Refractive index degeneration in older lenses: A potential functional correlate to structural changes that underlie cataract formation

Estimating the astigmatic power of the crystalline lens and eye from ocular biometry

PURPOSE

To estimate the astigmatic power of the crystalline lens and the whole eye without phakometry using a set of linear equations and to provide estimates for the astigmatic powers of the crystalline lens surfaces.

METHODS

Linear optics expresses astigmatic powers in the form of matrices and uses paraxial optics and a 4 × 4 ray transfer matrix to generalise Bennett's method comprehensively to include astigmatic elements. Once this is established, the method is expanded to estimate the contributions of the front and back lens surfaces. The method is illustrated using two examples. The first example is of an astigmatic model eye and compares the calculated results to the original powers. In the second example, the method is applied to the biometry of a real eye with large lenticular astigmatism.

RESULTS

When the calculated powers for the astigmatic model eye were compared to the actual powers, the difference in the power of the eye was0.03 0.13 0.04 T D (where T represents the matrix transpose) and for the crystalline lens, the difference was0.08 0.29 0.08 T D (power vector format). A second example applies the method to a real eye, obtaining lenticular astigmatism of -5.84 × 175.

CONCLUSIONS

The method provides an easy-to-code way of estimating the astigmatic powers of the crystalline lens and the eye.

Insights into the biochemical and biophysical mechanisms mediating the longevity of the transparent optics of the eye lens

In the human eye, a transparent cornea and lens combine to form the "refracton" to focus images on the retina. This requires the refracton to have a high refractive index "n," mediated largely by extracellular collagen fibrils in the corneal stroma and the highly concentrated crystallin proteins in the cytoplasm of the lens fiber cells. Transparency is a result of short-range order in the spatial arrangement of corneal collagen fibrils and lens crystallins, generated in part by post-translational modifications (PTMs). However, while corneal collagen is remodeled continuously and replaced, lens crystallins are very long-lived and are not replaced and so accumulate PTMs over a lifetime. Eventually, a tipping point is reached when protein aggregation results in increased light scatter, inevitably leading to the iconic protein condensation-based disease, age-related cataract (ARC). Cataracts account for 50% of vision impairment worldwide, affecting far more people than other well-known protein aggregation-based diseases. However, because accumulation of crystallin PTMs begins before birth and long before ARC presents, we postulate that the lens protein PTMs contribute to a "cataractogenic load" that not only increases with age but also has protective effects on optical function by stabilizing lens crystallins until a tipping point is reached. In this review, we highlight decades of experimental findings that support the potential for PTMs to be protective during normal development. We hypothesize that ARC is preventable by protecting the biochemical and biophysical properties of lens proteins needed to maintain transparency, refraction, and optical function.

The Influence of Inflammation in Posterior Capsule Opacification Development

Cataract represents the reduction of the transparency of the crystalline lens. Cataract surgery is the most commonly performed surgical procedure worldwide. One of the most common postoperative complication of successfully performed cataract surgery is a development of posterior capsule opacification (PCO). In the postoperative period, lens epithelial cells (LECs) undergo proliferation, migration and differentiation, which is clinically manifested by the development of PCO. Inflammation has a central role in these processes. Cytokines, such as transforming growth factor β, fibroblast growth factor, interleukin 1, interleukin 6, matrix metalloproteinases have a huge effect on the activity of LECs. Understanding these processes can find a great usage in clinical practice. By prescribing anti-inflammatory therapy in the early postoperative period, the incidence of PCO can be significantly reduced.

Use of Human Pluripotent Stem Cells to Define Initiating Molecular Mechanisms of Cataract for Anti-Cataract Drug Discovery

Cataract is a leading cause of blindness worldwide. Currently, restoration of vision in cataract patients requires surgical removal of the cataract. Due to the large and increasing number of cataract patients, the annual cost of surgical cataract treatment amounts to billions of dollars. Limited access to functional human lens tissue during the early stages of cataract formation has hampered efforts to develop effective anti-cataract drugs. The ability of human pluripotent stem (PS) cells to make large numbers of normal or diseased human cell types raises the possibility that human PS cells may provide a new avenue for defining the molecular mechanisms responsible for different types of human cataract. Towards this end, methods have been established to differentiate human PS cells into both lens cells and transparent, light-focusing human micro-lenses. Sensitive and quantitative assays to measure light transmittance and focusing ability of human PS cell-derived micro-lenses have also been developed. This review will, therefore, examine how human PS cell-derived lens cells and micro-lenses might provide a new avenue for development of much-needed drugs to treat human cataract.

Carrier-free self-built aspirin nanorods as anti-aggregation agents towards alpha-crystallin-derived peptide aggregates: potential implications in non-invasive cataract therapy

The aggregation of the α-crystallin protein is the pathological hallmark of cataract. In the current work, peptide fragments derived from native α-crystallin were synthesized and explored as a peptide-based crystallin aggregation model towards cataract. The anti-aggregation potential of aspirin was evaluated towards these peptide-generated aggregates as well as towards the α-crystallin aggregate. The results demonstrated that aspirin had the capacity to inhibit crystallin and crystallin-derived peptide aggregation and could act as a potential therapeutic agent in mitigating cataract. Computational studies were also carried out to study the interaction between the model peptides and aspirin. The results revealed the existence of molecular interactions between the peptides and aspirin, which had a significant impact on the secondary structure of the peptides and potentially modulated their assembly and aggregation behavior. The formation of self-built aspirin nanorods was also explored and their ability to inhibit the aggregation of model cataract peptides and α-crystallin aggregation was validated. These findings open up the possibility of using small molecule-based nanotherapeutics for cataract merely through topical applications, which can be beneficial to cataract patients.

Off-axis optical coherence tomography imaging of the crystalline lens to reconstruct the gradient refractive index using optical methods

Earlier studies have shown that the gradient index of refraction (GRIN) of the crystalline lens can be reconstructed in vitro using Optical Coherence Tomography (OCT) images. However, the methodology cannot be extended in vivo because it requires accurate measurements of the external geometry of the lens. Specifically, the posterior surface is measured by flipping the lens so that the posterior lens surface faces the OCT beam, a method that cannot be implemented in vivo. When the posterior surface is imaged through the lens in its natural position, it appears distorted by the unknown GRIN. In this study, we demonstrate a method to reconstruct both the GRIN and the posterior surface shape without the need to flip the lens by applying optimization routines using both on-axis and off-axis OCT images of cynomolgous monkey crystalline lenses, obtained by rotating the OCT delivery probe from -45 to +45 degrees in 5 degree steps. We found that the GRIN profile parameters can be reconstructed with precisions up to 0.009, 0.004, 1.7 and 1.1 (nucleus and surface refractive indices, and axial and meridional power law, respectively), the radius of curvature within 0.089 mm and the conic constant within 0.3. While the method was applied on isolated crystalline lenses, it paves the way to in vivo lens GRIN and posterior lens surface reconstruction.

Simulation and analysis of light scattering by multilamellar bodies present in the human eye

A modified computational model of the human eye was used to obtain and compare different probability density functions, radial profiles of light pattern distributions, and images of the point spread function formed in the human retina under the presence of different kinds of particles inside crystalline lenses suffering from cataracts. Specifically, this work uses simple particles without shells and multilamellar bodies (MLBs) with shells. The emergence of such particles alters the formation of images on the retina. Moreover, the MLBs change over time, which affects properties such as the refractive index of their shell. Hence, this work not only simulates the presence of such particles but also evaluates the incidence of particle parameters such as particle diameter, particle thickness, and shell refractive index, which are set based on reported experimental values. In addition, two wavelengths (400 nm and 700 nm) are used for light passing through the different layers of the computational model. The effects of these parameters on light scattering are analyzed using the simulation results. Further, in these results, the effects of light scattering on image formation can be seen when single particles, early-stage MLBs, or mature MLBs are incorporated in the model. Finally, it is found that particle diameter has the greatest impact on image formation.