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Potop V, Dragosloveanu CDM, Ciocâlteu AM, Burcel MG, Marinescu MC, Dăscălescu DMC. The Mirror Theory: Parallels between Open Angle and Angle Closure Glaucoma. Life (Basel) 2024; 14:1154. [PMID: 39337937 PMCID: PMC11433309 DOI: 10.3390/life14091154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/19/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
Glaucoma is a widespread ophthalmological disease, with a high impact and frequent visual morbidity. While the physiopathology of the two types of primary glaucoma (open angle and angle closure) has been studied, there seems to be little relationship between the two. In this study, we gather clinical and preclinical data to support the idea that the two primary glaucomas are "mirrored" in terms of morphological parameters and disease physiopathology. In short, primary angle closure glaucoma (PACG) is associated with hyperopia and low axial length, and primary open angle glaucoma (POAG) is associated with myopia and high axial length. Moreover, in PACG and in primary angle closure or primary angle closure suspect cases, while there is extensive iridotrabecular contact, the intraocular pressure (IOP) is still maintained in the lower half of the normal range throughout the evolution of the disease, which suggests a baseline trabecular hyperfiltration in PACG. In the opposite case, myopic eyes with open angles and a higher risk of developing POAG often have a baseline IOP in the upper half of the normal range, suggesting a baseline trabecular hypofiltration. As we explore clinical, genetic and animal model data regarding these opposing aspects, we hypothesize the existence of a mirroring relationship between PACG and POAG. Defining the relationship between the two potentially blinding diseases, with a high prevalence worldwide, may aid in understanding the mechanisms better and refining diagnosis and treatment. Thus, our theory has been named the Mirror Theory of Primary Glaucomas.
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Affiliation(s)
- Vasile Potop
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Christiana Diana Maria Dragosloveanu
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Alina Mihaela Ciocâlteu
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | | | - Maria Cristina Marinescu
- Discipline Physiology III, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dana Margareta Cornelia Dăscălescu
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
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2
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Kim D, Park SE, Hwang J, Kang N, Jung JS, Park KM. Ultrasound biomicroscopy analysis of ciliary muscle dynamics and its relation to intra-ocular pressure after phacoemulsification in dogs. Front Vet Sci 2024; 11:1366997. [PMID: 38784657 PMCID: PMC11111888 DOI: 10.3389/fvets.2024.1366997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction This study investigates the relationship between ciliary muscle dynamics, thickness, and the regulation of intraocular pressure (IOP), focusing on the progression of cataracts and changes post-phacoemulsification. It explores how these factors impact canine ocular health, particularly in the context of cataract development and subsequent surgical intervention. Materials and methods Data was collected using Ultrasound Biomicroscopy (UBM) from dogs at the Veterinary Medical Teaching Hospital of Chungbuk National University, Korea. The study involved 57 eyes from 35 dogs, categorized into five groups: 13 normal eyes, 14 with incipient cataracts, 12 with immature cataracts, 6 with mature cataracts, and 12 post-phacoemulsification. UBM measurements assessed various ciliary muscle parameters including ciliary body axial length (CBAXL), ciliary process-sclera angle (CPSA), longitudinal fibers of ciliary muscle thickness (Lf-CMT), and longitudinal and radial fibers of ciliary muscle thickness (LRf-CMT). Results Findings indicated a decrease in CBAXL and an increase in Lf-CMT as cataracts progressed in severity. Post-phacoemulsification, there was a notable increase in CBAXL and a decrease in CPSA, Lf-CMT, and LRf-CMT, compared to both cataractous and normal eyes. Regression analysis revealed a significant positive association between CBAXL and IOP, alongside a negative association between Lf-CMT and IOP. These findings suggest that variations in ciliary muscle dynamics and thickness, as influenced by cataract progression and phacoemulsification, have distinct impacts on intraocular pressure. Discussion The study proposes that phacoemulsification leads to ciliary muscle contraction, causing an inward and anterior movement of the ciliary muscle. This movement results in the narrowing of the ciliary cleft and constriction of the unconventional outflow pathway, potentially causing an increased risk of glaucoma post-surgery. Our research contributes to understanding the anatomical and physiological changes in the canine eye following cataract surgery and underscores the importance of monitoring IOP and ciliary muscle dynamics in these patients.
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Affiliation(s)
| | | | | | | | | | - Kyung-Mee Park
- Laboratory of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
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Ayaki M, Hanyuda A, Negishi K. Symptomatic Presbyopia may Develop Earlier in Patients With Glaucoma-A Cross-Sectional Retrospective Cohort Study. Transl Vis Sci Technol 2024; 13:21. [PMID: 38619925 PMCID: PMC11037495 DOI: 10.1167/tvst.13.4.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/04/2024] [Indexed: 04/17/2024] Open
Abstract
Purpose The purpose of this study was to explore risk factors for symptomatic presbyopia, defined as near add power ≥1.50 diopters, in patients with glaucoma. Methods Treated glaucoma (n = 56), untreated glaucoma (n = 21), and control individuals (n = 376), aged 40 to 55 years at first visit, were enrolled in the study, and near add power, retinal thickness, and visual field were examined. The association between near add power and ocular parameters and the odds ratios (ORs) for symptomatic presbyopia were investigated. Survival analysis for symptomatic presbyopia was conducted. Results Age, astigmatic power, mean deviation, and ganglion cell complex thickness were associated with near add power. The OR for symptomatic presbyopia was significant for age (OR = 1.51), astigmatism (OR = 1.01), mean deviation (OR = 0.72), ganglion cell complex thickness (OR = 0.98), treated and untreated glaucoma (OR = 2.09), and use of glaucoma eye drops (OR = 3.33). Survival analysis showed that the treated glaucoma group reached the near add power endpoint of ≥1.50 D (symptomatic presbyopia) significantly earlier than the other two groups, and there was no difference between the control and untreated glaucoma groups. Conclusions Glaucoma patients treated with eye drops may start near correction earlier. Translational Relevance Symptomatic presbyopia may develop earlier in patients with glaucoma, and our findings could further contribute to better management and understanding of presbyopia with glaucoma.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Abstract
Purpose: Presbyopia-the progressive loss of near focus with age-is primarily a result of changes in lens biomechanics. In particular, the shape of the ocular lens in the absence of zonular tension changes significantly throughout adulthood. Contributors to this change in shape are changes in lens biomechanical properties, continuous volumetric growth lens, and possibly remodeling of the lens capsule. Knowledge in this area is growing rapidly, so the purpose of this mini-review was to summarize and synthesize these gains.Methods: We review the recent literature in this field.Results: The mechanisms governing age-related changes in biomechanical properties remains unknown. We have recently shown that lens growth may be driven by zonular tension. The same mechanobiological mechanism driving lens growth may also lead to remodeling of the capsule, though this remains to be demonstrated.Conclusions: This mini-review focuses on identifying mechanisms which cause these age-related changes, suggesting future work which may elucidate these mechanisms, and briefly discusses ongoing efforts to develop a non-surgical approach for therapeutic management of presbyopia. We also propose a simple model linking lens growth and biomechanical properties.
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Affiliation(s)
- Wade Rich
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Matthew A Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.,Department of Ophthalmology & Visual Sciences, The Ohio State University, Columbus, OH, USA
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5
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Tian J, Wei S, Li S, An W, Bai W, Liang X, Du J, Wang N. The effect of atropine 0.01% eyedrops on relative peripheral refraction in myopic children. Eye (Lond) 2023; 37:356-361. [PMID: 35094028 PMCID: PMC9873619 DOI: 10.1038/s41433-021-01923-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 12/01/2021] [Accepted: 12/22/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Relative peripheral refraction (RPR) is a significant factor that participates in myopic development. Here, we evaluated the effects of atropine 0.01% eyedrops, as an antimyopia drug, on RPR. METHODS Seventy-three children were enrolled from a randomized, double-blinded, placebo-0.01% atropine eyedrops cross-over trial. The study group had used the placebo for one year and then crossed over to atropine 0.01% eyedrops for half a year. The control group had used 0.01% atropine for one year and then crossed over to placebo eyedrops for half a year. Central and horizontal peripheral refractions (15° and 30° at the temporal and nasal retina) were measured under non-cycloplegia and cycloplegia. RESULTS No significant differences in age, gender, and central refraction were identified between the two groups (P > 0.05). Under non-cycloplegia, the control group showed significant relative hyperopia in the temporal 30° retina and the nasal retina (P = 0.031; P < 0.001; P < 0.001). In the study group, the relative hyperopia in the temporal 30° retina disappeared (P = 0.983). After cycloplegia, the control group had less myopia in central refractions and less hyperopia in temporal RPR (P < 0.001; P = 0.039; P < 0.001). The study group did not present significant changes in central refractions and temporal RPR (P = 0.122; P = 0.222; P = 0.475). CONCLUSIONS For myopic children, atropine 0.01% eyedrops can alleviate relative hyperopia in the temporal retina and the hyperopic shift before cycloplegia. The effect might participate in myopia control.
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Affiliation(s)
- Jiaxin Tian
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Shifei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Shiming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Wenzai An
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Weiling Bai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Xintong Liang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Jialing Du
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Capital Medical University, 100730, Beijing, China.
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Abstract
Glaucoma is a progressive, age-related optic neuropathy, whereby the prevalence increases sharply over the age of 60 and is associated with increased systemic tissue stiffness. On a molecular basis, this is associated with increased deposition of collagen and loss of elastin structure, resulting in aberrant biomechanical compliance and reduced tissue elasticity. Increased tissue stiffness is a known driver of myofibroblast activation and persistence, especially in chronic cellular injuries via mechanotransduction pathways mediated by integrins and focal adhesion kinases. Evidence from histological and imaging studies plus force measurements of glaucomatous eyes show that several ocular tissues are stiffer than normal, healthy age-matched controls including the trabecular meshwork, Schlemm's canal, cornea, sclera and the lamina cribrosa. This is associated with increased extracellular matrix deposition and fibrosis. This review reports on the evidence to support the concept that glaucoma represents 'a stiff eye in a stiff body' and addresses potential mechanisms to attenuate this.
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Affiliation(s)
- Sarah Powell
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.,Catherine McAuley Research Centre, University College Dublin, Dublin, Ireland
| | - Mustapha Irnaten
- Catherine McAuley Research Centre, University College Dublin, Dublin, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.,Catherine McAuley Research Centre, University College Dublin, Dublin, Ireland
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Coleman-Belin J, Harris A, Chen B, Zhou J, Ciulla T, Verticchio A, Antman G, Chang M, Siesky B. Aging Effects on Optic Nerve Neurodegeneration. Int J Mol Sci 2023; 24:2573. [PMID: 36768896 PMCID: PMC9917079 DOI: 10.3390/ijms24032573] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
Common risk factors for many ocular pathologies involve non-pathologic, age-related damage to the optic nerve. Understanding the mechanisms of age-related changes can facilitate targeted treatments for ocular pathologies that arise at any point in life. In this review, we examine these age-related, neurodegenerative changes in the optic nerve, contextualize these changes from the anatomic to the molecular level, and appreciate their relationship with ocular pathophysiology. From simple structural and mechanical changes at the optic nerve head (ONH), to epigenetic and biochemical alterations of tissue and the environment, multiple age-dependent mechanisms drive extracellular matrix (ECM) remodeling, retinal ganglion cell (RGC) loss, and lowered regenerative ability of respective axons. In conjunction, aging decreases the ability of myelin to preserve maximal conductivity, even with "successfully" regenerated axons. Glial cells, however, regeneratively overcompensate and result in a microenvironment that promotes RGC axonal death. Better elucidating optic nerve neurodegeneration remains of interest, specifically investigating human ECM, RGCs, axons, oligodendrocytes, and astrocytes; clarifying the exact processes of aged ocular connective tissue alterations and their ultrastructural impacts; and developing novel technologies and pharmacotherapies that target known genetic, biochemical, matrisome, and neuroinflammatory markers. Management models should account for age-related changes when addressing glaucoma, diabetic retinopathy, and other blinding diseases.
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Affiliation(s)
- Janet Coleman-Belin
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bo Chen
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jing Zhou
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Thomas Ciulla
- Vitreoretinal Medicine and Surgery, Midwest Eye Institute, Indianapolis, IN 46290, USA
| | - Alice Verticchio
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gal Antman
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva 4941492, Israel
| | - Michael Chang
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brent Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Lv K, Liang Z, Yang K, Chen X, Ma Y, Wu H. Novel Discoveries of the Relationship Between the Vitreous Zonule and the Anterior Segment Characteristics in Eyes With Primary Angle-Closure Disease. Invest Ophthalmol Vis Sci 2022; 63:16. [PMID: 36520454 PMCID: PMC9769030 DOI: 10.1167/iovs.63.13.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose To investigate the presence of the vitreous zonule (VZ) in different subtypes of primary angle-closure disease (PACD) and to explore the relationship between VZ and anterior chamber angle characteristics. Methods Patients with clinical diagnoses of acute primary angle-closure (PAC)/PAC glaucoma (APAC[G]) or chronic PAC/PAC glaucoma (CPAC[G]) and healthy subjects were enrolled. A total of 300 eyes of 180 subjects were included. Anterior segment parameters and the presence of the VZ were assessed by ultrasound biomicroscopy. The presence of VZ was compared among different subtypes of PACD. Anterior segment parameters were compared between eyes in vitreous zonule group (VZG) and no vitreous zonule group (NVZG). Logistic regression analysis was conducted to identify factors associated with the presence of VZ. Results APAC(G) eyes had lower VZ presence compared to the fellow eyes of APAC(G) (P < 0.001). VZ was more likely to be seen in the eyes of healthy subjects and PAC suspect than in the eyes of PAC and PAC glaucoma (PACG) (P < 0.05). NVZG had shorter angle opening distance 500/750 (P < 0.001), smaller trabecular iris angle 500/750 (P < 0.001), smaller trabecular-iris space area 500/750 (P < 0.001), smaller trabecular-ciliary angle (P = 0.009), smaller iris area (P = 0.010), and greater lens vault (P = 0.004) compared to VZG. Greater lens vault (LV) was independently associated with absence of VZ (odds ratio = 0.253; 95% confidence interval, 0.109-0.586; P = 0.001). Conclusions VZ was less likely to be observed in PAC/PACG eyes. PACD eyes with less VZ had narrower angle, more anteriorly rotated ciliary body, and greater LV.
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Affiliation(s)
- Kun Lv
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Zhiqiao Liang
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Kangyi Yang
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Xuanzhu Chen
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Yao Ma
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Huijuan Wu
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China,Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
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Croft MA, Peterson J, Smith C, Kiland J, Nork TM, Mcdonald JP, Katz A, Hetzel S, Lütjen-Drecoll E, Kaufman PL. Accommodative movements of the choroid in the optic nerve head region of human eyes, and their relationship to the lens. Exp Eye Res 2022; 222:109124. [PMID: 35688214 PMCID: PMC9783760 DOI: 10.1016/j.exer.2022.109124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 04/30/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022]
Abstract
The ciliary muscle (CM) powers the accommodative response, and during accommodation the CM pulls the choroid forward in the region of the ora serrata. Our goal was to elucidate the accommodative movements of the choroid in the optic nerve region in humans and to determine whether these movements are related to changes in the lens dimensions that occur with aging, in the unaccommodated and accommodated state. Both eyes of 12 human subjects (aged 18-51 yrs) were studied. Homatropine (1 drop/5%) was used to relax the ciliary muscle (unaccommodated or "resting" eye) and pilocarpine was used to induce the maximum accommodative response (2 drops/4%) (accommodated eye). Images of the fundus and choroid were collected in the region of the optic nerve (ON) via Spectralis OCT (infrared and EDI mode), and choroidal thickness was determined. Ultrasound biomicroscopy (UBM; 50 MHz, 35 MHz) images were collected in the region of the lens/capsule and ciliary body. OCT and UBM images were collected in the resting and accommodated state. The unaccommodated choroidal thickness declined significantly with age (p = 0.0073, r = 0.73) over the entire age range of the subjects studied (18-51 years old). The choroidal thickness was significantly negatively correlated with lens thickness in the accommodated (p = 0.01) and the unaccommodated states (p = 0.005); the thicker the lens the thinner the choroid. Choroid movements around the optic nerve during accommodation were statistically significant; during accommodation the choroid both thinned and moved centrifugally (outward/away from the optic nerve head). The accommodative choroid movements did not decline significantly with age and were not correlated with accommodative amplitude. Measurement of the choroidal thickness is possible with the Spectralis OCT instrument using EDI mode and can be used to determine the accommodative changes in choroidal thickness. The choroidal thickness decreased with age and during accommodation. It may be that age-related choroidal thinning is due to changes in the geometry of the accommodative apparatus to which it is attached (i.e., ciliary muscle/lens complex) such that when the lens is thicker, the choroid is thinner. Accommodative decrease in choroidal thickness and stretch of the retina/choroid may indicate stress/strain forces in the region of the optic nerve during accommodation and may have implications for glaucoma.
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Affiliation(s)
- Mary Ann Croft
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA.
| | - John Peterson
- Diagnostic Imaging Services Lead, UCSF Health, Wayne and Gladys Valley Center for Vision, 490 Illinois St., San Francisco, CA, 94158, USA
| | - Christopher Smith
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Julie Kiland
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - T Michael Nork
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Jared P Mcdonald
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Alexander Katz
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Scott Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, USA
| | | | - Paul L Kaufman
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA; Wisconsin National Primate Research Center, USA
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Croft MA, Nork TM, Heatley G, Mcdonald JP, Katz A, Kaufman PL. Intraocular accommodative movements in monkeys; relationship to presbyopia. Exp Eye Res 2022; 222:109029. [PMID: 35283107 PMCID: PMC9749451 DOI: 10.1016/j.exer.2022.109029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/21/2022] [Accepted: 03/06/2022] [Indexed: 12/16/2022]
Abstract
Our goal was to quantify the age-related changes in the dynamic accommodative movements of the vitreous and aqueous humor in iridic, aniridic, phakic and aphakic primate eyes. Six bilaterally iridic and four bilaterally iridectomized rhesus monkeys, ranging in age from 6 to 25 years, received a stimulating electrode in the midbrain Edinger-Westphal nucleus to induce accommodation, measured by a Hartinger coincidence refractometer. One of the four iridectomized monkeys underwent unilateral extracapsular and another monkey underwent intracapsular lens extraction. Eyes were imaged utilizing specialized techniques and contrast agents to resolve intraocular structures. During accommodation the anterior hyaloid membrane and the posterior lens capsule bowed backward. Central vitreous fluid and structures/strands moved posteriorly toward the optic nerve region as peripheral vitreous, attached to the vitreous zonule, was pulled forward by ciliary muscle contraction. Triamcinolone particles injected intravitreally were also observed in the anterior chamber and moved from the anterior chamber toward the cleft of the anterior hyaloid membrane and then further posteriorly into the vitreous-filled cleft between the vitreous zonule and the ciliary body pars plana. These accommodative movements occurred in all eyes, and declined with age. There are statistically significant accommodative movements of various intravitreal structures. The posterior/anterior fluid flow between the anterior chamber and the vitreous compartments during accommodation/disaccommodation represents fluid displacement to allow/facilitate lens thickening. The posterior accommodative movement of central vitreous fluid may result from centripetal compression of the anterior tips of the cistern-like structure attached to the vitreous zonule, and posterior displacement of the central trunk of the cistern during ciliary muscle contraction and centripetal muscle movement. The findings may have implications for presbyopia.
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Affiliation(s)
- Mary Ann Croft
- Department of Ophthalmology and Visual Sciences, Madison, WI, 53792, USA.
| | - T Michael Nork
- Department of Ophthalmology and Visual Sciences, Madison, WI, 53792, USA
| | - Gregg Heatley
- Department of Ophthalmology and Visual Sciences, Madison, WI, 53792, USA
| | - Jared P Mcdonald
- Department of Ophthalmology and Visual Sciences, Madison, WI, 53792, USA
| | - Alexander Katz
- Department of Ophthalmology and Visual Sciences, Madison, WI, 53792, USA
| | - Paul L Kaufman
- Department of Ophthalmology and Visual Sciences, Madison, WI, 53792, USA; Wisconsin National Primate Research Center, Madison, WI, 53792, USA; McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, 53792, USA
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11
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Li Z, Meng Z, Qu W, Li X, Chang P, Wang D, Zhao Y. The Relationship Between Age and the Morphology of the Crystalline Lens, Ciliary Muscle, Trabecular Meshwork, and Schlemm's Canal: An in vivo Swept-Source Optical Coherence Tomography Study. Front Physiol 2021; 12:763736. [PMID: 34867468 PMCID: PMC8640208 DOI: 10.3389/fphys.2021.763736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/29/2021] [Indexed: 01/07/2023] Open
Abstract
Purpose: To evaluate the effects of age on the morphologies of the crystalline lens, ciliary muscle (CM), Schlemm’s canal (SC), and trabecular meshwork (TM) using swept-source optical coherence tomography (SS-OCT). Methods: Images of the crystalline lens and iridocorneal angle were obtained in healthy participants’ eyes using SS-OCT. Morphological parameters of the crystalline lens, CM, and TM/SC were measured, and the relationship between these parameters and age was evaluated. Results: A total of 62 healthy participants were enrolled, with an age range of 7–79 years. With adjustments for the effects of axial length and sex, both the nasal and temporal SC cross-sectional areas (CSA) and the cross-sectional area of the CM (CMA), distance from the scleral spur to the inner apex of the ciliary muscle (IA-SS), and nasal SC volume were negatively correlated with age (P ≤ 0.041). Meanwhile, the lens thickness (LT) (P < 0.001) and lens vault (LV) (P < 0.001) were positively correlated with age, and the radius of the curvature of the anterior lens (ALR) was negatively correlated with age (P < 0.001). Conclusion: Increasing age was associated with a thicker crystalline lens, a steeper anterior lens curvature, an anteriorly located and smaller CM, and a narrower SC. Clinical Trial Registration:https://register.clinicaltrials.gov/prs/app/action/Select Protocol?sid=S000A3JZ&selectaction=Edit&uid=U00019K7&ts=4&cx=-c5xxp8, identifier [NCT04576884].
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Affiliation(s)
- Zhangliang Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Ziqi Meng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Wenyong Qu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Xiuyuan Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Pingjun Chang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Dandan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
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Monterano Mesquita G, Patel D, Chang YC, Cabot F, Ruggeri M, Yoo SH, Ho A, Parel JMA, Manns F. In vivo measurement of the attenuation coefficient of the sclera and ciliary muscle. BIOMEDICAL OPTICS EXPRESS 2021; 12:5089-5106. [PMID: 34513244 PMCID: PMC8407821 DOI: 10.1364/boe.427286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
We acquired 1325 nm OCT images of the sclera and ciliary muscle of human subjects. The attenuation coefficients of the sclera and ciliary muscle were determined from a curve fit of the average intensity profile of about 100 A-lines in a region of interest after correction for the effect of beam geometry, using a single scattering model. The average scleral attenuation coefficient was 4.13 ± 1.42 mm-1 with an age-related decrease that was near the threshold for statistical significance (p = 0.053). The average ciliary muscle attenuation coefficient was 1.72 ± 0.88 mm-1, but this value may be an underestimation due to contributions from multiple scattering. Overall, the results suggest that inter-individual variations in scleral attenuation contribute to variability in the quality of transscleral OCT images of the ciliary muscle and the outcome of transscleral laser therapies.
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Affiliation(s)
- Gabrielle Monterano Mesquita
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Disha Patel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Yu-Cherng Chang
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Florence Cabot
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Sonia H. Yoo
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Arthur Ho
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
- Brien Holden Vision Institute, Sydney, NSW 2052, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2033, Australia
| | - Jean-Marie A. Parel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
- Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
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Aggarwala KRG. Ocular Accommodation, Intraocular Pressure, Development of Myopia and Glaucoma: Role of Ciliary Muscle, Choroid and Metabolism. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2020; 9:66-70. [PMID: 31976346 PMCID: PMC6969557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ocular accommodation is not just a mechanism for altering curvature of the crystalline lens of the eye, it also enables aqueous humor outflow through the trabecular meshwork, influencing intraocular pressure (IOP). Long term stress on the ciliary muscle from sustained near focusing may initiate myopic eye growth in children and primary open angle glaucoma in presbyopic adults. Multi-factorial studies of ocular accommodation that include measures of IOP, ciliary muscle morphology, anterior chamber depth and assessment of nutritional intake and metabolic markers may elucidate etiology and novel strategies for management of both myopia and chronic glaucoma. Anatomy of the ciliary fibers from anterior insertion in the fluid drainage pathway to their posterior consanguinity with the vascular choroid, alters ocular parameters such as micro-fluctuations of accommodation and pulsatile ocular blood flow that are driven by cardiac contractions conveyed by carotid arteries. Stretching of the choroid has consequences for thinning of the peripheral retina, sclera and lamina cribrosa with potential to induce retinal tears and optic nerve cupping. Early metabolic interventions may lead to prevention or reduced severity of myopia and glaucoma. Finally, it might improve quality of life of patients and decrease disability from visual impairment and blindness.
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