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Scarabosio A, Surico PL, Tereshenko V, Singh RB, Salati C, Spadea L, Caputo G, Parodi PC, Gagliano C, Winograd JM, Zeppieri M. Whole-eye transplantation: Current challenges and future perspectives. World J Transplant 2024; 14:95009. [PMID: 38947970 PMCID: PMC11212585 DOI: 10.5500/wjt.v14.i2.95009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/24/2024] [Accepted: 05/15/2024] [Indexed: 06/13/2024] Open
Abstract
Whole-eye transplantation emerges as a frontier in ophthalmology, promising a transformative approach to irreversible blindness. Despite advancements, formidable challenges persist. Preservation of donor eye viability post-enucleation necessitates meticulous surgical techniques to optimize retinal integrity and ganglion cell survival. Overcoming the inhibitory milieu of the central nervous system for successful optic nerve regeneration remains elusive, prompting the exploration of neurotrophic support and immunomodulatory interventions. Immunological tolerance, paramount for graft acceptance, confronts the distinctive immunogenicity of ocular tissues, driving research into targeted immunosuppression strategies. Ethical and legal considerations underscore the necessity for stringent standards and ethical frameworks. Interdisciplinary collaboration and ongoing research endeavors are imperative to navigate these complexities. Biomaterials, stem cell therapies, and precision immunomodulation represent promising avenues in this pursuit. Ultimately, the aim of this review is to critically assess the current landscape of whole-eye transplantation, elucidating the challenges and advancements while delineating future directions for research and clinical practice. Through concerted efforts, whole-eye transplantation stands to revolutionize ophthalmic care, offering hope for restored vision and enhanced quality of life for those afflicted with blindness.
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Affiliation(s)
- Anna Scarabosio
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
- Department of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Pier Luigi Surico
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, United States
| | - Vlad Tereshenko
- Department of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Rohan Bir Singh
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, United States
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Glenda Caputo
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
| | - Pier Camillo Parodi
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy
- Eye Clinic Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi 95121 Catania, Italy
| | - Jonathan M Winograd
- Department of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Eltanahy AM, Franco C, Jeyaraj P, Goswami S, Hughes E, Gonzales AL. Ex vivo ocular perfusion model to study vascular physiology in the mouse eye. Exp Eye Res 2023; 233:109543. [PMID: 37390954 PMCID: PMC10637262 DOI: 10.1016/j.exer.2023.109543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/30/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
Several hypotheses have been tested to understand whole organ regulation in other organs such as the brain and kidney, but no such hypothesis has yet been proposed for ocular circulations. To some extent resolve this deficit our ex vivo mouse eye perfusion model takes the first step in elucidating the mechanisms controlling the individual components of the ocular circulation. Various isolated ocular vascular preparations have been utilized in studies of ocular vascular biology, physiology, and pharmacology, including studies on both normal and pathological conditions. However, there is still significant potential for further studies to improve our understanding of ocular circulation and its regulation. The choroid specifically is inaccessible to direct visualization due to the retina's high metabolic requirement with a transparency that cannot be compromised by an overly rich vascular network on the inner retinal side hindering the visualization of the choroid. In this technical paper, we provide a detailed description of all the steps to be followed from the enucleation of mouse eyes to cannulation of the ophthalmic artery and perfusion and ex vivo confocal microscopy imaging of the dynamic nature of the choroid circulation.
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Affiliation(s)
- Ahmed M Eltanahy
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557-0318, USA
| | - Cristian Franco
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557-0318, USA
| | - Priscilla Jeyaraj
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557-0318, USA
| | - Shipra Goswami
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557-0318, USA
| | - Elena Hughes
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557-0318, USA
| | - Albert L Gonzales
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557-0318, USA.
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Zhu Y, Cao B, Tolone A, Yan J, Christensen G, Arango-Gonzalez B, Ueffing M, Paquet-Durand F. In vitro Model Systems for Studies Into Retinal Neuroprotection. Front Neurosci 2022; 16:938089. [PMID: 35873807 PMCID: PMC9301112 DOI: 10.3389/fnins.2022.938089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Therapy development for neurodegenerative diseases of the retina constitutes a major unmet medical need, and this may be particularly relevant for inherited diseases of the retina, which are largely untreatable to this day. Therapy development necessitates appropriate models to improve the understanding of the underlying degenerative mechanisms, as well as for the testing and evaluation of novel treatment approaches. This review provides an overview of various in vitro model systems used to study retinal neuroprotection. The in vitro methods and technologies discussed range from primary retinal cell cultures and cell lines, to retinal organoids and organotypic retinal explants, to the cultivation of whole eyeballs. The advantages and disadvantages of these methods are compared and evaluated, also in view of the 3R principles (i.e., the refinement, reduction, and replacement of live animal testing), to identify suitable in vitro alternatives for in vivo experimentation. The article further expands on the use of in vitro models to test and evaluate neuroprotective treatments and to aid the development of retinal drug delivery systems. Among the pharmacological agents tested and characterized in vitro are such that interfere with aberrant cyclic guanosine monophosphate (cGMP) -signaling or such that inhibit the activities of poly (ADP-ribose) polymerase (PARP), histone deacetylases (HDAC), calpain-type proteases, as well as unfolded protein response-related stress. We then introduce nanoparticle-based drug delivery systems and discuss how different in vitro systems may be used to assess their efficacy in the treatment of retinal diseases. The summary provides a brief comparison of available in vitro models and relates their advantages and limitations to the various experimental requirements, for instance, for studies into disease mechanisms, novel treatments, or retinal toxicity. In many cases, combinations of different in vitro models may be required to obtain a comprehensive view of the efficacy of a given retinal neuroprotection approach.
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Affiliation(s)
- Yu Zhu
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
- Graduate Training Centre of Neuroscience, University of Tübingen, Tübingen, Germany
| | - Bowen Cao
- Graduate Training Centre of Neuroscience, University of Tübingen, Tübingen, Germany
- Molecular Biology of Retinal Degenerations, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Arianna Tolone
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Jie Yan
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
- Graduate Training Centre of Neuroscience, University of Tübingen, Tübingen, Germany
| | - Gustav Christensen
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
- Graduate Training Centre of Neuroscience, University of Tübingen, Tübingen, Germany
| | - Blanca Arango-Gonzalez
- Molecular Biology of Retinal Degenerations, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Marius Ueffing
- Molecular Biology of Retinal Degenerations, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
- *Correspondence: Marius Ueffing,
| | - François Paquet-Durand
- Cell Death Mechanisms Group, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
- François Paquet-Durand,
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Schnichels S, Paquet-Durand F, Löscher M, Tsai T, Hurst J, Joachim SC, Klettner A. Retina in a dish: Cell cultures, retinal explants and animal models for common diseases of the retina. Prog Retin Eye Res 2020; 81:100880. [PMID: 32721458 DOI: 10.1016/j.preteyeres.2020.100880] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
For many retinal diseases, including age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR), the exact pathogenesis is still unclear. Moreover, the currently available therapeutic options are often unsatisfactory. Research designed to remedy this situation heavily relies on experimental animals. However, animal models often do not faithfully reproduce human disease and, currently, there is strong pressure from society to reduce animal research. Overall, this creates a need for improved disease models to understand pathologies and develop treatment options that, at the same time, require fewer or no experimental animals. Here, we review recent advances in the field of in vitro and ex vivo models for AMD, glaucoma, and DR. We highlight the difficulties associated with studies on complex diseases, in which both the initial trigger and the ensuing pathomechanisms are unclear, and then delineate which model systems are optimal for disease modelling. To this end, we present a variety of model systems, ranging from primary cell cultures, over organotypic cultures and whole eye cultures, to animal models. Specific advantages and disadvantages of such models are discussed, with a special focus on their relevance to putative in vivo disease mechanisms. In many cases, a replacement of in vivo research will mean that several different in vitro models are used in conjunction, for instance to analyze and validate causative molecular pathways. Finally, we argue that the analytical decomposition into appropriate cell and tissue model systems will allow making significant progress in our understanding of complex retinal diseases and may furthermore advance the treatment testing.
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Affiliation(s)
- Sven Schnichels
- University Eye Hospital, Centre for Ophthalmology, University of Tübingen, Germany.
| | - François Paquet-Durand
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Germany
| | - Marina Löscher
- University Eye Hospital, Centre for Ophthalmology, University of Tübingen, Germany
| | - Teresa Tsai
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Germany
| | - José Hurst
- University Eye Hospital, Centre for Ophthalmology, University of Tübingen, Germany
| | - Stephanie C Joachim
- Experimental Eye Research Institute, University Eye Hospital, Ruhr-University Bochum, Germany
| | - Alexa Klettner
- Department of Ophthalmology, University Medical Center, University of Kiel, Kiel, Germany
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Schnichels S, Kiebler T, Hurst J, Maliha AM, Löscher M, Dick HB, Bartz-Schmidt KU, Joachim SC. Retinal Organ Cultures as Alternative Research Models. Altern Lab Anim 2019; 47:19-29. [DOI: 10.1177/0261192919840092] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Ex vivo organ cultures represent unique research models, as they combine the advantages of cell cultures with those of animal models. Being able to mimic in vivo situations through the use of organ cultures provides an excellent opportunity to investigate cellular processes, molecular pathways and cell–cell interactions, as well as structural and synaptic organisation. Human and animal organ cultures are now well established and comprise sensitive, easy-to-manipulate experimental systems that raise minimal ethical concerns. The eye, in particular, is a very complex organ that is not easy to reproduce in vitro. However, a lot of research has been dedicated to the development of suitable ocular organ cultures. This review covers the various ex vivo retinal organ culture systems available for use in ophthalmology research and compares them with commonly used animal models. In particular, bovine and porcine retinal organ culture systems are described, because the size, anatomy, physiology and vessel morphology of bovine and porcine eyes are similar to the human eye in an undisputed way, thus making them good models. In addition, these animals are widely used by the food industry and the eyes are considered surplus material. A short overview of murine, rat, rabbit, cat, canine and simian retinal organ cultures is also provided.
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Affiliation(s)
- Sven Schnichels
- Centre for Ophthalmology, University Eye Hospital Tübingen, Tübingen, Germany
| | - Tobias Kiebler
- Centre for Ophthalmology, University Eye Hospital Tübingen, Tübingen, Germany
| | - José Hurst
- Centre for Ophthalmology, University Eye Hospital Tübingen, Tübingen, Germany
| | - Ana M. Maliha
- Experimental Eye Research, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Marina Löscher
- Centre for Ophthalmology, University Eye Hospital Tübingen, Tübingen, Germany
| | - H. Burkhard Dick
- Experimental Eye Research, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
| | | | - Stephanie C. Joachim
- Experimental Eye Research, University Eye Hospital, Ruhr-University Bochum, Bochum, Germany
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Rousou C, Hoogenboom P, van Overdam K, Storm G, Dorrestijn J, Mastrobattista E. A technical protocol for an experimental ex vivo model using arterially perfused porcine eyes. Exp Eye Res 2019; 181:171-177. [DOI: 10.1016/j.exer.2019.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/10/2019] [Accepted: 02/03/2019] [Indexed: 11/24/2022]
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Retinal capillary perfusion: Spatial and temporal heterogeneity. Prog Retin Eye Res 2019; 70:23-54. [PMID: 30769149 DOI: 10.1016/j.preteyeres.2019.01.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 01/17/2023]
Abstract
The central role of the cardiovascular system is to maintain adequate capillary perfusion. The spatially and temporally heterogeneous nature of capillary perfusion has been reported in some organs. However, such heterogeneous perfusion properties have not been sufficiently explored in the retina. Arguably, spatial and temporal heterogeneity of capillary perfusion could be more predominant in the retina than that in other organs. This is because the retina is one of the highest metabolic demand neural tissues yet it has a limited blood supply due to optical requirements. In addition, the unique heterogeneous distribution of retinal neural cells within different layers and regions, and the significant heterogeneity of intraretinal oxygen distribution and consumption add to the complexity. Retinal blood flow distribution must match consumption of nutrients such as oxygen and glucose within the retina at the cellular level in order to effectively maintain cell survival and function. Sophisticated local blood flow control in the microcirculation is likely required to control the retinal capillary perfusion to supply local retinal tissue and accommodate temporal and spatial variations in metabolic supply and demand. The authors would like to update the knowledge of the retinal microvessel and capillary network and retinal oxidative metabolism from their own studies and the work of others. The coupling between blood supply and energy demands in the retina is particularly interesting. We will mostly describe information regarding the retinal microvessel network and retinal oxidative metabolism relevant to the spatial and temporal heterogeneity of capillary perfusion. We believe that there is significant and necessary spatial and temporal heterogeneity and active regulation of retinal blood flow in the retina, particularly in the macular region. Recently, retinal optical coherence tomography angiography (OCTA) has been widely used in ophthalmology, both experimentally and clinically. OCTA could be a valuable tool for examining retinal microvessel and capillary network structurally and has potential for determining retinal capillary perfusion and its control. We have demonstrated spatial and temporal heterogeneity of capillary perfusion in the retina both experimentally and clinically. We have also found close relationships between the smallest arterioles and capillaries within paired arterioles and venules and determined the distribution of smooth muscle cell contraction proteins in these vessels. Spatial and temporal heterogeneity of retinal capillary perfusion could be a useful parameter to determine retinal microvessel regulatory capability as an early assay for retinal vascular diseases. This topic will be of great interest, not only for the eye but also other organs. The retina could be the best model for such investigations. Unlike cerebral vessels, retinal vessels can be seen even at the capillary level. The purpose of this manuscript is to share our current understanding with the readers and encourage more researchers and clinicians to investigate this field. We begin by reviewing the general principles of microcirculation properties and the spatial and temporal heterogeneity of the capillary perfusion in other organs, before considering the special requirements of the retina. The local heterogeneity of oxygen supply and demand in the retina and the need to have a limited and well-regulated retinal circulation to preserve the transparency of the retina is discussed. We then consider how such a delicate balance of metabolic supply and consumption is achieved. Finally we discuss how new imaging methodologies such as optical coherence tomography angiography may be able to detect the presence of spatial and temporal heterogeneity of capillary perfusion in a clinical setting. We also provide some new information of the control role of very small arterioles in the modulation of retinal capillary perfusion which could be an interesting topic for further investigation.
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Peynshaert K, Devoldere J, De Smedt SC, Remaut K. In vitro and ex vivo models to study drug delivery barriers in the posterior segment of the eye. Adv Drug Deliv Rev 2018; 126:44-57. [PMID: 28939376 DOI: 10.1016/j.addr.2017.09.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/18/2017] [Accepted: 09/08/2017] [Indexed: 12/18/2022]
Abstract
Many ocular disorders leading to blindness could benefit from efficient delivery of therapeutics to the retina. However, despite extensive research into drug delivery vehicles and administration techniques, efficacy remains limited because of the many static and dynamic barriers present in the eye. Comprehension of the various barriers and especially how to overcome them can improve our ability to estimate the potential of existent drug delivery vectors and support the design of new ones. To this end, this review gives an overview of the most important ocular barriers for each administration route to the back of the eye. For each barrier, its biological composition and its role as an obstacle towards macromolecules, nanoparticles and viral vectors will be discussed; special attention will be paid to the influence of size, charge and lipophilicity of drug(s) (carrier) on their ability to overcome each barrier. Finally, the most significant available in vitro and ex vivo methods and models to test the potential of a therapeutic to cross each barrier are listed.
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Total Human Eye Allotransplantation: Developing Surgical Protocols for Donor and Recipient Procedures. Plast Reconstr Surg 2016; 138:1297-1308. [PMID: 27879599 DOI: 10.1097/prs.0000000000002821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Vascularized composite allotransplantation of the eye is an appealing, novel method for reconstruction of the nonfunctioning eye. The authors' group has established the first orthotopic model for eye transplantation in the rat. With advancements in immunomodulation strategies together with new therapies in neuroregeneration, parallel development of human surgical protocols is vital for ensuring momentum toward eye transplantation in actual patients. METHODS Cadaveric donor tissue harvest (n = 8) was performed with orbital exenteration, combined open craniotomy, and endonasal approach to ligate the ophthalmic artery with a cuff of paraclival internal carotid artery, for transection of the optic nerve at the optic chiasm and transection of cranial nerves III to VI and the superior ophthalmic vein at the cavernous sinus. Candidate recipient vessels (superficial temporal/internal maxillary/facial artery and superficial temporal/facial vein) were exposed. Vein grafts were required for all anastomoses. Donor tissue was secured in recipient orbits followed by sequential venous and arterial anastomoses and nerve coaptation. Pedicle lengths and calibers were measured. All steps were timed, photographed, video recorded, and critically analyzed after each operative session. RESULTS The technical feasibility of cadaveric donor procurement and transplantation to cadaveric recipient was established. Mean measurements included optic nerve length (39 mm) and caliber (5 mm), donor artery length (33 mm) and caliber (3 mm), and superior ophthalmic vein length (15 mm) and caliber (0.5 mm). Recipient superficial temporal, internal maxillary artery, and facial artery calibers were 0.8, 2, and 2 mm, respectively; and superior temporal and facial vein calibers were 0.8 and 2.5 mm, respectively. CONCLUSION This surgical protocol serves as a benchmark for optimization of technique, large-animal model development, and ultimately potentiating the possibility of vision restoration transplantation surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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Clinical Considerations for Vascularized Composite Allotransplantation of the Eye. J Craniofac Surg 2016; 27:1622-1628. [PMID: 27513765 DOI: 10.1097/scs.0000000000002985] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Vascularized composite allotransplantation represents a potential shift in approaches to reconstruction of complex defects resulting from congenital differences as well as trauma and other acquired pathology. Given the highly specialized function of the eye and its unique anatomical components, vascularized composite allotransplantation of the eye is an appealing method for restoration, replacement, and reconstruction of the nonfunctioning eye. Herein, we describe conventional treatments for eye restoration and their shortcomings as well as recent research and events that have brought eye transplantation closer to a potential clinical reality. In this article, we outline some potential considerations in patient selection, donor facial tissue procurement, eye tissue implantation, surgical procedure, and potential for functional outcomes.
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Skov Jensen P, Metz Mariendal Pedersen S, Aalkjaer C, Bek T. The vasodilating effects of insulin and lactate are increased in precapillary arterioles in the porcine retina ex vivo. Acta Ophthalmol 2016; 94:454-62. [PMID: 27009434 DOI: 10.1111/aos.13025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 01/24/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE Disturbances in the diameter regulation of the larger retinal vessels are involved in the pathophysiology of a number of vision threatening retinal diseases, but the role of the smaller vessels has received less attention. Therefore, an experimental model was developed for studying diameter changes in retinal vessels at all branching levels secondary to pharmacological interventions ex vivo. METHODS Porcine hemiretinas were mounted in a tissue chamber that allowed the control of temperature, pH and oxygen saturation. The chamber was positioned in a fluorescence microscope, and changes in the diameter of larger arterioles, precapillary arterioles and capillaries were studied after intravascular and extravascular application of the thromboxane analogue U46619, lactate, the glutamate agonist N-Methyl-D-aspartic acid (NMDA) and insulin. RESULTS U46619 induced significant contraction of all vessel calibres after extravascular application, but had no significant effect on vessel diameters after intravascular application. In contracted vessels, lactate induced significant dilatation in all vessel calibres, and the effect was more pronounced after intravascular than after extravascular application where only precapillary arterioles dilated significantly. N-Methyl-D-aspartic acid (NMDA) induced similar dilatation in the three vessel types after intra- and extravascular application, whereas the dilating effect of insulin was significantly more pronounced in the precapillary arterioles than in the other vessel types. CONCLUSION The diameter regulation in precapillary retinal arterioles differs from that of other retinal vascular branching levels and may play a special role in the pathophysiology of retinal vascular disease.
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Affiliation(s)
- Peter Skov Jensen
- Department of Ophthalmology; Aarhus University Hospital; Aarhus C Denmark
| | | | - Christian Aalkjaer
- Department of Biomedicine (Physiology); University of Aarhus; Aarhus C Denmark
| | - Toke Bek
- Department of Ophthalmology; Aarhus University Hospital; Aarhus C Denmark
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12
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Arduini A, Escobar J, Vento M, Escrig R, Quintás G, Sastre J, Saugstad OD, Solberg R. Metabolic adaptation and neuroprotection differ in the retina and choroid in a piglet model of acute postnatal hypoxia. Pediatr Res 2014; 76:127-34. [PMID: 24819373 DOI: 10.1038/pr.2014.70] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 02/12/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hypoxic-ischemic insults to the neonatal brain may cause neurodevelopmental disorders. Vulnerability of different areas of the neural tissue to hypoxic-ischemic stress might be explained by either heterogeneous sensitivity to oxygen or neuroprotective capability. Our understanding of regional heterogeneity is still incomplete in terms of metabolic reconfiguration and/or activation of neuroprotective mechanisms. METHODS We studied, by western blotting, reverse-transcriptase PCR, and tandem mass spectrometry, the response of retina and choroid at protein, gene, and metabolic levels during hypoxia in a piglet model of acute postnatal hypoxia. RESULTS We evidenced a metabolic shift towards glycolysis in choroid after hypoxia while retina experienced a dramatic energy stress with decreased mitochondrial metabolites. Hypoxia-inducible transcription factor-1α (HIF-1α) was not stabilized in retina during hypoxia, supported by a deficient signaling from v-akt murine thymoma viral oncogene (AKT) and ERK1/2, and unchanged glutathione redox status. In retina, but not in choroid, phosphorylation of p65 (NF-κB) and increased transcription of target genes may have a major role during hypoxic stress. CONCLUSION We showed that the retina engages a distinct pattern of signaling and transcriptional events than observed in the choroid. Retina and choroid may reflect regional sensitivity to hypoxia. While prolonged and intense hypoxia may jeopardize retinal cell survival, choroid sets up a different pattern of response, which promotes adaptation to these adverse conditions.
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Affiliation(s)
- Alessandro Arduini
- 1] Department of Physiology, Faculty of Pharmacy, University of Valencia, Valencia, Spain [2] Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Javier Escobar
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - Maximo Vento
- 1] Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain [2] Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Raquel Escrig
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Guillermo Quintás
- Leitat Technological Center, Bio In Vitro Division, Barcelona, Spain
| | - Juan Sastre
- Department of Physiology, Faculty of Pharmacy, University of Valencia, Valencia, Spain
| | - Ola Didrik Saugstad
- Department of Pediatric Research, Institute for Surgical Research, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Rønnaug Solberg
- Department of Pediatric Research, Institute for Surgical Research, Oslo University Hospital-Rikshospitalet, Oslo, Norway
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13
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Abarca EM, Salmon JH, Gilger BC. Effect of choroidal perfusion on ocular tissue distribution after intravitreal or suprachoroidal injection in an arterially perfused ex vivo pig eye model. J Ocul Pharmacol Ther 2013; 29:715-22. [PMID: 23822159 DOI: 10.1089/jop.2013.0063] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To compare tissue distribution of dye-drug surrogates after intravitreal (IVT) and suprachoroidal (SCS) delivery to determine the influence of drug lipophilicity and choroidal circulation. METHODS Thirty-two pig eyes were collected immediately after euthanasia. Sixteen eyes were perfused for 30 min through one long posterior ciliary artery with nondye containing nutrient media. An IVT or SCS injection was performed with either a 100 μL balanced salt solution (BSS, n=8), 1% sodium fluorescein (NaF, n=12) or 0.12% lipophilic carbocyanine dye (DiI, n=12). Globes were maintained at 37°C for 15 min, and then snap-frozen and dissected. Aqueous extraction and measurement of NaF or DiI concentration was performed using spectrophotometry and spectrofluorometry, respectively. RESULTS After SCS delivery of NaF scleral, iris-ciliary body, choroidal and vitreous dye levels were higher in nonperfused eyes compared to perfused eyes. After DiI SCS or IVT delivery, no significant differences were found in dye tissue concentrations in perfused eyes compared to nonperfused eyes. Following perfusion, a better and even drug distribution was found in the retinal pigmented epithelium (RPE)-choroid following IVT and SCS delivery of the hydrophilic drug and after IVT injection of the lipophilic drug compared to nonperfused eyes. CONCLUSIONS Choroidal circulation reduces the tissue drug concentration of the hydrophilic drug suggesting an early clearance mechanism after SCS delivery. SCS injections of lipid and hydrophilic drugs allowed direct drug delivery to the retina and RPE-choroid with limited exposition to the anterior segment.
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Affiliation(s)
- Eva M Abarca
- Department of Clinical Sciences, North Carolina State University , Raleigh, North Carolina
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14
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Mains J, Tan LE, Wilson C, Urquhart A. A pharmacokinetic study of a combination of beta adrenoreceptor antagonists - in the isolated perfused ovine eye. Eur J Pharm Biopharm 2011; 80:393-401. [PMID: 22120686 DOI: 10.1016/j.ejpb.2011.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 10/17/2011] [Accepted: 11/10/2011] [Indexed: 11/27/2022]
Abstract
The treatment of posterior eye diseases, such as diabetic retinopathy and age-related macular degeneration, is of growing interest as the number of people affected by these conditions continues to rise. This study utilises the methods of cassette dosing and the perfused ovine eye model - to reduce animal usage and therefore animal time - to show that for a series of beta adrenoreceptor antagonists, lipophilicity is a key physicochemical property that governs drug distribution within the eye. Following intravitreal injection, lipophilic beta adrenoreceptor antagonists penetrate to the posterior eye, where they bind to the choroid and reside in the retina at greater concentrations than more hydrophilic beta adrenoreceptor antagonists, which preferentially penetrate to the anterior eye.
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Affiliation(s)
- Jenifer Mains
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Scotland, United Kingdom
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15
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Xiao Q, Hartzell HC, Yu K. Bestrophins and retinopathies. Pflugers Arch 2010; 460:559-69. [PMID: 20349192 DOI: 10.1007/s00424-010-0821-5] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/01/2010] [Accepted: 03/04/2010] [Indexed: 10/19/2022]
Abstract
Best vitelliform macular dystrophy (BVMD, also called Best's disease) is a dominantly inherited, juvenile-onset form of macular degeneration, which is characterized by abnormal accumulation of yellow pigment in the outer retina and a depressed electro-oculogram light peak (LP). Over 100 disease-causing mutations in human bestrophin-1 (hBest1) are closely linked to BVMD and several other retinopathies. However, the physiological role of hBest1 and the mechanisms of retinal pathology remain obscure partly because hBest1 has been described as a protein with multiple functions including a Ca2+-activated Cl- channel, a Ca2+ channel regulator, a volume-regulated Cl- channel, and a HCO3- channel. This review focuses on how dysfunction of hBest1 is related to the accumulation of yellow pigment and a decreased LP. The dysfunction of hBest1 as a HCO3- channel or a volume-regulated Cl- channel may be associated with defective regulation of the subretinal fluid or phagocytosis of photoreceptor outer segments by retinal pigment epithelium cells, which may lead to fluid and pigment accumulation.
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Affiliation(s)
- Qinghuan Xiao
- Department of Cell Biology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA 30322, USA.
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16
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Delgado E, Marques-Neves C, Rocha I, Sales-Luís J, Silva-Carvalho L. Intrinsic vasomotricity and adrenergic effects in a model of isolated rabbit eye. Acta Ophthalmol 2009; 87:443-9. [PMID: 18705679 DOI: 10.1111/j.1755-3768.2008.01285.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE We aimed to investigate the responsiveness of the ocular arteries to adrenergic drugs in a model of perfused isolated rabbit eye. METHODS Rabbit external ophthalmic arteries (n = 15) in a head-mounted preparation were cannulated and the retinal and uveal vasculature perfused at a constant flow with warmed tyrode. The three-way polypropylene catheter was further connected to a pressure transducer and intraluminal pressure was taken as a measure of vascular resistance. Effects of intra-arterial injections of phenylephrine (group A, n = 5), prazosin (group B, n = 5) and phentolamine (group C, n = 5) on the recorded pressure were obtained. Student's paired-t test and one-way analysis of variance were used for statistical analysis (p < 0.05). RESULTS Intrinsic vasomotricity was observed in all preparations prior to any drug administration. Phenylephrine produced an increase in total vascular resistance. Intrinsic vasomotricity became more evident, showing a lower frequency but higher amplitude of oscillations. Evoked vasomotor responses with phenylephrine (250 microg/ml) were inhibited by intra-arterial administration of the selective alpha(1)-adrenergic antagonist, prazosin (0.5 mg/ml), as well as the non-selective alpha-adrenergic antagonist phentolamine (6 mg/ml). CONCLUSIONS Rabbit external ophthalmic arteries showed spontaneous contractions under constant perfusion. Phenylephrine elicited a vasoconstrictor response that was inhibited by adrenergic antagonists. In addition, the intrinsic vasomotricity was enhanced by phenylephrine and blocked by adrenergic antagonists. These results show that under in vitro perfusion the territory presents similar responses to adrenergic drugs to those observed in in vivo models and also provides evidence of myogenic autoregulatory properties in the rabbit ophthalmic artery and/or choroid.
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Affiliation(s)
- Esmeralda Delgado
- Clinical Department, Centre for Interdisciplinary Investigation into Animal Health, Faculty of Veterinary Medicine, Technical University of Lisbon, Lisbon, Portugal.
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17
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Hartzell HC, Qu Z, Yu K, Xiao Q, Chien LT. Molecular physiology of bestrophins: multifunctional membrane proteins linked to best disease and other retinopathies. Physiol Rev 2008; 88:639-72. [PMID: 18391176 DOI: 10.1152/physrev.00022.2007] [Citation(s) in RCA: 256] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This article reviews the current state of knowledge about the bestrophins, a newly identified family of proteins that can function both as Cl(-) channels and as regulators of voltage-gated Ca(2+) channels. The founding member, human bestrophin-1 (hBest1), was identified as the gene responsible for a dominantly inherited, juvenile-onset form of macular degeneration called Best vitelliform macular dystrophy. Mutations in hBest1 have also been associated with a small fraction of adult-onset macular dystrophies. It is proposed that dysfunction of bestrophin results in abnormal fluid and ion transport by the retinal pigment epithelium, resulting in a weakened interface between the retinal pigment epithelium and photoreceptors. There is compelling evidence that bestrophins are Cl(-) channels, but bestrophins remain enigmatic because it is not clear that the Cl(-) channel function can explain Best disease. In addition to functioning as a Cl(-) channel, hBest1 also is able to regulate voltage-gated Ca(2+) channels. Some bestrophins are activated by increases in intracellular Ca(2+) concentration, but whether bestrophins are the molecular counterpart of Ca(2+)-activated Cl(-) channels remains in doubt. Bestrophins are also regulated by cell volume and may be a member of the volume-regulated anion channel family.
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Affiliation(s)
- H Criss Hartzell
- Department of Cell Biology, Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
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18
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The characteristics of multifocal electroretinogram in isolated perfused porcine eye. Doc Ophthalmol 2008; 117:205-14. [DOI: 10.1007/s10633-008-9124-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 03/08/2008] [Indexed: 02/04/2023]
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19
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Kobuch K, Herrmann WA, Framme C, Sachs HG, Gabel VP, Hillenkamp J. Maintenance of adult porcine retina and retinal pigment epithelium in perfusion culture: Characterisation of an organotypic in vitro model. Exp Eye Res 2008; 86:661-8. [DOI: 10.1016/j.exer.2008.01.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 01/08/2008] [Accepted: 01/10/2008] [Indexed: 11/28/2022]
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Koeberle MJ, Hughes PM, Skellern GG, Wilson CG. Pharmacokinetics and disposition of memantine in the arterially perfused bovine eye. Pharm Res 2006; 23:2781-98. [PMID: 17103338 DOI: 10.1007/s11095-006-9106-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Accepted: 06/30/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE To develop an improved ((1)This is to clearly acknowledge that we have tried to improve an existing model.) arterially perfused bovine eye model and investigate the general ocular disposition of memantine. MATERIALS AND METHODS Fresh bovine eyes were prepared by exposing and cannulating one ciliary artery, placing the eye into a perfusion chamber and slowly increasing the rate of perfusion to 1.0 ml/min. Analysis of the arterial perfusion pressure (APP), intraocular pressure (IOP), venous perfusate for glucose consumption and lactate dehydrogenase (LDH) activity, and histopathology ensured viability. Memantine was administered with the perfusate (simulated systemic access), by an intravitreal injection and by topical infusion. At the appropriate time points, the cornea, aqueous humour, sclera, iris-ciliary body, choroid/RPE, retina and vitreous humour were harvested and analysed for memantine. RESULTS The preparation remained viable for at least 9 h. At this time, histopathological examination showed mild to moderate deterioration of retinal layers. However, all retinal layers remained well defined and the integrity of the inner limiting membrane and Bruch's membrane were preserved. Glucose consumption, LDH levels and constant APP and IOP showed that correct cannulation and viability was maintained. After administration, memantine accumulated in the melanin rich iris-ciliary body and choroid/RPE. Results following topical administration indicate that substantial concentrations of memantine are present in the retina and choroid/RPE. CONCLUSIONS The arterial perfused bovine eye system proved to be a useful system for ocular drug delivery studies. The experimental results indicate that memantine will accumulate in the posterior segment when delivered by the topical route and that melanin-binding may support sustaining significant concentrations in the retina.
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Affiliation(s)
- Martin J Koeberle
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 27 Taylor Street, Glasgow, G4 0NR, UK
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Niemeyer G. ERG components of negative polarity from the inner retina and the optic nerve response. Doc Ophthalmol 2006; 111:179-89. [PMID: 16523235 DOI: 10.1007/s10633-005-5504-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2005] [Indexed: 10/24/2022]
Abstract
ERG components of negative polarity in the light-adapted and in the dark-adapted inner retina are reviewed from a clinical perspective and include consideration of experimental research. Field potentials are inherently complex including summating contributions from specialized neurons as well as from glial elements. This property applies to the PERG, PhNR and to the STR. Experimental research can contribute to identifying the sites/cells of origins i.e. by determining depth profiles and by pharmacological manipulation. Intraretinal microelectrode-studies and pharmacological dissection of light-evoked responses have elucidated the origin of field potentials from the retinal pigment epithelium to the retinal ganglion cells. Thresholds for dark-adapted response components have been compared. Attenuation of the STR by anesthesia was found in cats in vivo when compared to threshold intensities used in isolated eye preparations in vitro, suggestive of depression of inner retinal activity by anesthetics. Evidence has been presented for antidromically elicited retinal responses of negative polarity that resemble the STR and summate with the light-evoked retinal response. This observation supports the notion that negative field potentials and components as recorded in the vitreous and at the cornea receive contributions from retinal ganglion cells. The weight of this contribution appears to vary among species, at least concerning the STR. The ocular negative responses from the inner retina are compared to cortical excitatory mechanisms generating negativity in the baseline of the EEG.
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Affiliation(s)
- Günter Niemeyer
- Department of Ophthalmology, University Hospital Zurich, Wissmannstr.16, CH-8057, Zurich, Switzerland.
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Shahidullah M, Chan HHL, Yap MK, Liu Q, To CH. Multifocal electroretinography in isolated arterially perfused bovine eye. Ophthalmic Physiol Opt 2005; 25:27-34. [PMID: 15649180 DOI: 10.1111/j.1475-1313.2004.00241.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To develop an isolated arterially perfused bovine eye as an in vitro model for studying retinal electrophysiology using multifocal electroretinography (mfERG). METHODS Fresh bovine eyes were cannulated through the ophthalmic artery and perfused with oxygenated Krebs' solution at 37 degrees C within 15 min postmortem. Multifocal ERG was recorded using the veris 1.0 (Visual Evoked Response Imaging System). RESULTS The mfERG waveform of in vitro bovine eyes had a typical trough (negative wave, N1) and peak (positive wave, P1) similar to those of human mfERG. The implicit times (peak latencies) for N1 and P1 were 20 and 42 ms respectively, and the average response amplitude (N1P1) was 55 nV. The implicit times of N1 and P1 were maintained for more than 4 h. The mfERG responses were affected proportionately by the stimulus intensity. Without a neutral density filter, the mean response amplitude was about 55 nV, which was diminished to 26, 18 and 10 nV under neutral density filters of 0.4, 1.0 and 1.4, respectively. Partial occlusion of the pupil completely abolished mfERG responses from the corresponding part of the retina. CONCLUSIONS Isolated arterially perfused bovine eye may be used as an experimental model to study retinal electrophysiology using mfERG. The in vitro eye may offer a convenient and easily obtainable alternative to live animals, particularly for drug screening and invasive studies.
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Affiliation(s)
- Mohammad Shahidullah
- Department of Optometry and Radiography, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Brigell M, Dong CJ, Rosolen S, Tzekov R. An Overview of Drug Development with Special Emphasis on the Role of Visual Electrophysiological Testing. Doc Ophthalmol 2005; 110:3-13. [PMID: 16249953 DOI: 10.1007/s10633-005-7338-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Visual electrophysiological techniques, such as electroretinography (ERG) and visual evoked potentials (VEP) can provide useful information on the safety, efficacy, and proper dosing of chemical entities under development as new drug therapies. During post-marketing safety surveillance, a variety of visual electrophysiological measures can be used to objectively assess and document individual patient response to ophthalmic drugs and ocular or visual system side effects of non-ophthalmic drugs. In this paper, the discovery, exploratory development, full-development and post-marketing stages of drug development are briefly outlined. The potential role of visual electrophysiological techniques in each of these stages is described and discussed.
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Affiliation(s)
- Mitchell Brigell
- Clinical Technology, Pfizer Global Research & Development, 2800 Plymouth Road, Ann Arbor, MI 48105, USA.
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Uji Y, Kuze M, Matubara H, Doi M, Sasoh M. Effects of the beta1-selective adrenergic antagonist betaxolol on electroretinography in the perfused cat eye. Doc Ophthalmol 2003; 106:37-41. [PMID: 12675484 DOI: 10.1023/a:1022404630736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The effects of the beta1-selective adrenergic antagonist betaxolol on electroretinography (ERG) were studied in the isolated and arterially perfused cat eye. Betaxolol increased the perfusion flow rate, significantly at the administrations of more than 50 microM concentrations and induced a dose-related, reversible increase in the amplitudes of both the a-wave and b-wave of ERG. These results suggest that the calcium-channel blocking mechanism of betaxolol has a beneficial influence on ocular blood flow and retinal electrical activity in response to light. As it is known that ERG is a good indicator of the functional integrity of the retina, this indicates that betaxolol could be an ideal drug for treating glaucoma in which ischemia is involved to some extent.
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Affiliation(s)
- Yukitaka Uji
- Department of Ophthalmology, Mie University School of Medicine, Edobashi 2-174, Tsu 514-8507, Japan
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Macaluso C, Frishman LJ, Frueh B, Kaelin-Lang A, Onoe S, Niemeyer G. Multiple effects of adenosine in the arterially perfused mammalian eye. Possible mechanisms for the neuroprotective function of adenosine in the retina. Doc Ophthalmol 2003; 106:51-9. [PMID: 12675486 DOI: 10.1023/a:1022456615715] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
It has been postulated that the major physiological role of adenosine is protection of the central nervous system in conditions such as ischemia, hypoxia, or prolonged neuronal excitation. Under these conditions adenosine is released, and exerts multiple effects, including vasodilation, inhibition of neuronal activity, and enhancement of glycogenolysis, resulting in neuroprotection. In this article, published as well as unpublished data on the multiple effects of exogenous adenosine and application of adenosine-related agents, performed using the arterially perfused cat eye, will be reviewed and discussed within the framework of the neuroprotective role of adenosine. The isolated, arterially perfused eye preparation has the advantage of combining integrity of the eye structure, exact control of arterial concentration and timing of applied pharmacological agents, and access to electrophysiological parameters of both retina and optic nerve, as well as the ability to control and monitor perfusate flow. The absence of red blood cells in the perfusate prevents adenosine from being metabolized prior to reaching the eye.
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