression network analyses were conducted to explore the biological functions of the differentially expressed lncRNAs. In addition, the levels of differentially expressed lncRNAs in the myopic retinas were validated by quantitative real-time PCR (qRT-PCR). Fluorescence in situ hybridization (FISH) was used to detect the localization of lncRNAs in mouse retinas. Results: FDM eyes exhibited reduced refraction and increased ocular axial length compared to control fellow eyes. RNA sequencing revealed that there were 655 differentially expressed lncRNAs between the FDM and control retinas. Functional enrichment analysis indicated that the differentially expressed RNAs were mostly enriched in cellular processes, cytokine-cytokine receptor interactions, retinol metabolism, and rhythmic processes. Differentially expressed lncRNAs were validated by qRT-PCR. Additionally, RNA FISH showed that XR_384718.4 (Gm35369) localized in the ganglion cell (GCL) and inner nuclear layers (INL). Conclusion: This study identified the differential expression profiles of lncRNAs in myopic mouse retinas. Our results provide scientific evidence for investigations of myopia and the development of putative interventions in the future.
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Affiliation(s)
- Yuanjun Li
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ying Lu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Kaixuan Du
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yewei Yin
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tu Hu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qiuman Fu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yanni Zhang
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Dan Wen
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoying Wu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaobo Xia
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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93
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Guan C, Pease ME, Quillen S, Ling YTT, Li X, Kimball E, Johnson TV, Nguyen TD, Quigley HA. Quantitative Microstructural Analysis of Cellular and Tissue Remodeling in Human Glaucoma Optic Nerve Head. Invest Ophthalmol Vis Sci 2022; 63:18. [PMID: 36269186 PMCID: PMC9617510 DOI: 10.1167/iovs.63.11.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/23/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To measure quantitatively changes in lamina cribrosa (LC) cell and connective tissue structure in human glaucoma eyes. Methods We studied 27 glaucoma and 19 age-matched non-glaucoma postmortem eyes. In 25 eyes, LC cross-sections were examined by confocal and multiphoton microscopy to quantify structures identified by anti-glial fibrillary acidic protein (GFAP), phalloidin-labeled F-actin, nuclear 4',6-diamidino-2-phenylindole (DAPI), and by second harmonic generation imaging of LC beams. Additional light and transmission electron microscopy were performed in 21 eyes to confirm features of LC remodeling, including immunolabeling by anti-SOX9 and anti-collagen IV. All glaucoma eyes had detailed clinical histories of open-angle glaucoma status, and degree of axon loss was quantified in retrolaminar optic nerve cross-sections. Results Within LC pores, the proportionate area of both GFAP and F-actin processes was significantly lower in glaucoma eyes than in controls (P = 0.01). Nuclei were rounder (lower median aspect ratio) in glaucoma specimens (P = 0.02). In models assessing degree of glaucoma damage, F-actin process width was significantly wider in glaucoma eyes with more damage (P = 0.024), average LC beam width decreased with worse glaucoma damage (P = 0.042), and nuclear count per square millimeter rose with worse damage (P = 0.019). The greater cell count in LC pores represented 92.3% astrocytes by SOX9 labeling. The results are consistent with replacement of axons in LC pores by basement membrane labeled by anti-collagen IV and in-migrating astrocytes. Conclusions Alteration in LC structure in glaucoma involves migration of astrocytes into axonal bundles, change in astrocyte orientation and processes, production of basement membrane material, and thinning of connective tissue beams.
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Affiliation(s)
- Carolyn Guan
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Mary Ellen Pease
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Sarah Quillen
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Yik Tung Tracy Ling
- Departments of Mechanical Engineering and Materials Science & Engineering, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Ximin Li
- Department of Biostatistics, The Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Elizabeth Kimball
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Thomas V. Johnson
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Thao D. Nguyen
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
- Departments of Mechanical Engineering and Materials Science & Engineering, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Harry A. Quigley
- Wilmer Ophthalmological Institute, School of Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
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94
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Chou CC, Shih PJ, Wang CY, Jou TS, Chen JP, Wang IJ. Corvis Biomechanical Factor Facilitates the Detection of Primary Angle Closure Glaucoma. Transl Vis Sci Technol 2022; 11:7. [PMID: 36180025 PMCID: PMC9547358 DOI: 10.1167/tvst.11.10.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To characterize the corneal biomechanical properties of primary angle closure glaucoma (PACG) and to investigate the diagnostic performance of combining corneal biomechanical parameters and anterior segment parameters in detecting PACG. Methods This retrospective cross-sectional study evaluated 79 and 81 eyes of normal controls and patients with PACG, respectively. Corvis Biomechanical Factor (CBiF) and anterior chamber volume (ACV) were measured using the Corvis ST and Pentacam, respectively. We performed multivariable logistic regression, adjusted for age, sex, central corneal thickness, intraocular pressure, and ACV to evaluate the effect of CBiF on PACG. The area under the receiver operating curve (AUC) was calculated to compare the diagnostic performance of ACV, CBiF, and ACV-CBiF combination for detecting PACG. Results The median CBiF of the control and PACG groups was 6.61 (interquartile range [IQR], 6.39–6.88) and 6.20 (IQR, 5.93–6.48), respectively (P < 0.001). A lower CBiF, suggestive of decreased corneal biomechanical stability, increased the odds of PACG (odds ratio, 0.029; 95% confidence interval [CI], 0.003–0.266; P = 0.002) in the multivariable logistic regression model. The ACV–CBiF combination yielded the highest AUC (0.934; 95% CI, 0.882–0.968) compared with ACV alone (0.878; 95% CI, 0.823–0.928). The ACV-CBiF combination had significantly higher discriminatory ability than that of ACV alone (DeLong test, P = 0.004). Conclusions Lower CBiF and ACV may act as independent predictors for PACG. Combining ACV and CBiF may enhance detection of PACG. Translational Relevance The combination of corneal biomechanical parameters and anterior segment parameters enhances the detection of PACG.
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Affiliation(s)
- Chien-Chih Chou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Chun-Yuan Wang
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tzuu-Shuh Jou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center of Precision Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - I-Jong Wang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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95
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Vinas-Pena M, Feng X, Li GY, Yun SH. In situ measurement of the stiffness increase in the posterior sclera after UV-riboflavin crosslinking by optical coherence elastography. BIOMEDICAL OPTICS EXPRESS 2022; 13:5434-5446. [PMID: 36425630 PMCID: PMC9664890 DOI: 10.1364/boe.463600] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/16/2023]
Abstract
Scleral crosslinking may provide a way to prevent or treat myopia by stiffening scleral tissues. The ability to measure the stiffness of scleral tissues in situ pre and post scleral crosslinking would be useful but has not been established. Here, we tested the feasibility of optical coherence elastography (OCE) to measure shear modulus of scleral tissues and evaluate the impact of crosslinking on different posterior scleral regions using ex vivo porcine eyes as a model. From measured elastic wave speeds at 6 - 16 kHz, we obtained out-of-plane shear modulus value of 0.71 ± 0.12 MPa (n = 20) for normal porcine scleral tissues. After riboflavin-assisted UV crosslinking, the shear modulus increased to 1.50 ± 0.39 MPa (n = 20). This 2-fold change was consistent with the increase of static Young's modulus from 5.5 ± 1.1 MPa to 9.3 ± 1.9 MPa after crosslinking, which we measured using conventional uniaxial extensometry on tissue stripes. OCE revealed regional stiffness differences across the temporal, nasal, and deeper posterior sclera. Our results show the potential of OCE as a noninvasive tool to evaluate the effect of scleral crosslinking.
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96
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Hatami-Marbini H, Mehr JA. Modeling and experimental investigation of electromechanical properties of scleral tissue; a CEM model using an anisotropic hyperelastic constitutive relation. Biomech Model Mechanobiol 2022; 21:1325-1337. [PMID: 35962249 DOI: 10.1007/s10237-022-01590-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/01/2022] [Indexed: 12/15/2022]
Abstract
The sclera is a soft tissue primarily consisting of collagen fibers, elastin, and proteoglycans. The proteoglycans are composed of a core protein and negatively charged glycosaminoglycan side chains. The fixed electric charges inside the scleral extracellular matrix play a key role in its swelling and are expected to cause the tissue to deform in response to an electric field. However, the electroactive response of the sclera has not yet been investigated. The present work experimentally demonstrates that sclera behaves similar to an anionic electrosensitive hydrogel and develops a chemo-electro-mechanical (CEM) mathematical framework for its electromechanical response. In the numerical model, a hyperelastic constitutive law with distributed collagen fibers is used to capture the nonlinear mechanical properties of the sclera, and the coupled Poisson-Nernst-Planck equations represent the distribution of mobile ions throughout the domain. After calibrating the proposed numerical CEM model against the experimental measurements, we employ it to investigate the effects of different parameters on the scleral electromechanical response including the voltage and fixed charge density. The experimental and numerical findings of the present study confirm that sclera behaves as an electroactive hydrogel and provide new insight into the mechanical response of this ocular tissue.
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Affiliation(s)
- Hamed Hatami-Marbini
- Mechanical and Industrial Engineering Department, University of Illinois at Chicago, 2039 Engineering Research Facility, 842 West Taylor St, Chicago, IL, 60607, USA.
| | - Jafar Arash Mehr
- Mechanical and Industrial Engineering Department, University of Illinois at Chicago, 2039 Engineering Research Facility, 842 West Taylor St, Chicago, IL, 60607, USA
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97
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Hwang HB, Yeon JS, Moon GS, Jung HN, Kim JY, Jeon SH, Yoon JM, Kim HW, Kim YC. 3D Reconstruction of a Unitary Posterior Eye by Converging Optically Corrected Optical Coherence and Magnetic Resonance Tomography Images via 3D CAD. Transl Vis Sci Technol 2022; 11:24. [PMID: 35895054 PMCID: PMC9344223 DOI: 10.1167/tvst.11.7.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose In acquiring images of the posterior eye, magnetic resonance imaging (MRI) provides low spatial resolution of the overall shape of the eye while optical coherence tomography (OCT) offers high spatial resolution of the limited range. Through the merger of the two devices, we attempted to acquire detailed anatomy of the posterior eye. Methods Optical and display distortions in OCT images were corrected using the Listing reduced eye model. The 3.0T orbital MRI images were placed on the three-dimensional coordinate system of the computer-aided design (CAD) program. Employing anterior scleral canal opening, visual axis, and scleral curvature as references, original and corrected OCT images were ported into the CAD application. The radii of curvature of the choroid–scleral interfaces (Rc values) of all original and corrected OCT images were compared to the MRI images. Results Sixty-five eyes of 33 participants (45.58 ± 19.82 years) with a mean Rc of 12.94 ± 1.24 mm on axial MRI and 13.66 ± 2.81 mm on sagittal MRI were included. The uncorrected horizontal OCT (30.51 ± 9.34 mm) and the uncorrected vertical OCT (34.35 ± 18.09 mm) lengths differed significantly from the MRI Rc values (both P < 0.001). However, the mean Rc values of the corrected horizontal (12.50 ± 1.21 mm) and vertical (13.05 ± 1.98 mm) images did not differ significantly from the Rc values of the corresponding MRI planes (P = 0.065 and P = 0.198, respectively). Conclusions Features identifiable only on OCT and features only on MRI were successfully integrated into a unitary posterior eye. Translational Relevance Our CAD-based converging method may establish the collective anatomy of the posterior eye and the neural canal, beyond the range of the OCT.
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Affiliation(s)
- Hyung Bin Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | | | | | | | - Seung Hee Jeon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joon Myoung Yoon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Won Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Yong Chan Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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98
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Wu Y, Vora LK, Mishra D, Adrianto MF, Gade S, Paredes AJ, Donnelly RF, Singh TRR. Nanosuspension-loaded dissolving bilayer microneedles for hydrophobic drug delivery to the posterior segment of the eye. BIOMATERIALS ADVANCES 2022; 137:212767. [PMID: 35929230 DOI: 10.1016/j.bioadv.2022.212767] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 06/15/2023]
Abstract
Intravitreal injections (IVT) are regarded as the gold standard for effective delivery of hydrophobic drugs to the back of the eye. However, as a highly invasive procedure, the injection itself may lead to poor patient compliance and severe complications. In this research work, a hybrid system of nanosuspensions (NS) and dissolving microneedles (MNs) was developed as an alternative to conventional hypodermic needles used in IVT for minimally invasive transscleral delivery of hydrophobic drugs. NS of a hydrophobic drug, triamcinolone acetonide (TA), were fabricated using a wet milling technique. TA NS optimised by central composite factorial design had a proven diameter of 246.65 ± 8.55 nm. After optimisation, TA NS were incorporated into MN arrays to form a bilayer structure by high-speed centrifugation. TA NS-loaded MNs were robust enough to pierce excised porcine sclera with insertion depth higher than 80% of the needle height and showed rapid dissolution (<3 min). In contrast, the plain TA-loaded MNs exhibited poor mechanical and insertion performances and took more than 8 min to be fully dissolved in the scleral tissue. Importantly, transscleral deposition studies showed that 56.46 ± 7.76 μg/mm2 of TA was deposited into the sclera after 5 min of NS-loaded MN application, which was 4.5-fold higher than plain drug-loaded MNs (12.56 ± 2.59 μg/mm2). An ex vivo distribution study revealed that MN arrays could promote the transscleral penetration of hydrophobic molecules with higher drug concentrations observed in the deep layer of the sclera. Moreover, the developed TA NS-loaded MN array was biocompatible with ocular tissues, as demonstrated using the hens egg-chorioallantoic membrane assay and cytotoxicity test. The results presented here demonstrate that the hybrid system of NS and dissolving MNs can provide a novel and promising technology to alleviate retinal diseases in a therapeutically effective and minimally invasive manner.
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Affiliation(s)
- Yu Wu
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Lalitkumar K Vora
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Deepakkumar Mishra
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Muhammad Faris Adrianto
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Airlangga University, Surabaya, East Java 60115, Indonesia
| | - Shilpkala Gade
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Alejandro J Paredes
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Ryan F Donnelly
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Thakur Raghu Raj Singh
- School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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99
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Brown DM, Mazade R, Clarkson-Townsend D, Hogan K, Datta Roy PM, Pardue MT. Candidate pathways for retina to scleral signaling in refractive eye growth. Exp Eye Res 2022; 219:109071. [PMID: 35447101 PMCID: PMC9701099 DOI: 10.1016/j.exer.2022.109071] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 12/22/2022]
Abstract
The global prevalence of myopia, or nearsightedness, has increased at an alarming rate over the last few decades. An eye is myopic if incoming light focuses prior to reaching the retinal photoreceptors, which indicates a mismatch in its shape and optical power. This mismatch commonly results from excessive axial elongation. Important drivers of the myopia epidemic include environmental factors, genetic factors, and their interactions, e.g., genetic factors influencing the effects of environmental factors. One factor often hypothesized to be a driver of the myopia epidemic is environmental light, which has changed drastically and rapidly on a global scale. In support of this, it is well established that eye size is regulated by a homeostatic process that incorporates visual cues (emmetropization). This process allows the eye to detect and minimize refractive errors quite accurately and locally over time by modulating the rate of elongation of the eye via remodeling its outermost coat, the sclera. Critically, emmetropization is not dependent on post-retinal processing. Thus, visual cues appear to influence axial elongation through a retina-to-sclera, or retinoscleral, signaling cascade, capable of transmitting information from the innermost layer of the eye to the outermost layer. Despite significant global research interest, the specifics of retinoscleral signaling pathways remain elusive. While a few pharmacological treatments have proven to be effective in slowing axial elongation (most notably topical atropine), the mechanisms behind these treatments are still not fully understood. Additionally, several retinal neuromodulators, neurotransmitters, and other small molecules have been found to influence axial length and/or refractive error or be influenced by myopigenic cues, yet little progress has been made explaining how the signal that originates in the retina crosses the highly vascular choroid to affect the sclera. Here, we compile and synthesize the evidence surrounding three of the major candidate pathways receiving significant research attention - dopamine, retinoic acid, and adenosine. All three candidates have both correlational and causal evidence backing their involvement in axial elongation and have been implicated by multiple independent research groups across diverse species. Two hypothesized mechanisms are presented for how a retina-originating signal crosses the choroid - via 1) all-trans retinoic acid or 2) choroidal blood flow influencing scleral oxygenation. Evidence of crosstalk between the pathways is discussed in the context of these two mechanisms.
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Affiliation(s)
- Dillon M Brown
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Reece Mazade
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Danielle Clarkson-Townsend
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA; Gangarosa Department of Environmental Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA
| | - Kelleigh Hogan
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Pooja M Datta Roy
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Machelle T Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA.
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100
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Li J, Wang Y, Li D, Zhou N, Du A, Qin X, Hu J. Application of Allogeneic Sclera Combined with Tarso-conjunctival Flap in Total Excision of Divided Eyelid Nevus. J Plast Reconstr Aesthet Surg 2022; 75:3789-3794. [DOI: 10.1016/j.bjps.2022.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022]
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