Three Common Assumptions About Ocular Blood Flow and Glaucoma

First insight into the proteome landscape of the porcine short posterior ciliary arteries: Key signalling pathways maintaining physiologic functions

Short posterior ciliary arteries (sPCA) provide the major blood supply to the optic nerve head. Emerging evidence has linked structural and functional anomalies of sPCA to the pathogenesis of several ocular disorders that cause varying degrees of visual loss, particularly anterior ischaemic optic neuropathy and glaucoma. Although the functional relevance of this vascular bed is well-recognized, the proteome of sPCA remains uncharacterized. Since the porcine ocular system closely resembles that of the human's and is increasingly employed in translational ophthalmic research, this study characterized the proteome of porcine sPCA employing the mass spectrometry-based proteomics strategy. A total of 1742 proteins and 10527 peptides were identified in the porcine sPCA. The major biological processes involved in the maintenance of physiological functions of the sPCA included redox and metabolic processes, and cytoskeleton organization. These proteins were further clustered into diverse signalling pathways that regulate vasoactivity of sPCA, namely the tight junction, α- and β-adrenoceptor, 14-3-3, nitric oxide synthase and endothelin-1 -mediated signalling pathways. This study provides the first insight into the complex mechanisms dictating the vast protein repertoire in normal vascular physiology of the porcine sPCA. It is envisioned that our findings will serve as important benchmarks for future studies of sPCA.

Anterior and posterior optic nerve head blood flow in nonhuman primate experimental glaucoma model measured by laser speckle imaging technique and microsphere method

PURPOSE

To characterize optic nerve head (ONH) blood flow (BF) changes in nonhuman primate experimental glaucoma (EG) using laser speckle flowgraphy (LSFG) and the microsphere method and to evaluate the correlation between the two methods.

METHODS

EG was induced in one eye each of 9 rhesus macaques by laser treatment to the trabecular meshwork. Prior to lasering and following onset of intraocular pressure (IOP) elevation, retinal never fiber layer thickness (RNFLT) and ONH BF were measured biweekly by spectral-domain optical coherence tomography and LSFG, respectively, until RNFLT loss was approximately 40% in the EG eye. Final BF was measured by LSFG and by the microsphere method in the anterior ONH (MS-BF(ANT)), posterior ONH (MS-BF(POST)), and peripapillary retina (MS-BF(PP)).

RESULTS

Baseline RNFLT and LSFG-BF showed no difference between the two eyes (P = 0.69 and P = 0.43, respectively, paired t-test). Mean (± SD) IOP was 30 ± 6 mm Hg in EG eyes and 13 ± 2 mm Hg in control eyes (P < 0.001). EG eye RNFLT and LSFG-BF were reduced by 42 ± 16% (P < 0.0001) and 22 ± 13% (P = 0.003), respectively, at the final time point. EG eye MS-BF(ANT), MS-BF(POST), and MS-BF(PP) were reduced by 41 ± 17% (P < 0.001), 22 ± 34% (P = 0.06), and 30 ± 12% (P = 0.001), respectively, compared with the control eyes. Interocular ONH LSFG-BF differences significantly correlated to that measured by the microsphere method (R(2) = 0.87, P < 0.001).

CONCLUSIONS

Chronic IOP elevation causes significant ONH BF decreases in the EG model. The high correlation between the BF reduction measured by LSFG and the microsphere method provides evidence that the LSFG is capable of assaying BF for a critical deep ONH region.

Comparison of choroidal thickness measured by two methods

AIM

To examine the profile of the choroidal thickness (CT) in healthy myopia subjects and emmetropic participants by Heidelberg Eye explore software and Image J software so as to compare the agreement and reproducibility of the two methods.

METHODS

Thirty-six study participants (36 eyes) were enrolled in this research. The fovea and parafoveal region (the region of 6mm diameter of the fovea as center) of the images were selected by spectral domain optic coherence tomography (SD-OCT). The choroidal thickness was measured manually by the Heidelberg Eye explore software (version 5.3.3.0, Heidelberg Engineering) with a vertical line and the Image J software with a line vertical to the retinal pigment epithelial layer. The agreement and reproducibility of the two methods were described by the Bland-Altmann analysis.

RESULTS

As compared with Heidelberg Eye explore software (39.9186), the repeatability coefficient is lower calculated by Image J software (27.3525). The Bland-Altmann analysis showed that the limits of 95% CI of agreement analysis is -18.437-63.949µm and the upper limits of the precision of the 95% CI of agreement is between 16.102 and 111.796µm and the lower limits is range from -66.29-21.41µm, which reflected a great variations of the difference.

CONCLUSION

The repeatability and agreement of measurement implied by Image J software was better than the Heidelberg Eye explore software. The Image J software should be used for measuring the choroidal thickness in future study in China.

Choroidal and Photoreceptor Layer Thickness in Myopic Population

Purpose

This study examined the profile of the choroidal thickness and photoreceptor layer thickness (PRLT) in healthy myopia subjects, with an attempt to find the connection between change of the choroidal thickness and retinal thickness changes.

Methods

A total of 64 study participants (64 eyes) were divided into 3 groups in terms of their refractive status: normal sight group (+1.0 D˜−1.0 D), mild or moderate myopia group (−1.0 D˜−6.0 D), high myopia group (>−6.0 D). The fovea and parafoveal region (the region of 6 mm diameter of the fovea as center) of the images were selected by spectral domain optical coherence tomography. A circle of retinal pigment epithelium (RPE) layer simulated by applying the least square curve fitting technique was obtained. Along the vertical direction of the RPE layer, choroidal thickness (choroidal thickness involved the total thickness at the fovea and parafoveal), PRLT, retinal thickness (RT), ganglion layer thickness (GLT), and retinal nerve fiber layer thickness (RNFLT) in the fovea (PRLT-f, RT-f) or in the parafoveal region (PRLT-pf, RT-pf, GLT and RNFLT) were calculated by Image J software manually.

Results

As compared with group 1, PRLT-pf, RT-pf, and choroidal thickness were significantly reduced (p<0.05) in group while no significant difference was found in PRLT-f, RT-f, GLT, and RNFLT between the 2 groups. Both univariate and forward multivariate linear regression analysis showed that PRLT-pf and choroidal thickness intertwined obviously.

Conclusions

In high myopia subjects, not only choroidal thickness, but also photoreceptor layer thickness in the parafoveal region decreased significantly. On the basis of neuron vascular unit theory, the change in choroidal thickness is significantly related to the alternation in PRLT and vice versa.

Hemoglobin expression and regulation in glaucoma: insights into retinal ganglion cell oxygenation

PURPOSE

To determine expression, cellular distribution, and regulation of hemoglobin (Hb) in normal and glaucomatous tissues.

METHODS

Proteomic analysis of Hb expression was conducted on protein samples from ocular hypertensive and control rat eyes and human donor eyes with or without glaucoma. Proteomic findings were validated by quantitative (q)RT-PCR, Western blot analysis, immunohistochemistry, and the analysis of new Hb synthesis in culture. Hypoxic regulation of Hb expression was also studied in primary cultures of rat RGCs and macroglia and after transfer of the glia-conditioned medium to RGCs. The role of erythropoietin (EPO) signaling in Hb induction and cell survival was determined by applying recombinant (r)EPO treatment and performing EPO neutralization experiments by using soluble EPO receptor treatment of hypoxic cultures.

RESULTS

In vivo findings revealed Hb expression in the retina and optic nerve head macroglia and RGCs, suggesting an approximately two-fold upregulation in ocular hypertensive rat eyes and glaucomatous human donor eyes relative to the control eyes. In vitro findings collectively supported that hypoxia boosts glial Hb expression through hypoxia-inducible EPO signaling in an autocrine manner. Based on passive transfer experiments, hypoxia-induced production of glial EPO was also found to upregulate Hb expression in RGCs in a paracrine manner, thereby increasing the hypoxic survival of these neurons.

CONCLUSIONS

Findings of this study provide new insights into tissue oxygen transport in the inner retina and optic nerve head through the regulated expression of Hb in macroglia and RGCs. Upregulation of Hb expression appears to be an intrinsic protective mechanism to facilitate cellular oxygenation and may also provide free radical scavenging.

Depletion of taurine and glutamate from damaged photoreceptors in the retinas of dogs with primary glaucoma

OBJECTIVE

To determine whether taurine and glutamate contents are reduced in damaged photoreceptors in dogs with primary glaucoma (PG) in a manner consistent with an ischemia-like release of both of these amino acids from damaged cells.

SAMPLE POPULATION

Retinas from 6 dogs with PG and 3 control dogs.

PROCEDURE

Serial, semithin sections of each canine retina were stained with toluidine blue to identify damaged photoreceptors or via immunogold techniques to quantify taurine and glutamate content in retinal cells.

RESULTS

Regions with a thin outer nuclear layer and pathologic nuclear changes in photoreceptors were evident in retinas of dogs with PG. The density of immunostaining for taurine in damaged photoreceptors was significantly reduced to (mean +/- SEM) 37.5 +/- 2.6% of the density in adjacent undamaged photoreceptors. Photoreceptors with decreased taurine immunostaining also had decreased glutamate immunostaining, consistent with ischemia-like release of both of these amino acids from damaged cells. Immunostaining for glutamate, but not taurine, was increased in presumptive radial glial cells (i.e., Miller cells) in damaged regions, consistent with an ischemia-induced redistribution of amino acids in dogs with PG.

CONCLUSIONS AND CLINICAL RELEVANCE

Retinal damage in dogs with PG includes ischemia-like losses of taurine and glutamate from photoreceptors and accumulation of glutamate, but not taurine, in nearby Müller cells. These changes are consistent with glutamate release and depletion of intracellular taurine in damaged regions, perhaps contributing to progressive damage in these areas.

[Evaluation of focal arteriolar narrowing of retinal arterioles in glaucoma]

PURPOSE

Vascular risk factors seem to play a role in the pathogenesis of glaucoma. This study was performed to compare the prevalence of focal arteriolar narrowing in glaucoma patients and normals.

MATERIAL AND METHODS

Stereoscopic optic disc photographs of 40 normal subjects and 14 primary open-angle glaucoma (POAG) patients were reviewed independently in a masked fashion by two graders. Focal arteriolar narrowing within one disc diameter from the rim edge was evaluated based on two different methods: narrowing present if (1) the arteriole was wider distal to the narrowing and (2) if the arteriole was wider both distal and proximal to the narrowing.

RESULTS

With both methods, focal arteriolar narrowing was significantly higher in glaucoma versus normal eyes. Focal arteriolar narrowing was observed with definition 1 in 35.0% of normals and 71.4% of POAG patients and with definition 2 in 12.5% of normals and 42.9% of POAG patients.

CONCLUSIONS

Focal arteriolar narrowing is more frequent in glaucoma patients than in normals. Independent of the method for assessing arteriolar narrowing, however, the diagnostic value of arteriolar narrowing seems limited due to the high incidence in normals.

Differential effects of ischemia/reperfusion on amacrine cell subtype-specific transcript levels in the rat retina

Transient retinal ischemia induces loss of retinal ganglion cells, supporting the hypothesis that ischemic conditions contribute to the induction and progression of glaucoma. However, after 60 min of ischemia, also amacrine cells are lost from the inner nuclear layer. The main goal was to determine the relative vulnerability of various amacrine subpopulations by measuring the levels of transcripts that are known to be specifically expressed by different amacrine subpopulations. A 60-min ischemic period was administered to the rat eye by raising the intraocular pressure, followed by a reperfusion period lasting between 2 h and 4 weeks. Total RNA was isolated from the whole retina and expression levels were assessed by real-time quantitative polymerase chain reaction (qPCR). Retinal ischemia/reperfusion has differential effects on the levels of the various transcripts. Three main patterns of changes were identified. (i) A gradual decrease of transcript level without recovery was observed for parvalbumin; this transcript is expressed by the glycinergic AII cells. (ii) A gradual reduction to different levels at 72 h of reperfusion followed by a partial or complete recovery (glycine transporter 1, glutamate decarboxylase, calretinin, and several other transcripts). The glycinergic amacrine cell markers recovered to 65-75% of the control level, while the main GABAergic markers had completely recovered at 4 weeks. (iii) No significant changes of transcript levels were found for markers of several smaller GABAergic subpopulations [including substance P (Tac1), somatostatin, and others]. Expression levels of photoreceptor-, horizontal cell-, and bipolar cell-specific transcripts were not altered. These patterns were confirmed by a cluster analysis of the data. Based on gene expression levels, it may be concluded that amacrine cells are vulnerable to ischemic insults and that the glycinergic amacrine cells are relatively more sensitive to ischemia than the GABAergic population. In particular, the extensive loss of the parvalbumin-containing AII amacrine cells, which serve in the rod pathway, may have functional implications for vision under scotopic conditions. In the accompanying paper [F. Dijk and W. Kamphuis, An immunocytochemical study on specific amacrine subpopulations in the rat retina after ischemia, Brain Res. (2004).], the results are evaluated at the protein level by immunostaining for a selection of the amacrine cell markers.

Evaluation of glutamate loss from damaged retinal cells of dogs with primary glaucoma

OBJECTIVE

To determine whether retinal damage in dogs with primary glaucoma (PG) is consistent with ischemia-induced glutamate toxicosis.

SAMPLE POPULATION

Retinal tissue sections from 25 dogs with PG and 12 normotensive control dogs.

PROCEDURE

Retinal sections from control and glaucomatous dogs were stained for morphometric and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) analyses to determine whether retinal damage was consistent with glutamate toxicosis. Immunohistochemical analysis was performed to detect ischemia-like loss of glutamate from neurons in damaged areas.

RESULTS

In severely damaged glaucomatous retinas, all neurosensory layers had focal regions that were thin or disrupted. There was less thinning of the outer nuclear layer (ONL) and inner nuclear layer (INL) in moderately damaged retinas than in severely damaged retinas. Acute signs of damage in the INL included cells with dark, condensed chromatin and lightly stained cytoplasm interspersed with a few TUNEL-positive cells, which was consistent with glutamate toxicosis. Glutamate immunoreactivity was reduced in thin areas and in damaged cells of the INL and ONL, which was consistent with glutamate release in damaged areas. Glutamate immunoreactivity was increased in putative Müller cells in damaged areas, which also was consistent with glutamate release.

CONCLUSIONS AND CLINICAL RELEVANCE

Retinal damage in dogs with PG differs in intensity in focal areas. Damage in affected regions resembles damage induced by glutamate. Glutamate is lost from damaged neurons and accumulates in Müller cells, which is consistent with increased glutamate release contributing to the damage. Glutamate antagonists may protect INL cells in dogs with glaucoma.

In vivo dynamic human retinal blood flow imaging using ultra-high-speed spectral domain optical coherence tomography

An ultra-high-speed spectral domain optical Doppler tomography (SD-ODT) system is used to acquire images of blood flow in a human retina in vivo, at 29,000 depth profiles (A-lines) per second and with data acquisition over 99% of the measurement time. The phase stability of the system is examined and image processing algorithms are presented that allow accurate determination of bi-directional Doppler shifts. Movies are presented of human retinal flow acquired at 29 frames per second with 1000 A-lines per frame over a time period of 3.28 seconds, showing accurate determination of vessel boundaries and time-dependent bi-directional flow dynamics in artery-vein pairs. The ultra-high-speed SD-ODT system allows visualization of the pulsatile nature of retinal blood flow, detects blood flow within the choroid and retinal capillaries, and provides information on the cardiac cycle. In summary, accurate video rate imaging of retinal blood flow dynamics is demonstrated at ocular exposure levels below 600 microW.

Effects of intraocular injection of a low concentration of zinc on the rat retina

The main aim of this study was to investigate whether intraocular injection of low concentrations of zinc (no greater than 10 microM) aid the survival of ganglion cells in the rat retina after excitotoxic (NMDA) and ischemia/reperfusion injuries. We also determined whether low amounts of zinc cause any detectable retinal toxicity. Intraocular injection of NMDA caused substantial reductions in the mRNA levels of the ganglion cell-specific markers Thy-1 and neurofilament light (NF-L). Co-injection of 0.1 or 1 nmol zinc neither diminished nor exacerbated the effect of NMDA on the levels of these mRNAs. Likewise, ischemia/reperfusion caused significant decreases in the levels of Thy-1 and NF-L mRNAs and in the b-wave amplitude of the electroretinogram. These effects were not counteracted by injection of zinc. Intraocular injection of NMDA caused marked toxicological effects in retinal glial cells, including upregulations of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), glial fibrial acidic protein (GFAP), basic fibroblast growth factor (FGF-2) and ciliary neurotrophic factor (CNTF). Interestingly, injection of 1 nmol zinc caused no changes in the levels of COX-2 and iNOS, yet produced similar, although quantitatively less pronounced, changes in FGF-2, GFAP and CNTF. The upregulations of FGF-2 and CNTF suggest that increasing zinc intake may benefit injured retinal neurons. However, this was not found to be the case in the present studies, perhaps due to the acute nature of the injury paradigms utilised.