琥珀酸甲泼尼龙兔眼球周注射的药代动力学研究

目的：检测琥珀酸甲泼尼龙(methylprednisolone sodium succinate,MPS)兔眼球周注射后,MPS和其在眼内的代谢产物甲泼尼龙(methylprednisolone,MP)的分布及药代动力学情况。

方法：兔眼球周注射琥珀酸甲泼尼龙钠10mg,采用质谱-液相色谱方法检测MPS和MP在巩膜、脉络膜和视网膜、玻璃体、虹膜、房水、晶状体、视神经和血浆中的浓度。

结果：球周注射琥珀酸甲泼尼龙钠后, MPS浓度在眼内组织中的达峰时间为注药后0.25～1h,在血浆中的达峰时间为注药后0.25h; MP浓度在眼内组织中的达峰时间为0.5～6h,在血浆中的达峰时间为注药后0.5h。MPS和MP在眼内各组织的达峰浓度由高到低依次为巩膜、视神经、脉络膜和视网膜、虹膜、晶状体,二者在晶状体内的浓度均为所有眼部组织中最低,且远远低于眼内其它组织的含量,但平均驻留时间最长。

结论：球周注射MPS是一种有效的向眼组织传递药物的方式,且该药在眼内的分布有利于向巩膜、视神经和脉络膜视网膜给药,而不易被晶状体吸收。     

Periocular injection of microspheres containing PKC412 inhibits choroidal neovascularization in a porcine model

PURPOSE: Oral administration of PKC412, a kinase inhibitor that blocks several isoforms of protein kinase C (PKC) and receptors for vascular endothelial growth factor (VEGF), platelet-derived growth factor, and stem cell factor, inhibits ocular neovascularization in a murine model. The purpose of this study was to determine whether sustained local delivery of PKC412 in a human-sized eye inhibits choroidal neovascularization (CNV). METHODS: Laser photocoagulation was used to rupture Bruch's membrane in young domestic pigs, and then a periocular injection of control microspheres or microspheres containing 25% or 50% PKC412 was given. After 10 days the integrated area of CNV at Bruch's membrane rupture sites was measured by image analysis. The levels of PKC412 in choroid, retina, and vitreous were measured either 10 or 20 days after periocular injection of 50% PKC microspheres or at 20 days after injection of 25% PKC412 microspheres. RESULTS: The areas of CNV at Bruch's membrane rupture sites were significantly smaller in eyes that received a periocular injection of microspheres containing 25% (P=0.0042) or 50% (P=0.0012) PKC412 than those in eyes injected with control microspheres. Ten days after periocular injection of 50% PKC412 microspheres, PKC412 was detected in the choroid, but not in the retina or vitreous. Twenty days after periocular injection of 50% PKC412, high levels of PKC412 were measured in the choroid, vitreous, and retina. Levels were lower but still substantial in all three compartments 20 days after periocular injection of 25% microspheres. CONCLUSIONS: Sustained local delivery of PKC412 provides a promising approach for treatment of CNV.     

Pharmacokinetics of systemic versus focal Carboplatin chemotherapy in the rabbit eye: possible implication in the treatment of retinoblastoma

PURPOSE: To characterize the pharmacology and toxicity of intravenous versus focal carboplatin delivery in the rabbit eye. METHODS: Pharmacological distribution of carboplatin was examined in New Zealand White Rabbits after a single intravenous infusion of carboplatin (18.7 mg/kg of body weight), a single subconjunctival carboplatin injection (5.0 mg/400 microL), or a single application of carboplatin delivered by Coulomb-controlled iontophoresis (CCI; 14 mg/mL carboplatin, 5.0 mA/cm(2), 20 minutes). After each treatment, animals were euthanatized, and the eyes analyzed at 1, 2, 6, or 24 hours by atomic absorption spectroscopy to determine carboplatin concentration in ocular structures. Potential toxicity of focally delivered carboplatin was assessed by histology after six cycles of 5.0 mg carboplatin delivered by subconjunctival injection or six transscleral carboplatin CCI applications at 72-hour intervals (14.0 mg/mL, 20 minutes at 2.5 mA). RESULTS: Determination of concentrations through atomic absorption spectroscopy in the retina, choroid, vitreous humor, and optic nerve after subconjunctival injection or iontophoretic carboplatin delivery revealed significantly higher levels than those achieved with intravenous administration. Carboplatin concentrations in the blood plasma were found to be significantly higher after intravenous delivery than after focal delivery by subconjunctival injection or CCI. No evidence of ocular toxicity was detected after focally delivered Carboplatin. CONCLUSIONS: Focal administration of carboplatin using subconjunctival or noninvasive CCI safely and effectively transmits this chemotherapeutic drug into the target tissues of the retina, choroid, vitreous, and optic nerve. These results suggest that focal carboplatin delivery may effectively increase intraorbital carboplatin concentrations while decreasing systemic exposure to this cytotoxic drug.     

Pharmacokinetics of intraocular drug delivery by periocular injections using ocular fluorophotometry

PURPOSE: To evaluate the pharmacokinetics of the periocular injections: posterior subtenon (PST), retrobulbar (RB), and subconjunctival (SC) injection. METHODS: Two sodium fluorescein (NaF) concentrations, 2.5 mg in 0.1 mL (NaF1) and 2.5 mg in 0.5 mL (NaF2) were injected into live rabbits by the PST (NaF1 n = 4, NaF2 n = 3), RB (NaF1 n = 10), SC (NaF1 n = 6), and intravenous (IV, NaF1 n = 6) routes and into euthanatized rabbits by the RB (NaF1 n = 8) route. NaF concentrations in the choroid/retina, vitreous, and anterior segment were measured by ocular fluorophotometry. The NaF level in the contralateral choroid/retina was used as a measure of the systemic drug levels. RESULTS: The maximum NaF concentrations (nanograms per milliliter) in the choroid/retina after PST, RB, SC, and IV were 757 +/- 549 at 2 hours, 906 +/- 1014 at 1 hour, 320 +/- 462 at 2 hours, and 865 +/- 363 at 5 to 10 minutes, respectively. The PST had the highest and most prolonged vitreous NaF1 concentration (maximum: 270 +/- 226 ng/mL at 3.5 hours). The contralateral peak choroid/retina NaF levels after the RB, SC, and IV injections were 7, 4, and 21 times greater than after the PST injection. The SC injection had the highest anterior segment NaF concentration (5364 +/- 2840 ng/mL at 2 hours). PST with NaF2 resulted in intraocular NaF levels higher than with NaF1. CONCLUSIONS: NaF reaches the choroid/retina by transscleral diffusion from the periocular depot. The orbital and conjunctival vasculature and lymphatics have a larger role in NaF clearance than does the choroid. NaF diffuses into the vitreous from the choroid and the anterior segment; the periocular depot location determines the predominant diffusion pathway. The duration of high NaF levels in the choroid/retina or the anterior segment determines vitreous NaF levels. PST is the best periocular route for vitreous NaF delivery with minimal systemic levels. Increasing the volume of NaF PST depot enhances transscleral drug delivery.     

On the ocular distribution of cardiac glycosides in guinea pigs following acute administration

Tritiated ouabain, digitoxin, and digoxin were given IV to anesthetized guinea pigs. The tritium content of the ocular tissues (cornea, iris, lens, vitreous body, retina, choroid, sclera, and optic nerve) was measured after 1 and 3 h and compared with the amount of tritium found in the brain and some peripheral organs. High levels of digitoxin were found in the brain and retina. Digoxin was detected in large quantities in the retina, but only small levels were found in brain tissue. Ouabain was nearly absent in the retina and cerebrum, whereas in most other ocular and peripheral tissues the three cardiac glycosides were present in comparable quantities. The IP injection of tritiated digoxin resulted in lower absolute tissue levels, but a pattern of distribution similar to that observed in anesthetized guinea pigs was found in conscious animals.     

A rabbit model for assessing the ocular barriers to the transscleral delivery of triamcinolone acetonide

Transscleral delivery of triamcinolone acetonide into the vitreous using sub-Tenon's injections may be a safer alternative to reduce the sight-threatening complications of direct intravitreal injections. However, sub-Tenon's injections have demonstrated low and poorly sustained vitreous drug levels in animal studies. To improve our understanding of the clearance mechanisms of corticosteroids, we evaluated vitreous drug levels following sub-Tenon's injection of triamcinolone acetonide in rabbits with selective elimination of conjunctival lymphatic/blood vessels and the choroid. Pigmented rabbits were given a sub-Tenon's injection of a preservative-free triamcinolone acetonide formulation of either a 10- or 20-mg dose in the superotemporal quadrant. The effect eliminating both conjunctival and choroidal clearance was evaluated by injecting the drug, followed by immediate euthanasia, effectively terminating both lymph and blood flow in the conjunctiva and choroid. To inhibit only the clearance from conjunctival lymphatics/blood vessels of a sub-Tenon's injection of triamcinolone acetonide, a group of rabbits had a 'conjunctival window' created by incising an 7 mmx7 mmx7 mm square through the conjunctiva to bare sclera in the superotemporal quadrant. To eliminate only the clearance of drug from the choroidal circulation, cryotherapy was performed in another group of rabbits creating a chorioretinal scar in the superotemporal quadrant. Following the sub-Tenon's drug injection, the eyes were enucleated in all groups after 3 hr and vitreous drug levels were measured with HPLC. In normal animals, a 10-mg sub-Tenon's injection showed no detectable vitreous drug levels; however, a 20-mg injection showed positive vitreous drug levels. This suggested that collectively, the transscleral clearance mechanisms inhibiting delivery into the vitreous may be saturated with a drug depot that has a higher release rate. A 10-mg sub-Tenon's drug depot was able to deliver drug into the vitreous when both the conjunctival and choroidal drug clearance was eliminated by euthanizing the animal immediately following the drug injection. In rabbits that had only a 'conjunctival window', selectively eliminating conjunctival drug clearance, vitreous drug levels were detected. However, in rabbits that had only cryotherapy, selectively eliminating choroidal drug clearance, vitreous drug levels were not detected suggesting that the conjunctival lymphatics/blood vessels may be an important barrier to the transscleral delivery of triamcinolone acetonide. Variability in the vitreous drug levels between rabbits in each group precluded statistical testing. In summary, the rabbit appeared to demonstrate saturable ocular barriers to transscleral delivery of triamcinolone acetonide into the vitreous following a sub-Tenon's injection. The results suggested that the conjunctival lymphatics/blood vessels may be an important barrier to the delivery of triamcinolone acetonide to the vitreous in this rabbit model. The barrier location and clearance abilities of the ocular tissues are important to consider when developing a successful transscleral drug delivery system. Animal models, retaining the dynamics of blood and lymph flow, may improve the basic understanding of the ocular barriers involved with transscleral drug transport and warrants further investigation.     

Effect of sub-Tenon's and peribulbar anesthesia on intraocular pressure and ocular pulse amplitude

PURPOSE: To compare the effect of peribulbar and sub-Tenon's anesthesia on intraocular pressure (IOP) and ocular pulse amplitude (OPA) in the injected eye and the fellow noninjected (control) eye. SETTING: Tel Aviv Medical Center, Tel Aviv, Israel. METHODS: This prospective study measured IOP and OPA at baseline and 1 and 10 minutes after administration of lidocaine anesthesia in 40 consecutive adult patients having elective cataract surgery. RESULTS: The IOP remained stable throughout the study with both modes of anesthesia. One minute after injection of the anesthetic agent, the OPA was significantly decreased in the injected eyes in both the sub-Tenon's (24%; P < .05) and peribulbar (25%; P < .05) groups. The decrease in the OPA in the sub-Tenon's group (14%; P < .05) was detectable after 10 minutes in the control eyes. In the peribulbar anesthesia group, the OPA in the control eyes increased significantly (9%; P < .05) 1 minute after injection of the anesthetic agent, returning to preinjection levels 10 minutes after the injection. CONCLUSIONS: The OPA in the eyes in which lidocaine was injected decreased significantly in both the sub-Tenon's and peribulbar groups. These findings have implications for the management of patients whose ocular circulation may be compromised.     

Trans-scleral delivery of antiangiogenic proteins.

PURPOSE: In this study, we investigated the penetration of various proteins into the mouse eye after a periocular injection of the protein or an adenoviral vector (Ad) expressing the protein. METHODS: At several time points after the injection, the retina, retinal pigmented epithelium/choroid, and sclera were dissected and enzyme-linked immunosorbent assays were performed. RESULTS: After a periocular injection of AdsFlt-1.10, AdTGFbeta.10, or AdPEDF.11, choroidal levels of pigment epithelium-derived factor (PEDF) and transforming growth factor-beta (TGF-beta) were not significantly different from scleral levels, and choroidal levels of sFlt-1 (soluble Flt-1 or soluble VEGF receptor 1) were only moderately reduced from scleral levels, indicating that each of these proteins penetrate the sclera well. In contrast, retinal levels of each of the three proteins were low compared to choroidal levels, suggesting poor penetration into the retina. Levels of PEDF in the choroid peaked 2 h after a periocular injection of PEDF protein and returned to baseline between 6 and 24 h, and peak levels in the retina were 8.6% of peak choroidal levels. Levels of green fluorescent protein, a protein unlikely to have any binding sites in mouse tissues, peaked in the choroid 2 h after the periocular injection and were undetectable by 4 h, while peak levels in the retina were 64.3% of peak choroidal levels. CONCLUSIONS: These data suggest that size and binding characteristics of proteins are likely to influence their ability to penetrate the eye from the periocular space, but in general, proteins as large as 50-75 kDa penetrate well into the choroid, but not into the retina. Periocular injections are feasible for the treatment of choroidal neovascularization with proteins or vectors that express them, but additional investigations are needed before they can be considered for treatment of retinal diseases.     

Tolerability and pharmacokinetics of intravitreal sirolimus

Abstract Purpose: To evaluate the pharmacokinetics (PK) and tolerability of a proprietary sirolimus depot-forming ocular formulation in rabbits and humans after a single intravitreal (IVT) injection. Methods: New Zealand White (NZW) rabbits were intravitreally injected in both eyes with an injectable formulation in 5 (3 PK and 2 tolerability) studies. The rabbits received up to approximately 220?μg sirolimus per eye. At the desired timing post-injection, the animals were euthanized; both eyes were enucleated, frozen, and dissected to separate sclera, retina/choroid, and vitreous humor (VH). Whole blood (WB) samples were obtained at each time point before euthanasia. In clinical trials, patients received an IVT injection of approximately 352?μg sirolimus. Sirolimus concentrations in ocular tissues and WB samples were measured using liquid chromatography/tandem mass spectrometry (LC/MS/MS). In both single- and repeat-dose tolerability studies, systemic and ocular adverse effects were evaluated. Results: After IVT administration, sirolimus formed a depot in the VH. During dissolution, concentrations in VH were dose related and exhibited continuous release from the depot. This was characterized by a gradient of sirolimus concentration in the order of VH > retina/choroid > sclera > WB, and the concentrations were maintained for approximately 2 months after the IVT injection. After repeat dosing (132?μg), no drug accumulation was seen in the ocular tissue or systemically. In clinical studies, the highest blood levels were <2?ng/mL at day 2, and half-time (t(1/2)) was 8-9 days. There was no accumulation at day 30 after the IVT injection (up to 352?μg). Safety studies conducted on rabbits indicated good local tolerability. Sirolimus-related effects were limited to minor incipient cataract findings and mild lenticular changes. In the clinical studies where sirolimus was intravitreally administered up to 352?μg, injections were well tolerated. Conclusions: Sustained IVT delivery was achieved in a dose-dependent fashion after the IVT injection of a proprietary sirolimus depot-forming ocular formulation. Across the tolerability and safety studies, no significant findings were observed for systemic and ocular tolerability. The human WB levels were well below the daily trough systemic blood level range required for systemic immunosuppression. An IVT injection of sirolimus has a PK and safety profile that is favorable for treating inflammatory conditions of the eye, such as non-infectious uveitis, and warrants further investigation in humans.     

Somatostatin receptor gene expression in human ocular tissues: RT-PCR and immunohistochemical study

PURPOSE: Somatostatin (SST) analogues have been used to treat proliferative diabetic retinopathy, pseudotumor cerebri, thyroid orbitopathy, and cystoid macular edema. There is a paucity of published data in regards to cell-specific distribution of SST receptors (SSTR) in normal human eye tissues. Gene expression for all five known SSTRs in normal human ciliary body/iris, retina, choroid, and cultured retinal pigment epithelial (RPE) cells were studied. METHODS: mRNA was isolated from human ocular tissues (iris/ciliary body, retina, and choroid) dissected from eight pairs of normal eyes (9-62 years) and from RPE cells grown in culture. RT-PCR was done for all five SSTRs in all analyzed tissues. Immunohistochemistry for SSTR1 and SSTR2 was performed on eight pairs of normal human eyes (28-74 years) imbedded in paraffin. RESULTS: SSTR1 to 5 genes are expressed in retina, SSTR1 and SSTR2 genes in cultured RPE cells, and SSTR1, 2, and 4 in ciliary body and choroid. SSTR1 and SSTR2 immunoreactivity (-ir) was observed on a variety of cells within all analyzed tissues including cornea, iris, trabecular meshwork, Schlemm's canal, ciliary processes, ciliary muscle, retina, choroid, cultured RPE cells, and optic nerve. CONCLUSIONS: SSTR genes are widely expressed in normal human eye tissues, with genes for SSTR1 and SSTR2 being the most widely expressed. Genes for all SSTRs are expressed in retina. SSTR1-ir and SSTR2-ir were observed in all analyzed ocular tissues. Detailed knowledge of SSTRs distribution and function in the human eye will result in a better understanding of their role in health and disease.     

Change in the synthesis rates of ocular retinoic acid and scleral glycosaminoglycan during experimentally altered eye growth in marmosets

PURPOSE: The purpose of this study was to examine the possibility that all-trans-retinoic acid (RA) in the eye is a signal related to changes in scleral extracellular matrix in a primate model of postnatal eye growth. METHODS: Juvenile marmosets (Callithrix jacchus) were divided into two experimental groups based on their response to monocular deprivation with diffusers: group 1, treated eyes becoming longer than fellow control eyes (n = 8), and group 2, treated eyes becoming shorter than control eyes (n = 7). Eyes were enucleated, dissected, and assayed for changes in the rates of scleral glycosaminoglycan (GAG) synthesis and ocular RA synthesis. The rate of incorporation of (35)SO4 into CPC-precipitable GAG in scleras was taken as a measure of the rate of synthesis of proteoglycans. In the same eyes the rate of RA synthesis in vivo was measured separately in the retina and the choroid/RPE (choroid with RPE attached) by HPLC. The effect of RA on the rate of scleral GAG synthesis was also examined in tissue-cultured pieces of sclera from additional marmosets. RESULTS: Induced changes in vitreous chamber length in diffuser-treated eyes correlated inversely with the rate of scleral GAG synthesis (P < 0.05) and directly correlated with the rate of RA synthesis measured separately in the retina (P < 0.05) and the choroid/RPE (P < 0.05). In group 1, the rate of scleral GAG synthesis was significantly lower (P < 0.01) in the treated eyes relative to control eyes, and the rate of RA synthesis in both the retina and the choroid/RPE was significantly higher (P < 0.01). In group 2, the rates of scleral GAG synthesis and RA synthesis in either the retina or choroid/RPE were not found to change significantly in the treated eyes compared with the control eyes. RA partially reduces the rate of scleral GAG synthesis in tissue-cultured primate sclera in a dose-dependent manner after several days. CONCLUSIONS: RA may play a role in the visual control of postnatal eye growth in primates, possibly by inducing changes in scleral extracellular matrix associated with increasing eye size. Decreasing growth rate below control levels may involve other mechanisms.     

Heavy metal concentrations in human eyes

PURPOSE: To measure the concentration of toxic heavy metals in the fluids and tissues of human eyes. DESIGN: Laboratory investigation. METHODS: Thirty autopsy eyes of 16 subjects were dissected to obtain the aqueous, vitreous, lens, ciliary body, retina, and retinal pigment epithelium/choroid. Concentrations of lead, cadmium, mercury, and thallium in ocular tissues, ocular fluids, and blood were determined using an inductively coupled plasma-mass spectrometer and expressed as ng/g. Heavy metal concentrations in ocular tissues were compared using a paired t test. RESULTS: Lead and cadmium were found in all of the pigmented ocular tissues studied, concentrating to the greatest extent in the retinal pigment epithelium/choroid (mean, 432 +/- 485 ng/g and 2,358 +/- 1,522 ng/g). Cadmium was found in the retina in all eyes (mean, 1,072 +/- 489 ng/g) whereas lead was found in the retina in 9 (30%) of 30 eyes (mean, 53 +/- 54 ng/g). Trace concentrations of lead and cadmium were detected in the vitreous (mean, 0.5 +/- 1.0 ng/dl and 19 +/- 29 ng/dl), lens (mean, 13 +/- 18 ng/g and 20 +/- 18 ng/g), and blood (mean, 0.5 +/- 1.2 mug/dl and 3.1 +/- 4.1 mug/l) but were not detected in the aqueous. Mercury and thallium were not detected in any ocular tissues or fluids or in the blood. CONCLUSIONS: Lead and cadmium accumulate in human ocular tissues, particularly in the retinal pigment epithelium and choroid. The potential ocular toxicity of these heavy metals and their possible role in eye disease requires further study.     

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.     

Concentrations of betaxolol in ocular tissues of patients with glaucoma and normal monkeys after 1 month of topical ocular administration

PURPOSE: To measure the concentration of betaxolol in tissues of humans with glaucoma and normal monkeys after topical administration. METHODS: Enucleated eyes (n = 7) of patients with glaucoma (age range, 27-79 years), without apparent anatomic disruption that would be likely to influence betaxolol absorption and intraocular distribution (exceptions: one pseudophakic, one aphakic) or other disease, were analyzed for betaxolol concentrations after self-administration of 0.25% betaxolol twice daily for 28 days or longer. The last instillation was made within 6 hours of surgery. Cynomolgus monkeys (n = 3) received 0.25% betaxolol twice daily unilaterally for 30 days. Betaxolol was measured by HPLC and tandem mass spectrometry (MS/MS) in plasma and ocular tissues. RESULTS: In humans, mean betaxolol concentrations (excluding the aphakic patient) were 71.4 +/- 41.8 ng/g in the retina, 31.2 +/- 14.8 ng/g in the optic nerve head, and 1290 +/- 1170 ng/g in the choroid. Mean concentrations in the iris and ciliary body were 73,200 +/- 89,600 and 4,250 +/- 3,020 ng/g, respectively. Betaxolol concentration was higher in all ocular tissues than in the plasma (0.59 +/- 0.32 ng/mL). In the monkeys the concentrations in the posterior tissues of the treated eyes were higher than in the untreated eyes, with mean differences in the retina and optic nerve head of 121 and 130 ng/g, respectively. CONCLUSIONS: Topically applied betaxolol was bioavailable to posterior ocular tissues, including the retina and optic nerve head, of patients with glaucoma and of normal cynomolgus monkeys. The higher betaxolol levels in the treated versus untreated monkey eyes are consistent with betaxolol's reaching posterior tissues by local absorption and distribution.     

Identification and quantitation of carotenoids and their metabolites in the tissues of the human eye

There is increasing evidence that the macular pigment carotenoids, lutein and zeaxanthin, may play an important role in the prevention of age-related macular degeneration, cataract, and other blinding disorders. Although it is well known that the retina and lens are enriched in these carotenoids, relatively little is known about carotenoid levels in the uveal tract and in other ocular tissues. Also, the oxidative metabolism and physiological functions of the ocular carotenoids are not fully understood. Thus, we have set out to identify and quantify the complete spectrum of dietary carotenoids and their oxidative metabolites in a systematic manner in all tissues of the human eye in order to gain better insight into their ocular physiology.Human donor eyes were dissected, and carotenoid extracts from ocular tissues [retinal pigment epithelium/choroid (RPE/choroid), macula, peripheral retina, ciliary body, iris, lens, vitreous, cornea, and sclera] were analysed by high-performance liquid chromatography (HPLC). Carotenoids were identified and quantified by comparing their chromatographic and spectral profiles with those of authentic standards.Nearly all ocular structures examined with the exception of vitreous, cornea, and sclera had quantifiable levels of dietary (3R,3'R,6'R)-lutein, zeaxanthin, their geometrical (E / Z) isomers, as well as their metabolites, (3R,3'S,6'R)-lutein (3'-epilutein) and 3-hydroxy-beta,epsilon-caroten-3'-one. In addition, human ciliary body revealed the presence of monohydroxycarotenoids and hydrocarbon carotenoids, while only the latter group was detected in human RPE/choroid. Uveal structures (iris, ciliary body, and RPE/choroid) account for approximately 50% of the eye's total carotenoids and approximately 30% of the lutein and zeaxanthin. In the iris, these pigments are likely to play a role in filtering out phototoxic short-wavelength visible light, while they are more likely to act as antioxidants in the ciliary body. Both mechanisms, light screening and antioxidant, may be operative in the RPE/choroid in addition to a possible function of this tissue in the transport of dihydroxycarotenoids from the circulating blood to the retina. This report lends further support for the critical role of lutein, zeaxanthin, and other ocular carotenoids in protecting the eye from light-induced oxidative damage and aging.     

Further studies on the effect of retrobulbar epinephrine injection on ocular and optic nerve blood flow

The effect of retrobulbar epinephrine administration on ocular and optic nerve blood flow was studied in phakic rabbit eyes using a radioactive microsphere (85Sr) technique. Blood flow measurements were performed either 5 minutes or 30 minutes after retrobulbar injection of 10 microliter of a 2% (base) epinephrine bitartrate solution to the right eye of each rabbit. Blood flow was determined for the iris, scraped ciliary processes, choroid, retina, and optic nerve. Five minutes after retrobulbar injection, there was no statistically significant (P greater than 0.05) difference in epinephrine-treated eyes compared to contralateral control eyes that received 10 microliters of retrobulbar saline. Thirty minutes after injection, eyes receiving retrobulbar epinephrine had a statistically significant (P less than 0.05) fall in blood flow to the iris and scraped ciliary processes, but not to the choroid, retina, or optic nerve.     

Acute effects of dietary retinoic acid on ocular components in the growing chick

When the eyes of chicks are induced to grow toward myopia or hyperopia by having them wear spectacle lenses or diffusers, opposite changes take place in the retina and choroid in the synthesis and levels of all-trans Retinoic Acid (RA). To explore whether RA plays a causal role in the regulation of eye growth, we fed young chicks RA (doses 0.5 to 24 mg/kg) either twice a day or on alternate days or only once. Refractive error was measured with a Hartinger refractometer; ocular length, lens-thickness and choroidal thickness were measured by A-scan ultrasound. The amount of RA present in ocular tissues was determined using HPLC. Oral delivery of RA effectively increased RA in ocular tissues within 8h. During the first day after feeding RA at levels above 8 mg/kg, the rate of ocular elongation tripled, the choroid thickened and lens thickening was inhibited. The day following a dose of RA, the rate of ocular elongation was inhibited and the lens thickened more than normal. Nonetheless, the cumulative effect of repeated doses was that the eye became longer and the lens became thinner than normal, with no net change in refractive error. The rate of elongation was also increased by feeding 13-cis RA, and was reduced by citral, an inhibitor of RA synthesis. Surprisingly, birds fed RA while being kept in darkness also had normal refractive errors despite increased ocular elongation, and birds wearing either +6D or -6D spectacle lenses compensated normally for the lenses despite the enhanced ocular elongation caused by the RA. These results suggest that RA may act at the level of a coordinated non-visual regulatory system which controls the growth of the various ocular components, arguing that emmetropization does not depend entirely on vision.     

Effect of sensory and sympathetic denervation on substance P immunoreactivity in nerve fibres of the rabbit eye

Substance P (SP) immunoreactivity was demonstrated in ocular tissues of rabbit. SP was found in nerve fibres of cornea iris, ciliary body, choroid and in the inner plexiform layer of the retina.In order to verify the origin of these nerves the animals were subjected to two different denervation procedures: intracranial combined maxillary and ophthalmic neurotomy or superior cervical ganglionectomy. The former operation destroyed all SP immunoreactive nerves of the ipsilateral eye except for the retina, whereas the latter had no effect. It is concluded that the ocular SP immunoreactive nerves are sensory trigeminal fibres. SP immunoreactivity in the retina is not due to sensory nerves but probably to amacrine cells.     

Constitutive and inflammatory mediator-regulated fractalkine expression in human ocular tissues and cultured cells

PURPOSE: Fractalkine (FKN) is a dual-adhesion molecule-chemokine that plays a role in inflammation but has not been explored in the eye. In the current study, constitutive expression of FKN was identified in human iris and retina, and its regulation by various cytokines in endothelial cells (ECs) and stromal cells from human iris, retina, and choroid was investigated. METHODS: Human iris and retina explants were evaluated for FKN mRNA and protein expression using RT-PCR and immunohistochemistry, respectively. Cultured ocular ECs and stromal cells were stimulated with various inflammatory mediators (endotoxin; TNFalpha; interferon-gamma; interleukin (IL)-1alpha, -4, -10, -13, -17, and -18; and/or CD40 ligand, or combinations thereof), with FKN mRNA being subsequently evaluated by cDNA array and/or RT-PCR and FKN protein by enzyme-linked immunoculture assay (ELICA) and/or by Western blot analysis. RESULTS: Iris and retina explants constitutively expressed FKN protein in microvascular ECs and also in several stromal cell types. Iris and retina both express FKN mRNA. TNFalpha upregulated FKN in iris explants. All ocular microvascular ECs and stromal cultures expressed low FKN mRNA and/or protein levels, which were variably upregulated by endotoxin, TNFalpha, interferon-gamma, IL-1alpha, and/or CD40 ligand, but not by IL-18. In ECs, the Th2 cytokines IL-4 and -13, but not IL-10, reduced TNFalpha-induced FKN protein. IL-17, usually considered proinflammatory, reduced TNFalpha-induced FKN protein in ocular ECs. CONCLUSIONS: FKN is expressed in various ocular tissues and cells. Inflammatory mediator modulation of ocular FKN expression suggests that this adhesive chemokine may play important roles in regulating leukocyte efflux in inflammatory eye diseases, such as anterior uveitis and retinochoroiditis.     

Retinal and choroidal vasoreactivity to altered PaCO2 in rat measured with a modified microsphere technique

Rats are increasingly used in ophthalmic research. However, little is known about the metabolic regulation of ocular blood flow. The purpose of this study was to examine the vasoreactivity in retina and choroid of the rat eye in response to experimentally altered partial arterial pressure of CO2 (PaCO2). The retinal and choroidal blood flows were measured sequentially in different PaCO2 with a modified microspheres method. The experiments were performed in two groups of adult male Brown-Norway rats. Under isofluorane anesthesia and mechanical ventilation, PaCO2 was monitored continuously by recording end tidal carbon dioxide level. Both femoral arteries and a femoral vein were cannulated for arterial blood pressure monitoring, blood sampling and drug administration, respectively. The intraocular pressure in both eyes was manometrically controlled at 20mmHg by anterior chamber cannulation. The retinal and choroidal blood flows were simultaneously measured by cardiac injection of a mixture containing 3.75 million of 8microm, and 0.5 million of 10microm microspheres; each size having a distinct color. In one experiment (n=10), blood flow was first measured during normocapnia (PaCO2=35mmHg) and then during hypocapnia (PaCO2=20-25mmHg). In another experiment (n=7), blood flow was measured during hypercapnia (PaCO2=45-50mmHg) and repeated one more time under the same experimental conditions to evaluate the repeatability of sequential measurements and the variances of the measurement between the two eyes. The results show that the mean blood flow in the retina measured during hypocapnia, normocapnia and hypercapnia were 8.1+/-4.8, 15.1+/-8.5 and 27.4+/-4.6microl/min per tissue, respectively. In the choroid, the corresponding blood flow rates were 120+/-38, 166+/-28 and 149+/-28microl/min per tissue, respectively. The difference of the mean blood flows across all the three different PaCO2 groups was highly significant for both retina and choroid (ANOVA: P<0.0001 and P=0.01, respectively). The mean blood flow during hypocapnia was significantly lower than normocapnia in both retina and choroid (P<0.02). The blood flow under hypercapnia was significantly higher than normocapnia in retina (P<0.01), but not in choroid (P=0.62). In conclusion, the study demonstrated that the dual-size and dual-dose microspheres mixture can be used as a reliable method to measure the retinal and choroidal blood flows simultaneously and sequentially in rats. The vasoreactivity to altered systemic PaCO2 in the retina in rats is similar to that of most other species studied. However, the choroidal vascular system exhibited complicated features that remain to be further clarified.