Imaging light-modulated release of synaptic vesicles in the intact retina: retinal physiology at the dawn of the post-electrode era

Recent Innovations in Medical and Surgical Retina

PURPOSE

To highlight recent innovations in the medical and surgical treatment of retinal disease.

DESIGN

Retrospective literature review.

METHODS

The peer-reviewed, published (during 2012) English literature was searched using the Medline database. Articles deemed relevant were selected and highlighted.

RESULTS

A number of important innovations in the treatment of retinal disease have occurred during the past year. We review developments in regenerative medicine (e.g., retinal prosthesis, optogenetics, cell-based therapy), diagnostics (e.g., swept source optical coherence tomography [OCT], intraoperative OCT, multimodal imaging), surgical innovations (e.g., chemical vitreolysis with ocriplasmin, 27-gauge vitrectomy), and pharmacological therapy of retinal vascular disease (e.g., use of ranibizumab and aflibercept in the treatment of macular edema associated with diabetic retinopathy and retinal vein occlusion).

CONCLUSIONS

Many important innovations in regenerative medicine, diagnostic and surgical instrumentation, and pharmacological therapy for retinal vascular disease have occurred during the past year. In view of the number of agents in early phase clinical trials (e.g., treatments for dry age-related macular degeneration) as well as technologies under development (e.g., microrobots for vitreous surgery), this trend will continue.

Nanomedicine in ophthalmology: the new frontier

PURPOSE

To review the fields of nanotechnology and nanomedicine as they relate to the development of treatments for vision-threatening disorders.

DESIGN

Perspective following literature review.

METHODS

Analysis of relevant publications in the peer-reviewed scientific literature.

RESULTS

Nanotechnology involves the creation and use of materials and devices at the size scale of intracellular structures and molecules and involves systems and constructs on the order of <100 nm. The aim of nanomedicine is the comprehensive monitoring, control, construction, repair, defense, and improvement of human biological systems at the molecular level, using engineered nanodevices and nanostructures, operating massively in parallel at the single cell level, ultimately to achieve medical benefit. The earliest impact of nanomedicine is likely to involve the areas of biopharmaceuticals (eg, drug delivery, drug discovery), implantable materials (eg, tissue regeneration scaffolds, bioresorbable materials), implantable devices (eg, intraocular pressure monitors, glaucoma drainage valves), and diagnostic tools (eg, genetic testing, imaging, intraocular pressure monitoring). Nanotechnology will bring about the development of regenerative medicine (ie, replacement and improvement of cells, tissues, and organs), ultrahigh-resolution in vivo imaging, microsensors and feedback devices, and artificial vision. "Regenerative nanomedicine," a new subfield of nanomedicine, uses nanoparticles containing gene transcription factors and other modulating molecules that allow for the reprogramming of cells in vivo.

CONCLUSIONS

Nanotechnology already has been applied to the measurement and treatment of different disease states in ophthalmology (including early- and late-stage disease), and many additional innovations will occur during the next century.

Light regulation of Ca2+ in the cone photoreceptor synaptic terminal

Retinal cones are depolarized in darkness, keeping voltage-gated Ca2+ channels open and sustaining exocytosis of synaptic vesicles. Light hyperpolarizes the membrane potential, closing Ca2+ channels and suppressing exocytosis. Here, we quantify the Ca2+ concentration in cone terminals, with Ca2+ indicator dyes. Two-photon ratiometric imaging of fura-2 shows that global Ca2+ averages approximately 360 nM in darkness and falls to approximately 190 nM in bright light. Depolarizing cones from their light to their dark membrane potential reveals hot spots of Ca2+ that co-label with a fluorescent probe for the synaptic ribbon protein ribeye, consistent with tight localization of Ca2+ channels near ribbons. Measurements with a low-affinity Ca2+ indicator show that the local Ca2+ concentration near the ribbon exceeds 4 M in darkness. The high level of Ca2+ near the ribbon combined with previous estimates of the Ca2+ sensitivity of release leads to a predicted dark release rate that is much faster than observed, suggesting that the cone synapse operates in a maintained state of synaptic depression in darkness.

Synaptic Ca2+ in darkness is lower in rods than cones, causing slower tonic release of vesicles

Rod and cone photoreceptors use specialized biochemistry to generate light responses that differ in their sensitivity and kinetics. However, it is unclear whether there are also synaptic differences that affect the transmission of visual information. Here, we report that in the dark, rods tonically release synaptic vesicles at a much slower rate than cones, as measured by the release of the fluorescent vesicle indicator FM1-43. To determine whether slower release results from a lower Ca2+ sensitivity or a lower dark concentration of Ca2+, we imaged fluorescent indicators of synaptic vesicle cycling and intraterminal Ca2+. We report that the Ca2+ sensitivity of release is indistinguishable in rods and cones, consistent with their possessing similar release machinery. However, the dark intraterminal Ca2+ concentration is lower in rods than in cones, as determined by two-photon Ca2+ imaging. The lower level of dark Ca2+ ensures that rods encode intensity with a slower vesicle release rate that is better matched to the lower information content of dim light.