Pirenzepine affects scleral metabolic changes in myopia through a non-toxic mechanism

Whilst the precise mechanism regulating ocular growth is unknown, it has been shown that various pharmacological agents, including the muscarinic receptor antagonists, atropine and pirenzepine, are effective at preventing the development of myopia. A recent study, which demonstrated that muscarinic antagonists reduce the synthesis of glycosaminoglycans and DNA in chick sclera in vitro, led to the suggestion that such drugs may act directly on the sclera, possibly through a toxic mechanism. Accepted markers of scleral metabolism and cell viability were used in conjunction with a non-invasive, physiological method of ocular growth regulation to determine whether the selective muscarinic antagonist pirenzepine inhibits the development of myopia via toxicity to the sclera. Chicks were monocularly deprived (MD) of pattern vision and given daily intravitreal injections of either pirenzepine (700 microg) or saline vehicle into the deprived eye over 5 days. Unoccluded animals also received intravitreal injections of either pirenzepine or saline into one eye (n=6, all groups). The contralateral eye of all animals was left untreated for comparison. Optical and ocular biometric measures were collected on the final experimental day. Following in vivo delivery of [(35)S] labelled sulphate, levels of sulphate incorporation into scleral glycosaminoglycans were measured in proteinase K digests following selective precipitation with alcian blue dye. The DNA content was also assessed through luminescence spectrometry after binding to Hoechst 33258 dye. To allow comparison with an accepted non-invasive, physiological method of ocular growth regulation, myopia was prevented in additional groups of MD animals by allowing 3hr of unoccluded vision each day, over 5 days, before levels of sulphate incorporation were measured. Scleral DNA content, a marker of cell viability, was not significantly altered between treated and control eyes in any injected group. Relative levels of sulphate incorporation (% difference between treated and contralateral control eyes) were significantly lower in the cartilaginous sclera of pirenzepine-MD animals, compared to saline-MD controls (+35.9 +/- 10.1% vs +121.2 +/- 28.6%, P<0.05), after 2hr of incorporation. However, after 6hr incorporation, there was no significant difference in sulphate incorporation in the cartilaginous sclera between the two groups (+87.2 +/- 33.1% vs +111.0 +/- 14.4%, P=0.53). No significant change was found in the levels of glycosaminoglycan synthesis in the fibrous sclera of any pirenzepine treated group, when compared to the appropriate saline control. Relative patterns of sulphate incorporation, between treatment and control groups, were essentially identical at both time points examined, regardless of whether myopia was prevented through pirenzepine injection or periods of unoccluded vision. The present study shows that, at a dose of pirenzepine sufficient to prevent experimentally-induced axial myopia, glycosaminoglycan synthesis in the cartilaginous sclera was significantly reduced for a transient period following the injection. These pirenzepine-induced reductions in glycosaminoglycan synthesis were not caused by direct drug toxicity to scleral cells as these changes were reversible and no significant reduction in DNA content was observed in pirenzepine treated eyes. Similar patterns of scleral glycosaminoglycan synthesis changes were found following the provision of brief periods of unoccluded vision further demonstrating that pirenzepine is effective in myopia prevention via a non-toxic mechanism. Consequently, the prevention of myopia development in chicks, with either pirenzepine or brief periods of unoccluded vision, is associated with the transient modulation of scleral glycosaminoglycan synthesis in the cartilaginous sclera.     

Glycosaminoglycan synthesis in the separate layers of the chick sclera during myopic eye growth: comparison with mammals.

PURPOSE: Studies in animal models of refractive development have shown that the development of and recovery from induced myopia is associated with visually-guided changes in scleral glycosaminoglycan synthesis. The present study sought to determine whether differential patterns of scleral glycosaminoglycan synthesis are present in the fibrous scleral layer of the chick during myopia development or recovery, as has previously been reported in the mammalian sclera. METHODS: Myopia was induced in young chicks by monocular deprivation of pattern vision over 5 days. Other animals underwent monocular deprivation, then had the occluder removed and were allowed 2 days of recovery. A group of age-matched normal animals served as a control. Newly synthesised glycosaminoglycans in the scleral layers were labelled in vivo, using a [(35)S]-labelled precursor delivered intraperitoneally on the final experimental day. Incorporation of this sulphate into glycosaminoglycans of the fibrous and cartilaginous scleral layers was assessed in proteinase K digests by selective precipitation with alcian blue. RESULTS: Glycosaminoglycan synthesis in the fibrous scleral layers of myopic and recovering eyes was not significantly different to contralateral control eyes (+14 +/- 7%, p = 0.09 and -2 +/- 4%, p = 0.64 respectively). In contrast, glycosaminoglycan synthesis was significantly elevated, relative to controls, in the cartilaginous scleral layer of eyes developing myopia (+63 +/- 18%, p < 0.02), whereas in recovering eyes there was found to be a significant decrease in synthesis in the cartilaginous layer (-40 +/- 6%, p < 0.001). CONCLUSIONS: The results of the current study demonstrate that the fibrous scleral layer of the chick does not display the characteristic differential patterns of glycosaminoglycan synthesis that are found in the mammalian sclera during myopia development and recovery. However, as has previously been reported, the cartilaginous layer of the chick sclera does display differential glycosaminoglycan expression, although the direction of regulation is opposite to that found in the fibrous sclera of mammals.     

Optical correction of induced axial myopia in the tree shrew: implications for emmetropization.

PURPOSE: To determine whether an active emmetropization mechanism is involved in the recovery from axial myopia through the use of a mammalian model of refractive development. Specifically, we sought to establish whether the emmetropization mechanism is visually guided by the level of clarity of the image falling on the retina, or if recovery is driven by a mechanism sensitive to abnormal eye shape. METHODS: Young tree shrews had axial myopia induced by monocular deprivation (MD) of pattern vision and then the myopic eye was either: (1) accurately corrected with a negative lens or (2) had a zero-powered lens placed in front of it. Their emmetropization response was monitored, both through the use of ocular refractive and biometric measures, as well as through the assessment of scleral dry weight and glycosaminoglycan synthesis, as indicators of scleral metabolism. RESULTS: Corrective lenses prevented recovery from induced myopia (-6.8 +/- 0.7 D after 5 days MD vs. -6.6 +/- 0.6 D after 5 days of lens wear), whereas animals fitted with zero-powered lenses displayed near full recovery from the induced myopia (-6.6 +/- 0.6 D vs. -1.7 +/- 0.3 D). Significant reductions in scleral dry weight (-4.6 +/- 1.3%) and glycosaminoglycan synthesis (-28.6 +/- 7.3%) were found in the posterior sclera of animals wearing corrective lenses. Conversely, animals wearing zero-powered lenses displayed elevated levels of glycosaminoglycan synthesis (+62.3 +/- 11.1%) in conjunction with scleral dry weights that did not differ significantly between treated and fellow control eyes (-1.5 +/- 2.6%). CONCLUSIONS: Accurate correction of induced axial myopia prevents the refractive, biometric and scleral metabolic responses that are normally observed in tree shrew eyes recovering from induced myopia. These findings support the hypothesis that recovery is driven by an active emmetropization response dependent on the clarity of image falling on the retina and not by a mechanism that is sensitive to abnormal eye shape.     

Scleral remodeling during the development of and recovery from axial myopia in the tree shrew

PURPOSE: Recent investigations have suggested that scleral thinning in mammalian eyes with axial myopia is a consequence of the loss of scleral tissue, rather than the redistribution of existing tissue as the eye enlarges. The present study investigated whether further changes in the distribution and metabolism of scleral tissue occur during the process of recovery from axial myopia. Scleral glycosaminoglycan (GAG) synthesis and content as well as scleral dry weight changes were monitored as indicators of remodeling in myopic and recovering tree shrew sclerae. METHODS: Myopia was induced in tree shrews by monocularly depriving them of pattern vision. Some animals then had the occluder removed and were allowed to recover from the induced myopia for periods of 1, 3, 5, 7, and 9 days. Newly synthesized GAGs were radiolabeled in vivo with [(35)S]sulfate. Sulfate incorporation and total GAG content in the sclera was measured through selective precipitation of GAGs from proteinase K digests with alcian blue dye. Dry weights of the sclerae were also determined. Changes in ocular refraction and eye size were monitored using retinoscopy, keratometry, and ultrasonography. RESULTS: Eyes developing myopia showed a significant reduction in scleral GAG synthesis, particularly in the region of the posterior pole (-36% +/- 7%) compared with contralateral control eyes. Scleral dry weight was also significantly reduced in these eyes (-3.7% +/- 1.2%). In recovering eyes, significant changes in GAG synthesis were apparent after 24 hours of recovery. After 3 days of recovery, significantly elevated levels of GAG synthesis were found (+79% +/- 15%), returning to contralateral control eye values after 9 days of recovery. Interocular differences in scleral dry weight were shown to follow a similar pattern to that observed for GAG synthesis. CONCLUSIONS: Active remodeling, resulting in either the loss or replacement of scleral tissue and not passive redistribution of scleral tissue, is associated with changes in eye size during both myopia development and recovery. Regulatory changes in scleral metabolism can be rapidly evoked by a change in visual conditions and the direction of regulation is related to the direction of change in eye size.     

Decreased proteoglycan synthesis associated with form deprivation myopia in mature primate eyes

PURPOSE: The rate of proteoglycan synthesis was measured in the scleras of adolescent marmosets that had undergone monocular form deprivation to characterize the scleral extracellular matrix changes associated with the development of myopia in a mature primate. METHODS: Form deprivation myopia was induced in adolescent marmosets by unilateral lid suture for an average of 108 days. After the lids were reopened, the axial lengths and refractions were measured at intervals for up to 39 weeks. At the end of the study period, sclera were isolated and immediately radiolabeled with 35SO4 in organ culture. Proteoglycan synthesis rates were determined by measurement of 35SO4 incorporation into cetylpyridinium chloride-precipitable glycosaminoglycans after digestion of the scleral samples with proteinase K. Collagen content was determined by measurement of total hydroxyproline in scleral digests. Newly synthesized proteoglycans were separated on a Sepharose CL-4B molecular sieve column and identified by their core proteins by Western blot analyses. RESULTS: Lid suture resulted in myopia due to a significant increase in vitreous chamber depth. After Sepharose CL-4B chromatography, newly synthesized scleral proteoglycans isolated from normal, form-deprived, and contralateral control eyes, resolved into one major peak that eluted in the position of decorin, a small chondroitin-dermatan sulfate proteoglycan. After digestion of the major peak with chondroitinase ABC, an approximately 45-kDa core protein was detected by Western blot analyses, confirming the presence of decorin. Form deprivation resulted in a significant reduction in the rate of proteoglycan synthesis in the posterior sclera (-43.55%, P < or = 0.001). Proteoglycan synthesis was also significantly reduced in the posterior sclera of form-deprived eyes relative to total collagen content (-36.19%, P < or = 0.01) and was negatively correlated with the rate of vitreous chamber elongation in the deprived eye (r2 = 0.779, P < or = 0.05). CONCLUSIONS: Significant extracellular matrix remodeling occurs in the posterior sclera of the adolescent primate eye during vitreous chamber elongation and myopia development. The negative correlation between vitreous chamber elongation rates and the synthesis rates of decorin in form-deprived eyes suggests that proteoglycan synthesis within the posterior sclera plays a role in the regulation of ocular size and refraction in the adolescent marmoset.     

Protective effects of riboflavin-UVA-mediated posterior sclera collagen cross-linking in a guinea pig model of form-deprived myopia

AIM:To evaluate the effect of posterior sclera collagen cross-linking induced by riboflavin-ultraviolet A(UVA)on form-deprived myopia in guinea pigs.METHODES:Twenty-five pigmented guinea pigs of 3-week-old were randomly assigned into 4 groups that included normal control(NOR,n=7),form-deprived(FDM,n=7),normal with riboflavin-UVA cross-linking(NOR+CL,n=5)and form-deprived with cross-linking(FDM+CL,n=6).The NOR+CL group and the FDM+CL group received the riboflavin-UVA induced cross-linking at day 0.FDM was induced by monocularly deprived with facemask in the right eyes.The refraction,axial length and corneal curvature were measured by retinoscopy,A-scan and keratometer respectively in scheduled time points(day 0 and 1,2,3,4 wk after form-deprivation).At the end of 4 weeks’experiment,stress-strain tests of sclera were measured and morphological changes of sclera and retina were examined.RESULTS:After 4 wk,the interocular difference of refractive error were-0.11±0.67,-2.93±0.56,1.10±0.58,and-1.63±0.41 D in the NOR,FDM,NOR+CL,and FDM+CL groups respectively.Mixed-effect linear model revealed significant effect of FDM(P<0.01)and CL(P<0.001).Also,after 4 wk,the interocular difference of axial length were 0.01±0.04,0.29±0.07,-0.13±0.06,and 0.11±0.05 mm in the NOR,FDM,NOR+CL,and FDM+CL group.Mixedeffect linear model revealed significant effect of FDM(P<0.001)and CL(P<0.01).As for corneal curvature,significant interocular difference have not found between any of the two groups.At the end of this experiment,the ultimate stress and elastic modulus were found significantly increased in both CL groups.But no difference was found in the groups without cross-linked.There was no abnormality observed in the retina and RPE cells of the treated eyes.CONCLUSION:The posterior sclera collagen crosslinking induced by riboflavin-UVA can slow down the progress of myopia and increase the sclera biomechanical strength in the guinea pig model of form-deprived myopia.     

The time course of changes in mRNA levels in tree shrew sclera during induced myopia and recovery

PURPOSE: In tree shrews, visual form deprivation produces increased axial elongation of the deprived eye and a myopic shift in refractive state. A change in scleral extensibility (creep rate) is closely associated with the change in axial elongation rate. These effects may be due to scleral tissue remodeling produced by a change in scleral gene expression. In this study, the authors investigated the time course of changes in scleral mRNA levels for selected proteins during the development of form deprivation myopia and during recovery, to determine which, if any, are temporally associated with changes in scleral extensibility and axial elongation rate. METHODS: Competitive RT-PCR was used to measure the levels of mRNA for structural proteins (collagen [alpha1(I) chain], decorin core protein), degradative enzymes (MMP-2 [gelatinase-A], MMP-3 [stromelysin-1]), and a tissue inhibitor of metalloproteinase (TIMP-1) in the scleras of tree shrews that had been subjected to 1, 2, 4, or 11 days of monocular form deprivation (MD) or 11 days of MD followed by 2 or 4 days of recovery produced by removal of the MD. Four groups of normal animals provided age-matched normal data. RESULTS: Compared with the control eyes, deprived-eye MMP-2 mRNA levels were higher and MMP-3 levels were lower after 4 days of MD. Deprived-eye collagen mRNA levels were lower than control eye levels after 11 days of MD. The differential effects produced by MD were absent after 2 days of recovery and generally were reversed after 4 days. Decorin mRNA levels in the deprived and control eyes were not significantly different during either MD or recovery. During MD, mRNA levels for collagen, MMP-3, and TIMP-1 decreased in both the deprived and control eyes, compared with age-matched normal eyes. The binocular changes in collagen and TIMP-1 mRNA levels and the differential changes in MMP-2 and MMP-3 levels were detected at least as early as axial, refractive, and creep rate changes. CONCLUSIONS: The up- and downregulation of the specific mRNAs studied, on a time course similar to that for physical changes in the sclera, suggests that modulation of gene expression by the visual environment may produce scleral remodeling and changes in scleral creep rate during the development of form deprivation myopia and recovery.     

豚鼠实验怀近视眼巩膜的羟脯氨酸含量改变

目的：探讨胶原水平的变化在哺乳类动物近视眼发生机制中的作用。方法：出生3周的乳花色雄性豚鼠24只,单眼眼睑缝合75天后,检测影响眼轴。后极和前部巩膜分别称重后,以蛋白酶K消化和盐酸水解,用氯胺T氧化比色法测定每毫克巩膜中的羟脯酸含量。结果：豚鼠75天的形觉剥夺诱导了约－9D的相对近视和0．39mm的眼轴延长。剥夺眼部巩膜和后极巩膜的羟脯氨酸含量差异有显著性意义（P＜0．001）;对照前后巩膜的羟脯氨酸含量差异无统计学意义（P＞0．05）。双眼前部巩膜的羟脯氨酸含量差异无统计学意义（P＞0．05）;双眼后部巩膜的羟脯氨酸含量差异有显著性意义（P＜0．001）。结论：豚鼠眼形觉剥夺性近视时,主要是后极部羟脯胺酸含量减少,即后极部的巩膜胶原优先影响。由于后极部巩膜胶原减少,减弱了巩膜的抵抗力,使眼轴易于延展而发生近视。     

豚鼠短期形觉剥夺性近视屈光度眼轴及巩膜改变

目的:观察豚鼠短期形觉剥夺性近视(form deprivationmyopia,FDM)眼轴、屈光度变化及后极部巩膜病理性改变。方法:4周龄健康豚鼠40只,随机分成形觉剥夺实验组和年龄匹配正常对照组各20只。形觉剥夺实验组分为剥夺1,4,7和14d4个亚组,右眼为剥夺眼,采用半透明眼罩遮盖诱导轴性近视,左眼不予处理。对剥夺前后实验组和对照组双眼屈光度、眼轴进行测量,并对后极部巩膜进行HE染色光镜观察和透射电镜观察。结果:形觉剥夺7d近视程度和眼轴长度改变迅速,之后减慢并趋于平稳。4个实验亚组剥夺眼与实验前比较相对近视-0.30±0.45D,-3.65±0.78D,-6.98±0.65D,-8.68±1.12D,相对眼轴延长4.8±3.2,129.0±12.6,159.0±10.1,184.4±10.4μm。其中4,7,14d实验亚组剥夺眼与对照眼差别有统计学差异(P<0.01),剥夺眼后极部巩膜明显变薄,成纤维细胞密度降低,细胞外基质增多。1,4,7,14d实验亚组形觉剥夺眼后极部巩膜胶原纤维平均直径102.0,67.4,52.2,49.8nm,与正常对照眼比较差别有统计学意义(P<0.05)。结论:4周龄豚鼠单眼形觉剥夺4d即可出现轴性近视,1d即有巩膜病理改变,形态学改变先于生物学改变,形觉剥夺7d为近视发展高峰期。     

Expression of collagen-binding integrin receptors in the mammalian sclera and their regulation during the development of myopia

PURPOSE: The sclera has a collagen-rich extracellular matrix that undergoes significant biochemical and biomechanical remodeling during myopic eye growth. The integrin family of cell surface receptors play critical roles in extracellular matrix and biomechanical remodeling in connective tissues. This study identified the major collagen-binding integrin receptors in the mammalian sclera and investigated their mRNA expression during the development of and recovery from experimental myopia. METHODS: The presence of the alpha1, alpha2, and beta1 integrin subunits was examined by using tree-shrew-specific primers and RT-PCR. Scleral expression of alpha1beta1 and alpha2beta1 receptor proteins was further investigated by using Western blot analysis and immunocytochemistry. Myopia was induced monocularly by occluding pattern vision and scleral tissue collected after 24 hours and 5 days. In a subset of the 5-day treatment group, vision was restored for 24 hours before tissue was isolated. Total RNA was extracted, and integrin subunit expression levels were assessed with quantitative real-time PCR. RESULTS: The presence of the major collagen-binding integrin subunits alpha1, alpha2, and beta1 was confirmed by RT-PCR in both scleral tissue and cultured scleral fibroblasts. Both the alpha1 and alpha2 integrin subunit proteins were identified in tree shrew scleral tissues, and integrin receptor expression was localized to scleral fibroblast focal adhesions. After only 24 hours of myopia induction, a time when no structural elongation has occurred, significant decreases were observed in the expression of the alpha1 (-36%) and beta1 (-44%) integrin subunits. After 5 days of myopia induction, alpha1 integrin expression had returned to baseline levels, whereas the alpha2 subunit showed a significant decrease in expression (-52%). The 5-day integrin profiles were maintained during recovery from the induced myopia, with only alpha2 integrin showing a statistically significant relative decrease in expression (-41%). CONCLUSIONS: The mammalian sclera expresses the major collagen-binding integrin subunits. The alpha1 and beta1 subunit expression was decreased early during the development of myopia, whereas the regulation of alpha2 integrin occurred at a later time point. The differential regulation of alpha1beta1 and alpha2beta1 during the development of myopia may reflect specific roles for these receptors in the scleral extracellular matrix and biomechanical remodeling that accompanies myopic eye growth.     

Modulation of glycosaminoglycan levels in tree shrew sclera during lens-induced myopia development and recovery

PURPOSE: In juvenile tree shrews, positioning a negative-power lens in front of an eye produces a hyperopic shift in refractive state and causes a compensatory increase in axial length over several days so that the eye is myopic when the lens is removed. During negative lens compensation, the scleral extracellular matrix is remodeled. A biomechanical property of the sclera, creep rate, increases; during recovery from induced myopia, the creep rate decreases below normal levels. Changes in glycosaminoglycan (GAG) levels, including those of hyaluronan, may participate in these changes in creep rate and, in turn, participate in controlling the axial length and refractive state. This study investigated the unsulfated and sulfated GAG composition of the sclera during compensation for a -5 diopter (D) lens and during recovery. METHODS: Capillary electrophoresis was used to assess the relative levels (ng/mg dry scleral weight) of unsulfated GAGs (hyaluronan [HA] and chondroitin [C0S]), sulfated GAGs (chondroitin-4-sulfate [C4S], chondroitin-6-sulfate [C6S], and dermatan sulfate [DS]) in the sclera of groups of tree shrews (n = 5 per group) that wore a monocular -5 D lens for 1, 2, 4, or 11 days or had 11 days of -5 D lens wear followed by 1, 2, or 4 days of recovery from lens wear. The fellow eye served as an untreated control. Groups of normal and plano lens-treated animals provided age-matched values. RESULTS: Expressed as a fraction of dry weight, levels of HA were lower after 1, 4, and 11 days of -5 D lens wear. Levels of C0S, C6S, and C4S were significantly lower after 4 and 11 days of lens wear. After 1 and 2 days of recovery, GAG levels in the treated eyes were not significantly different from those in control eyes. After 4 recovery days, HA levels were lower, but the levels of all other GAGs were not different in the recovering and control eyes. Some binocular changes also occurred. CONCLUSIONS: The rapid differential decrease in HA levels during negative lens compensation and the absence of any difference after just 1 day of recovery suggest that HA levels may play a previously unrecognized early role in regulating the biomechanical property (creep rate) of the sclera. The reduced levels of the other GAGs, which occur when creep rate is at its peak elevation, and their rapid return to normal after 1 day of recovery suggest that they may also participate in regulating this biomechanical property of the sclera.     

Scleral changes in chicks with form-deprivation myopia

The sclera in myopic regions of chick eyes was studied histologically and compared to the sclera in corresponding regions of normal fellow eyes. Chicks had been monocularly deprived of form vision in the nasal half of the retina from hatching. The fellow control eye and the temporal retina of the deprived eye had normal vision. With this treatment, the resulting form-deprivation myopia and eye enlargement are restricted to the retinal region that had been form deprived. We found that the cartilaginous sclera in the myopic nasal region exhibited several differences from that in the corresponding non-myopic region: it was thicker, its cell density was lower, and the number of chondrocytes and binucleate cells was higher. In contrast, the fibrous sclera was thinner. These changes suggest that form-deprivation myopia causes an increased production of extracellular matrix and an increased level of mitotic activity in the cartilaginous sclera. As expected, the non-myopic temporal regions of experimental and control eyes did not differ in any of these parameters. The findings of the present study suggest that the eye enlargement accompanying form-deprivation myopia is not the consequence of scleral stretching but of abnormal growth.     

Regulation of the biphasic decline in scleral proteoglycan synthesis during the recovery from induced myopia

During the recovery from form deprivation myopia (myopic defocus), the rate of proteoglycan synthesis in the posterior sclera decreases co-incident with a deceleration of axial elongation. The choroid has been implicated in the regulation of scleral proteoglycan synthesis, possibly through the synthesis and secretion of scleral growth inhibitors. Therefore these studies were carried out to attempt to establish a causal relationship between choroidal secretion and the inhibition of scleral proteoglycan synthesis during the recovery from induced myopia. Chicks were form vision deprived for 10 days followed by a recovery period (3 h–20 days) of unrestricted vision. Sclera and choroids (5 mm punches) were isolated from control and treated eyes. The rate of proteoglycan synthesis was estimated by the incorporation of ³⁵c in cetylpyridinium chloride-precipitable glycosaminoglycans by isolated sclera of control and treated eyes. Additionally, choroids from control and treated eyes were placed in co-culture with untreated age-matched normal chick sclera for 20–24 h, after which time sclera were removed and scleral proteoglycan synthesis rates were determined. Following removal of occluders, a biphasic decline was observed in scleral proteoglycan synthesis: A rapid decline in proteoglycan synthesis (−7.6% per hr; r² = 0.923) was observed over the first 12 h of recovery, followed by a slow decline extending from 12 to 96 h (−0.3% per hr; r² = 0.735). Proteoglycan synthesis rates gradually increased to control levels over the next 96 h at a rate of +0.3% per hr. No relative proteoglycan inhibition was observed when untreated sclera were co-cultured with choroids from eyes recovering for 0–4 days, whereas co-culture of untreated sclera with choroids from eyes recovering for 5 and 8 days resulted in significant inhibition of sclera proteoglycan synthesis, relative to that of sclera co-cultured with choroids from control eyes (≈−24%, P < 0.05, paired t-test). In conclusion, recovery from induced myopia is characterized by a rapid decline in proteoglycan synthesis which occurs within the first 12 h of unrestricted vision as a well as a slower more gradual decline that occurs over the next four days. Choroidal inhibition of scleral proteoglycan synthesis in vitro occurs during the second phase of decline and is most likely related to increased choroidal permeability; whereas the rapid decline in proteoglycan synthesis that occurs during the first 12 h of recovery is regulated by an independent, yet to be identified mechanism.     

Observations on the effects of form deprivation on the refractive status of the monkey

The consistency of the refractive error alterations produced by monocular form deprivation in developing monkeys and the influence of the duration and the age at the onset of deprivation on the magnitude of these alterations was investigated. Refractive error and axial length measurements are presented for a group of monkeys which had one eye sutured closed for a period exceeding 18 months beginning at various ages ranging from 26 days to 25 months. In addition, we pooled and reanalyzed refractive error and axial length data for monocularly form-deprived monkeys from previous studies. When the alterations in the deprived eye's refractive status are specified with respect to the fellow nondeprived eye, the results are, with a few noteworthy exceptions, consistent between laboratories and individual animals. In most cases, early monocular form deprivation causes the treated eye to develop a longer axial length and to manifest a more myopic/less hyperopic refractive error than the fellow nontreated eye. The magnitude of this deprivation-induced alteration is generally dependent on the duration and the age at the onset of form deprivation. The earlier the deprivation is initiated and the longer it is maintained, the greater the degree of the relative myopia produced in the deprived eye.     

Structural and ultrastructural changes to the sclera in a mammalian model of high myopia

PURPOSE: The development of high myopia is associated with scleral thinning and changes in the diameter of scleral collagen fibrils in humans. In the present study, the association between these scleral changes and the losses in scleral tissue that have previously been reported in animal models were investigated to determine the relationship between changes in collagen fibril architecture and thinning of the sclera in high myopia. METHODS: Myopia was induced in young tree shrews by monocular deprivation of pattern vision for short-term (12 days) or long-term (3-20 months) periods. Scleral tissue from normal animals over a wide age range (birth to 21 months) was also collected to provide data on the normal development of the sclera. Light and electron microscopy were used to measure scleral thickness and to determine the frequency distribution of collagen fibril diameters in the sclera. Tissue loss was monitored through measures of scleral dry weight. RESULTS: Significant scleral thinning and tissue loss, particularly at the posterior pole of the eye, were associated with ocular enlargement and myopia development after both short- and long-term treatments. However, collagen fibril diameter distribution was not significantly altered after short-term myopia treatment, whereas, from 3 months of monocular deprivation onward, significant reductions in the median collagen fibril diameter were noted, particularly at the posterior pole. CONCLUSIONS: The results of this study demonstrated that loss of scleral tissue and subsequent scleral thinning occurred rapidly during development of axial myopia. However, this initial tissue loss progressed in a way that did not result in significant alterations to the collagen fibril diameter distribution. In the longer term, there was an increased number of small diameter collagen fibrils in the sclera of highly myopic eyes, which is consistent with findings in humans and is likely to contribute to the weakened biomechanical properties of the sclera that have previously been reported.     

鸡眼形觉剥夺性近视的实验研究

目的建立鸡形觉剥夺近视模型,观察形觉剥夺眼屈光、巩膜形态学改变。方法将孵出后一天的家鸡25只,以右眼为形觉剥夺眼,左眼为开放对照眼,2周后进行检影验光,并摘出眼球,测量眼轴长和赤道径。观察巩膜软骨层中细胞密度、增殖细胞率,并测量角巩膜的干湿重。结果剥夺眼的屈光度平均为-11.9±4.6D,对照眼平均为+3.0±1.2D,两者差异有显著性意义,轴长较对照眼明显延长（P<0.01）,剥夺眼的巩膜干湿重均明显重于对照眼（P<0.01）,并且巩膜软骨中增殖细胞率明显高于对照眼（P<0.05）,但细胞密度则低于对照眼（P<0.05）。结论鸡眼形觉剥夺可产生一定程度的近视和眼轴延长,并伴随着巩膜的病理形态改变。     

形觉剥夺下雏鸡视网膜、脉络膜和巩膜中全反视黄酸含量的变化

目的:雏鸡形觉剥夺性近视眼及形觉剥夺性近视恢复眼中视网膜、脉络膜和巩膜中视黄酸含量的作用.方法:选用新孵出的普通肉食家鸡75只,采用半透明薄膜眼罩遮盖的方法对左眼进行形觉剥夺,分为形觉剥夺组,遮盖时间为14d;形觉剥夺恢复组,遮盖11d后,去遮盖3d.两组的右眼作为对照眼.暗室内处死小鸡后,立即摘出眼球.冰台上用角膜钻取直径为8mm的后极部眼组织块,手术显微镜下快速分离出视网膜、脉络膜及巩膜纤维层和软骨层组织.将每3个标本作为一个样品.取空白样品,加入全反视黄酸标准溶液,按样品处理方法操作后,绘制标准曲线,根据标准品的色谱分析,分别确定出各组织中视黄酸的出峰位置,根据计算机的色谱工作站计算出样品的含量.结果:正常眼视网膜、脉络膜、巩膜中均有RA存在,其中脉络膜中RA含量最高,其次为巩膜及视网膜,其中巩膜纤维层的含量高于软骨层中的含量(P＜0.05).形觉剥夺14d后,视黄酸含量在视网膜中明显增高(P＜0.01,n=10);在脉络膜中明显下降(P＜0.01);在巩膜软骨层及纤维层中RA均明显下降(P＜0.01),其中,纤维层中下降得更为明显.除去形觉剥夺3d后,视黄酸含量在视网膜中明显下降(P＜0.01);在脉络膜中明显升高(P＜0.01),为剥夺眼视黄酸水平的7倍;在巩膜软骨层和纤维层中明显升高(P＜0.01),且纤维层中的含量高于软骨层中的含量(P＜0.05).结论:形觉剥夺及去形觉剥夺时,小鸡视网膜、脉络膜、巩膜纤维层及软骨层中视黄酸含量均发生了明显的变化,后极部巩膜纤维层中视黄酸含量变化比软骨层更为明显.     

Crosslinking of scleral collagen in the rabbit using glyceraldehyde

PURPOSE: To strengthen rabbit sclera in vivo using chemical crosslinking with glyceraldehyde for a scleral-based treatment of progressive myopia. SETTING: Department of Ophthalmology, Martin-Luther-University, Halle, Germany. METHODS: Five chinchilla rabbits were treated with sequential sub-Tenon injections of 0.15 mL 0.5 M glyceraldehyde into the superonasal quadrant of the right eye 5 times during 14 days. The rabbits were humanely killed and biomechanical stress-strain measurements of scleral strips from the treatment area were performed and compared with nontreated contralateral control sclera using a microcomputer-controlled biomaterial tester. The treated eyes were examined histologically by light microscopy to exclude possible adverse effects. RESULTS: Following the crosslinking treatment, the ultimate stress was 15.8 MPa +/- 6.0 (SD) versus 3.1 +/- 0.3 MPa in the controls (increase of 409.7%; P<.02), the Young modulus was 129.6 +/- 53.7 MPa versus 11.5 +/- 1.8 MPa in the controls (increase of 1027%, P<.01), and ultimate strain was 19.8% +/- 2.6% MPA versus 38.2% +/- 5.1% MPA in the controls (decrease of 48.2% P<.05). Histologically, mild side effects were found in the peripheral cornea adjacent to the treatment area, with some inflammatory infiltrate and moderate loss of keratocytes. CONCLUSIONS: Glyceraldehyde crosslinking of scleral collagen increased the scleral biomechanical rigidity efficiently. Glyceraldehyde can be easily applied by sequential parabulbar injections. There were no side effects on the retina, so the new method might become a treatment modality for strengthening scleral tissue to prevent progressive myopia.