Chapter 2 Molecular Approaches to the Study of the Na+,K+ -ATPase and Chloride Channels in the Ocular Ciliary Epithelium

Anatomical and physiological considerations in scleral lens wear: Intraocular pressure

Intraocular pressure (IOP) is maintained through complex and interrelated systems which control aqueous production and drainage, and it has been suggested that scleral lens (SL) wear may disrupt these vital homeostatic processes. This review provides an overview of anatomical and physiological processes that control IOP, identifies potential effects of SLs on these regulatory mechanisms, and examines studies that have attempted to quantify the effect of SLs on IOP. Lack of access to the cornea during SL wear makes accurate assessment of IOP challenging; therefore, a range of different assessment techniques and instruments have been employed to quantify IOP during and following SL wear. Some studies have evaluated IOP using standard techniques prior to lens application and following lens removal, or through a large central fenestration. Other studies have utilised instruments that facilitate assessment of IOP on the peripheral cornea or conjunctiva overlying the sclera (e.g. Schiotz, transpalpebral, and pneumatonometry). Two studies have recently evaluated changes in optic nerve structure during SL wear. Conflicting results have been reported on this topic, much of which examines changes in IOP in healthy subjects over limited periods of time. Currently, only a few studies have reported on long-term effects of SL wear on IOP in habitual SL wearers (after lens removal). Future research in this area must not only consider the fact that ocular conditions treated with SLs may potentially alter corneal biomechanical properties which can influence IOP, but also that these properties may be further altered by SL wear. Monitoring other risk factors for glaucoma (permanent alterations in optic nerve physiology, visual field defects) could provide a more comprehensive assessment of potentially increased risk of glaucomatous optic neuropathy due to SL wear. Ongoing clinical assessment of optic nerve structure and function is advisable in patients at risk for glaucoma who require SLs.

Hyposmotic activation of ICl,swell in rabbit nonpigmented ciliary epithelial cells involves increased ClC-3 trafficking to the plasma membrane

In mammalian nonpigmented ciliary epithelial (NPE) cells, hyposmotic stimulation leading to cell swelling activates an outwardly rectifying Cl(-) conductance (I(Cl,swell)), which, in turn, results in regulatory volume decrease. The aim of this study was to determine whether increased trafficking of intracellular ClC-3 Cl channels to the plasma membrane could contribute to the I(Cl,swell) following hyposmotic stimulation. Our results demonstrate that hyposmotic stimulation reversibly activates an outwardly rectifying Cl(-) current that is inhibited by phorbol-12-dibutyrate and niflumic acid. Transfection with ClC-3 antisense, but not sense, oligonucleotides reduced ClC-3 expression as well as I(Cl,swell). Intracellular dialysis with 2 different ClC-3 antibodies abolished activation of I(Cl,swell). Immunofluorescence microscopy showed that hyposmotic stimulation increased ClC-3 immunoreactivity at the plasma membrane. To determine whether this increased expression of ClC-3 at the plasma membrane could be due to increased vesicular trafficking, we examined membrane dynamics with the fluorescent membrane dye FM1-43. Hyposmotic stimulation rapidly increased the rate of exocytosis, which, along with ICl,swell, was inhibited by the phosphoinositide-3-kinase inhibitor wortmannin and the microtubule disrupting agent, nocodazole. These findings suggest that ClC-3 channels contribute to I(Cl,swell) following hyposmotic stimulation through increased trafficking of channels to the plasma membrane.