Long-term Lens Organ Culture System with a Method for Monitoring Lens Optical Quality¶

The effect of varying glucose levels on the ex vivo crystalline lens: implications for hyperglycaemia-induced refractive changes

PURPOSE

Refractive changes in diabetic eyes have long been reported but with equivocal results. The lens has been a more recent focus as the source of any change but it is possible that multiple sources of variation have made it difficult to demonstrate a systematic change clinically. The aim of this study was therefore to use a bovine lens model to investigate the optical changes in hyperglycaemia and when lenses are returned to normal glucose levels as would occur following commencement of treatment.

METHOD

Bovine eyes were obtained and their lenses excised under sterile conditions before placing them in culture medium within an incubator using standard tissue culture techniques. In the first experiment, lenses were transferred into culture medium containing 5 mm (n = 12), 15 mm (n = 12) and 30 mm (n = 12) glucose. Measurements were made of the change in back vertex focusing distance with equatorial lens diameter using the ScanTox(™) measurement system. From these measurements, the back vertex focal length and primary longitudinal spherical aberration were derived. In a second experiment, lenses maintained at 30 mm glucose (n = 7) were stepped down to 5 mm glucose to simulate starting diabetic therapy and measured in the same way. Changes over time were assessed with a linear regression model.

RESULTS

A trend towards myopia was observed with increasing hyperglycaemia, this was not statistically significant. When lenses were stepped-down from hyperglycaemia to normal physiological levels of glucose, a hyperopic shift was observed in line with published clinical studies that again failed to reach statistical significance. High variability in the measurement on longitudinal spherical aberration prevented any significant trends being measured.

CONCLUSIONS

Our results suggest that there are no consistent crystalline lens-induced refractive changes following exposure to hyperglycaemia for time-periods up to 5 days used in the current study. It is possible that bovine lenses are able to offset the raised osmotic pressure from high glucose levels in the short-term by a process of osmoregulation and that repeated osmotic stress or longer term exposure may be required to induce the changes in refraction that are seen clinically.

Desferrioxamine and zinc-desferrioxamine reduce lens oxidative damage

Our purpose was to investigate the quality and morphology of cultured bovine lenses after exposure to hyperbaric oxygen (HBO) in the presence or absence of desferrioxamine (DFO) or zinc-desferrioxamine (Zn-DFO). Intact bovine lenses were cultured and exposed to HBO of 100% oxygen at 2.5 ATA for 120 min. One hundred and fifty lenses were included in the present study. Lenses were divided into study groups of 25 lenses each: (1a) HBO-exposed lenses; (1b) control lenses extracted from the contralateral eyes of group 1a and exposed to normal room air. (2a) HBO-exposed lenses treated with DFO; (2b) control lenses extracted from the contralateral eyes of group 2a exposed to normal room air in the presence of DFO (3a) HBO-exposed lenses treated with Zn-DFO; (3b) control lenses extracted from the contralateral eyes of group 3a, exposed to normal room air in the presence of Zn-DFO. Lens optical quality and structural changes were assessed. Oxygen toxicity to lenses was demonstrated by decreased light transmission, increase in focal length variability and a decrease in morphological integrity. Light intensity measurements showed a distinct pattern in control lenses. A different pattern was noticed for hyperbaric oxygen-exposed lenses. Focal length variability values were stable in control lenses and increased significantly in oxygen-exposed lenses. Structural damage to lenses was demonstrated by the appearance of bubbles between lens' fibers possibly demonstrating failure of lens tissue to cope with oxygen load. All measured parameters showed that both Zn-DFO and DFO attenuated the oxidative damage. The effect of DFO was small whereas Zn-DFO demonstrated a significantly stronger effect. Treatment of hyperbaric oxygen-exposed lenses with DFO only marginally reduced the oxidative damage. Treatment with Zn-DFO was superior in reducing the oxidative damage to lenses. These results indicate a possible role for Zn-DFO in the prevention of cataracts.

Zinc-desferrioxamine reduces damage to lenses exposed to hyperbaric oxygen and has an ameliorative effect on catalase and Na, K-ATPase activities

Our purpose was to investigate the effects of exposure to high partial pressure of oxygen on lens optical quality and on the activities of lenticular catalase and Na, K-ATPase in culture and to examine the effect of zinc-desferrioxamine (Zn-DFO) addition to cultured lenses exposed to high oxygen partial pressure on these parameters. Bovine lenses, kept in organ culture, were exposed to different combinations of partial pressure of oxygen with and without addition of Zn-DFO complex (20 microM) and examined during a 14-day period. Lens optical quality, catalase, and Na, K-ATPase activity were compared between study and control groups. Two hundred lenses were included in the present study. Decreased lenticular optical quality and decreased catalase and Na, K-ATPase activities were observed in lenses exposed to hyperbaric oxygen. Lenses exposed to normobaric oxygen showed a reduction in these parameters to a lesser degree. The damaging optical and enzymatic effects of oxygen on lenses in culture increased in magnitude along the culture period. Addition of Zn-DFO to the culture just before the exposure to hyperbaric oxygen eliminated most of the optical and enzymatic oxygen-induced damage. Addition of Zn-DFO after the first exposure demonstrated reduction in the oxidative damage induced reduction of optical quality in a time-dependent manner - the later the addition of Zn-DFO took place the smaller the protective effect observed. High oxygen load has toxic effects on bovine lenses in organ culture conditions as determined by optical parameters as well as reduction of catalase and Na, K-ATPase activities. These toxic effects can be attenuated by introducing Zn-DFO just before lenses are exposed to oxygen. The beneficial effect of Zn-DFO, applied after lenses have been exposed to hyperbaric oxygen, on the oxidative damage was time-dependent - the earlier the application the more significant the observed protective effect. The present results may indicate a possible future role for Zn-DFO as a protective agent against oxygen-induced human cataract formation.

The lens of the eye as a focusing device and its response to stress

The continued peripheral growth of the lens, resulting in the concentration of older tissue toward the center, has the important optical consequence of producing a lens of variable refractive index. An approach consisting of the projection of fine laser beams through excised lenses in physiological solution has been used for in vitro study of lens optical quality. By varying the separation of the incident beams and/or the wavelength characteristics of the laser used, lens refractive properties and relative transparency may be examined. In the review provided, these optical properties are correlated to lens suture anatomy, lens mitochondrial morphology and function and the function of lens heat shock proteins. In addition, lens spherical aberration is evaluated as a function of accommodation. This work can be highlighted as follows: Mammalian lens suture morphology has a direct impact on lens optical function and, while suture structure of mammalian and avian lenses are very different, they both show an age-related deterioration in morphology and focusing ability. The distribution and appearance of mitochondria of the lens epithelium and superficial fiber cells are similar in all vertebrates. Lens mitochondrial integrity is correlated to lens focusing ability, suggesting a correlation between lens optical properties and lens metabolic function. The induction of cold cataract measured optically in cultured mammalian lenses is enhanced by thermal (heat) shock and this effect is prevented by inhibiting heat shock protein production. Finally, lens accommodative function can be studied by measuring lens refractive change using a physiological model involving an intact accommodative apparatus.