Ocular Blood Flow Evaluation in Injured and Healthy Fellow Eyes

PURPOSE

To assess if injured eyes develop ocular blood flow disturbances that may contribute to development of traumatic glaucoma.

METHODS

Twenty-five eyes of 25 patients hospitalized from January 1997 to July 1999 for blunt (15) or penetrating (10) eye injury and elevated intraocular pressure (IOP) (>23 mm Hg) were controlled at least 24 months after the trauma and underwent visual field examination, pulsatile ocular blood flow (pOBF), and color Doppler imaging (CDI) analysis of ophthalmic artery, central retinal artery, nasal and temporal short posterior ciliary arteries. Uninjured healthy eye was used as control.

RESULTS

IOP was significantly higher in injured eyes (15.1+/-3.3 vs 13.0+/-2.7 mmHg; p<0.01), but only 2 eyes (8%) were under medical treatment. pOBF values were significantly lower in injured eyes: 11.25+/-6.56 microL/sec in the trauma eyes and 15.40+/-7.29 in fellow eyes (p=0.002). Resistivity index of all investigated retrobulbar vessels was very significantly higher in injured eyes than in fellow eyes (p<0.0001). There is no significant correlation between IOP and ocular blood flow disturbance.

CONCLUSIONS

Long-term follow-up (mean 39+/-12 months) of injured eyes shows, besides a slight but significant increase of IOP, a very significant impairment of ocular blood supply to injured eyes compared to healthy fellow eyes with reduction of pulsatile ocular blood flow and marked increase of resistance to flow in all retrobulbar vessels. These anomalies may be considered an independent risk factor to develop traumatic glaucoma.

Access of autonomic nerves through the optic canal, and their orbital distribution in man

The notion that autonomic nerves from the internal carotid plexus are transmitted to the orbit with the ophthalmic artery through the optic canal has been variously assumed, disregarded, or denied, but never demonstrated. The objective of this study was to examine the contents of the canal, identify any autonomic nerves, and follow their passage within the orbit. The soft tissues of the optic canal, and the apical tissues of the orbit were removed and examined histologically using 10 cadaver preparations. Additionally, tissues from an orbital exenteration and 10 ocular enucleation or donor specimens were prepared. Some of the latter material was examined with an electron microscope. Numerous autonomic nerves (four to 25, ranging in diameter from 23 to 130 microm) entered the orbit from the internal carotid plexus in the periosteum of the optic canal, the optic nerve dura mater, or the adventitia of the ophthalmic artery. In the orbit they advanced in the loose connective tissue covering the optic nerve dura and joined ciliary nerves close to the eye or entered the eye directly. None were observed to penetrate the dura, apart from a nerve accompanying the central retinal artery. Others were distributed with the ophthalmic artery and its branches. It is concluded that the optic canal is a regular, and often major, route for autonomic nerve distribution to the eye and orbit.

Morphology of the murine optic nerve

PURPOSE

To study the morphology of the murine optic nerve (ON).

METHODS

Eyes of C57/Bl6 and BalbC mice were studied by light and electron microscopy. Microvascular castings of the ON region were prepared by transcardial injection of liquid plastic and studied with a scanning electron microscope. Immunohistochemistry was performed using antibodies against glial fibrillary acidic protein (GFAP), connexin 43, carbonic anhydrase II, and collagen types I and III.

RESULTS

The transition between nonmyelinated and myelinated portion of the ON started approximately 0.6 mm behind the globe. A lamina cribrosa was completely absent. Instead, ON axons passed through a scleral hole that was surrounded by a ring of type III and type I collagen fibers. Instead of connective tissue beams within the nerve, layers of elongated astrocytes traversed the ON. All astrocytes stained for GFAP, but not for carbonic anhydrase II. The arterial supply of the nonmyelinated ON derived from branches of the central retinal artery. None of the capillaries derived from choroidal vessels.

CONCLUSIONS

The mouse ON head differs from that of other species, because it lacks a lamina cribrosa and a choroidal vascular supply. Studies in glaucomatous mice might help to identify the importance of the lamina cribrosa and the choroidal vascular supply for optic nerve damage in glaucoma.

Corrosion cast demonstration of choroidal vasculature in normal Wistar Kyoto rat

No previous attempt has been made so to demonstrate the details of the choroid vascularization in the rat. This paper describes the choroidal vascular pattern of the normal Wistar Kyoto rat using the corrosion cast method. 6-month-old normal Wistar Kyoto rats were used. Vascular casts prepared by our previously described technique were observed with a Hitachi S-2360N scanning electron microscope. Corrosion casts of the entire choroidal vasculature showed that the ophthalmic artery branched into two main ciliary arteries: the nasal and temporal arteries, which extend forward to form the iridociliary circle. Further the inferior ciliary artery arises from the temporal ciliary artery. In the posterior eye segment these arteries form four to seven branches supplying the adjacent choriocapillaris. There are different arrangements of choriocapillaris. The larger veins formed four vortex veins, one in each quadrant, draining blood from the anterior region of the choroid or iris. Venous blood from the central region, peripapillary choroid and sometimes optic nerve head is drained by smaller veins, which run more or less directly into the posterior ciliary veins. In conclusion corrosion casts and SEM can show the details of the choroidal vascular architecture. These three-dimensional (3-D) findings of choroidal vessels of the rat are very useful for the study of choroid vascular abnormalities in various pathological conditions.

[Study of blood dynamics of ophthalmic artery in patients with sudden sensorineural hearing loss using color Doppler flow imaging]

OBJECTIVE

To investigate the relationship between the pathogenesis of sudden sensorineural hearing loss (SSHL) and the disorder of blood circulation in inner ear.

METHOD

Blood dynamics of the ophthalmic artery were studied quantitatively using color doppler imaging in 34 patients with SSHL.

RESULT

Compared with 34 self-controls and 15 normal controls, 28 patients (82.4%) with SSHL had significantly lower blood flow velocities and higher resistance indices (P < 0.05), and there was no significant difference between the self-control group and the normal control group (P > 0.05).

CONCLUSION

The study suggested that the blood situations--the decreased blood flow velocities and perfusion and increased resistance of ophthalmic artery in patients with SSHL maybe play a role in the pathogenesis of SSHL.

Microvasculature of the rat optic nerve head

PURPOSE

To describe the arterial blood supply, capillary bed, and venous drainage of the rat optic nerve head.

METHODS

Ocular microvascular castings from 6 Wistar rats were prepared by injection of epoxy resin through the common carotid arteries. After polymerization, tissues were digested with 6 M KOH, and the castings washed, dried, and coated for scanning electron microscopy.

RESULTS

Immediately posterior to the globe, the ophthalmic artery trifurcates into the central retinal artery and two posterior ciliary arteries. The central retinal artery directly provides capillaries to the nerve fiber layer and only contributes to capillary beds in the neck of the nerve head. The remainder is supplied by branches of the posterior ciliary arteries that are analogous to the primate circle of Zinn-Haller. Arterioles arising from these branches supply the capillaries of the transitional, or laminar, region of the optic nerve head. These capillaries are continuous with those of the neck and retrobulbar optic nerve head. All optic nerve head capillaries drain into the central retinal vein and veins of the optic nerve sheath. A flat choroidal sinus communicates with the central retinal vein, the choriocapillaris, and with large veins of the optic nerve sheath.

CONCLUSIONS

The microvasculature of the rat optic nerve head bears several similarities to that of the primate, with a centripetal blood supply from posterior ciliary arteries and drainage into the central retinal and optic nerve sheath veins. Association of nerve sheath veins with the choroid represents an important difference from the primate.

Microvascular change of the anterior eye segment after tenotomy in the rabbit

BACKGROUND

The microvascular changes secondary to anterior segment ischemia following tenotomy of the extraocular muscles have not been studied in the rabbit.

METHODS

Using scanning electron microscopy of methyl-methacrylate ocular microvascular luminal castings, the anterior eye segment vasculature after tenotomy was documented and compared to that after occlusion of the bilateral long posterior ciliary arteries and that in the eyes that were not subjected to any surgical intervention.

RESULTS

Five days and 1 week after the surgical intervention with tenotomy, microvascular change secondary to the anterior segment ischemia was not apparent, but 2 weeks after the tenotomy subtle evidence of ischemia such as new vessels in the iris was observed. Seven weeks after tenotomy, marked microvascular change was observed where corneal new vessels arose from the superior perilimbal arteries. In contrast, we found prominent microvascular changes 2 weeks after the occlusion of the long posterior ciliary arteries.

CONCLUSIONS

Tenotomy of the rabbit eye causes microvascular change similar to that in occlusion of the long posterior ciliary arteries. This result suggests that the anterior ciliary artery of the rabbit contributes blood flow to the anterior eye segment and also has a stronger connection with the long posterior ciliary artery than previously reported.

Formation of the ocular arteries in the chick embryo: observations of corrosion casts by scanning electron microscopy

An investigation was carried out on the formation of the blood vessels that supply the optic cup or eyeball in developing chick embryos ranging in age from Hamburger-Hamilton stage 17 (st17) to st44. Corrosion casts of the vasculature were made by injecting resin and examined by scanning electron microscopy. The optic cup was supplied by branches of the cranial ramus of the circle of Willis (CCW) from st17 to st19. By st23, a branch of the CCW and that of the internal carotid artery became anlagen of two ophthalmic arteries, namely, the cerebral ophthalmic artery (COA) and the internal carotid ophthalmic artery (ICOA) respectively. They were continued by primordia of the long posterior ciliary arteries, which connected with each other to form a ring around the pupil. Between st19 and st26, another branch of the CCW was found, by contrast, to supply the primitive pecten. The distal part of the nasal long posterior ciliary artery began to atrophy at st28, so the temporal long posterior ciliary artery only began to supply the ring artery around the pupil by st30. At the same time, the artery supplying the pecten became anastomosed with the ICOA behind the eyeball to form the definitive pectinate artery. By st30, the ophthalmic branch of the stapedial artery had also formed and connected with the distal part of the ICOA behind the eyeball, as well as with the distal part of the COA by st34. The supraorbital branch of the stapedial artery, which had replaced the CCW to anastomose with the ethmoidal artery by st30, was found to be connected to the COA at st36. The main vascular system supplying the eyeball was complete at st36, and its structure at st40 and st44 was fundamentally similar to that at st36.

Gross and histologic study of the rostral epidural rete mirabile and the cavernous sinus in one-humped camels

Gross and histologic features of the rostral epidural rete mirabile (carotid rete) and the cavernous sinus in one-humped camels were studied. It was evident that the branches of the carotid rete share a common tunica adventitia with the veins of the cavernous sinus. Transmission electron microscopy of the rostral epidural rete mirabile and the cavernous sinus revealed gap junctions in endothelial cells lining the walls of the arterial rete branches and veins. The internal elastic lamina of rete branches were fenestrated. Some of these structural features could facilitate countercurrent heat exchange between the rete branches and the venous plexus of the cavernous sinus to regulate brain temperature.