Time dependent degradation of vitreous gel under enzymatic reaction: Polymeric network role in fluid properties

An Inverse Method to Determine Mechanical Parameters of Porcine Vitreous Bodies Based on the Indentation Test

The vitreous body keeps the lens and retina in place and protects these tissues from physical insults. Existing studies have reported that the mechanical properties of vitreous body varied after liquefaction, suggesting mechanical properties could be effective parameters to identify vitreous liquefaction process. Thus, in this work, we aimed to propose a method to determine the mechanical properties of vitreous bodies. Fresh porcine eyes were divided into three groups, including the untreated group, the 24 h liquefaction group and the 48 h liquefaction group, which was injected collagenase and then kept for 24 h or 48 h. The indentation tests were carried out on the vitreous body in its natural location while the posterior segment of the eye was fixed in the container. A finite element model of a specimen undertaking indentation was constructed to simulate the indentation test with surface tension of vitreous body considered. Using the inverse method, the mechanical parameters of the vitreous body and the surface tension coefficient were determined. For the same parameter, values were highest in the untreated group, followed by the 24 h liquefaction group and the lowest in the 48 h liquefaction group. For C₁₀ in the neo-Hookean model, the significant differences were found between the untreated group and liquefaction groups. This work quantified vitreous body mechanical properties successfully using inverse method, which provides a new method for identifying vitreous liquefactions related studies.

The Roles of Vitreous Biomechanics in Ocular Disease, Biomolecule Transport, and Pharmacokinetics

PURPOSE

The biomechanical properties of the vitreous humor and replication of these properties to develop substitutes for the vitreous humor have rapidly become topics of interest over the last two decades. In particular, the behavior of the vitreous humor as a viscoelastic tissue has been investigated to identify its role in a variety of processes related to biotransport, aging, and age-related pathologies of the vitreoretinal interface.

METHODS

A thorough search and review of peer-reviewed publications discussing the biomechanical properties of the vitreous humor in both human and animal specimens was conducted. Findings on the effects of biomechanics on vitreoretinal pathologies and vitreous biotransport were analyzed and discussed.

RESULTS

The pig and rabbit vitreous have been found to be most mechanically similar to the human vitreous. Age-related liquefaction of the vitreous creates two mechanically unique phases, with an overall effect of softening the vitreous. However, the techniques used to acquire this mechanical data are limited by the in vitro testing methods used, and the vitreous humor has been hypothesized to behave differently in vivo due in part to its swelling properties. The impact of liquefaction and subsequent detachment of the vitreous humor from the posterior retinal surface is implicated in a variety of tractional pathologies of the retina and macula. Liquefaction also causes significant changes in the biotransport properties of the eye, allowing for significantly faster movement of molecules compared to the healthy vitreous. Recent developments in computational and ex vivo models of the vitreous humor have helped with understanding its behavior and developing materials capable of replacing it.

CONCLUSIONS

A better understanding of the biomechanical properties of the vitreous humor and how these relate to its structure will potentially aid in improving clinical metrics for vitreous liquefaction, design of biomimetic vitreous substitutes, and predicting pharmacokinetics for intravitreal drug delivery.

Novel vitreous substitutes: the next frontier in vitreoretinal surgery

PURPOSE OF REVIEW

After removing the native vitreous during vitreoretinal surgery, an adequate substitute is required to ensure homeostasis of the eye. Current clinically used endotamponades (silicone oil, gases, semifluorinated alkanes) are effective in promoting retinal reattachment, but lead to complications such as emulsification, prolonged inflammation, blurred vision, raised intraocular pressure, cataract formation or the need for revision surgery. The aim of this review is to provide an update on novel vitreous substitutes with a focus on polymer-based systems.

RECENT FINDINGS

Polymeric hydrogels provide favourable properties such as high water content, optical transparency, suitable refractive indices and densities, adjustable rheological properties, injectability, biocompatibility and their ability to tamponade the retina via viscosity and swelling pressure, comparable to the native human vitreous body. Here, vitreous replacement strategies can be divided into chemically or physically crosslinked hydrogel systems that are applied as preformed or in-situ gelling matrices.

SUMMARY

Several hydrogel-based vitreous substitutes have already been positively evaluated in preclinical tests and have the potential to enter the clinical phase soon.

The effects of aging on the mechanical properties of the vitreous

The vitreous body is a viscoelastic gel-like network that fills the space between the lens and the retina in the eye. With aging, the vitreous undergoes a liquefaction process in which liquid pockets form in the gel network, thereby motivating the detachment of the vitreous from the retina in a process known as posterior vitreous detachment (PVD). The PVD process may lead to the formation of floaters and even result in partial or complete loss of vision. Experiments show that the liquefaction and the PVD processes alter the mechanical properties of the vitreous. In this work, we propose a microscopically motivated model that characterizes the changes in the mechanical properties of the vitreous due to aging. To this end, we distinguish between four vitreous states: a homogeneous vitreous, a liquefied vitreous, a vitreous that undergoes partial PVD, and a vitreous with full PVD. The model predicts the time-dependent and the steady-state response of the vitreous in each of the four states. The proposed framework is validated through a comparison with various experimental findings and captures the softening of the vitreous due to aging. We illustrate the importance of the age at which the PVD process begins and of the rate of the detachment process. In addition, we introduce a quantifiable parameter that describes the stage of PVD in the eye. Lastly, we employ our model to investigate the possibility of restoring the mechanical properties of a vitreous that has undergone PVD through the addition of reinforcing fibers to the gel. This work provides insight into the consequences of the age-related changes in the microstructure of the eye and serves as a motivation for new therapeutic measures.

Macro- and Microscale Properties of the Vitreous Humor to Inform Substitute Design and Intravitreal Biotransport

Research on the vitreous humor and development of hydrogel vitreous substitutes have gained a rapid increase in interest within the past two decades. However, the properties of the vitreous humor and vitreous substitutes have yet to be consolidated. In this paper, the mechanical properties of the vitreous humor and hydrogel vitreous substitutes were systematically reviewed. The number of publications on the vitreous humor and vitreous substitutes over the years, as well as their respective testing conditions and testing techniques were analyzed. The mechanical properties of the human vitreous were found to be most similar to the vitreous of pigs and rabbits. The storage and loss moduli of the hydrogel vitreous substitutes developed were found to be orders of magnitude higher in comparison to the native human vitreous. However, the reported modulus for human vitreous, which was most commonly tested in vitro, has been hypothesized to be different in vivo. Future studies should focus on testing the mechanical properties of the vitreous in situ or in vivo. In addition to its mechanical properties, the vitreous humor has other biotransport mechanisms and biochemical functions that establish a redox balance and maintain an oxygen gradient inside the vitreous chamber to protect intraocular tissues from oxidative damage. Biomimetic hydrogel vitreous substitutes have the potential to provide ophthalmologists with additional avenues for treating and controlling vitreoretinal diseases while preventing complications after vitrectomy. Due to the proximity and interconnectedness of the vitreous humor to other ocular tissues, particularly the lens and the retina, more interest has been placed on understanding the properties of the vitreous humor in recent years. A better understanding of the properties of the vitreous humor will aid in improving the design of biomimetic vitreous substitutes and enhancing intravitreal biotransport.