Finite Element Model of Ocular Adduction by Active Extraocular Muscle Contraction

PurposeIn order to clarify the role of the optic nerve (ON) as a load on ocular rotation, we developed a finite element model (FEM) of incremental adduction induced by active contractility of extraocular muscles (EOMs), with and without tethering by the ON.MethodsThree-dimensional (3-D) horizontal rectus EOM geometries were obtained from magnetic resonance imaging of five healthy adults, and measured constitutive tissue properties were used. Active and passive strain energies of EOMs were defined using ABAQUS (Dassault Systemes) software. All deformations were assumed to be caused by EOM twitch activation that rotated the eye about a fixed center. The medial rectus (MR) muscle was commanded to additionally contract starting from 26 degrees adducted position, and the lateral rectus (LR) to relax, further adducting the eye either with or without loading by the ON. Tridimensional heat maps were generated to represent the stress and strain distributions.ResultsTensions in the EOMs were physiologically plausible during incremental adduction. Force in the MR increased from 10 gm at 26 degrees adduction to approximately 28 gm at 32 degrees adduction. Under identical MR contraction, adduction with ON loading reached 32 degrees but 36 degrees without it. Maximum and minimum principal strains within the MR were 16% and 22%, respectively, but when ON loading was included, resulting stress and strain were concentrated at the optic disc.ConclusionsThis physiologically plausible method of simulating EOM activation can provide realistic input to model biomechanical behavior of active and passive tissues in the orbit to clarify biomechanical consequences of ON traction during adduction.     

Identification of key genes and pathways in scleral extracellular matrix remodeling in glaucoma: Potential therapeutic agents discovered using bioinformatics analysis

Background: Glaucoma is a leading cause of irreversible blindness. Remodeling of the scleral extracellular matrix (ECM) plays an important role in the development of glaucoma. The aim of this study was to identify the key genes and pathways for the ECM remodeling of sclera in glaucoma by bioinformatics analysis and to explore potential therapeutic agents for glaucoma management.Methods: Genes associated with glaucoma, sclera and ECM remodeling were detected using the text mining tool pubmed2ensembl, and assigned Gene Ontology (GO) biological process terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways using the GeneCodis program. A protein-protein interaction (PPI) network was constructed by STRING and visualized in Cytoscape, module analysis was performed using the Molecular Complex Detection (MCODE) plugin, and GO and KEGG analyses of the gene modules were performed using the Database of Annotation, Visualization and Integrated Discovery (DAVID) platform. The genes that clustered in the significant module were selected as core genes, and functions and pathways of the core genes were visualized using ClueGO and CluePedia. Lastly, the drug-gene interaction database was used to explore drug-gene interactions of the core genes to find drug candidates for glaucoma.Results: We identified 125 genes common to “Glaucoma”, “Sclera”, and “ECM remodeling” by text mining. Gene functional enrichment analysis yielded 30 enriched GO terms and 20 associated KEGG pathways. A PPI network that included 60 nodes with 249 edges was constructed, and three gene modules were obtained using the MCODE. We selected 13 genes that clustered in module 1 as core candidate genes that were associated mainly with ECM degradation and cell proliferation and division. The HIF-1 signaling pathway, FOXO signaling pathway, PI3K-Akt signaling pathway and TGFB signaling pathway were found to be enriched. We found that 11 of the 13 selected genes could be targeted by 26 existing drugs.Conclusions: The results showed that VEGFA, TGFB1, TGFB2, TGFB3, IGF2, IGF1, EGF, FN1, KNG1, TIMP1, SERPINE1, THBS1, and VWF were potential key genes involved to scleral ECM remodeling. Furthermore, 26 drugs were identified as potential therapeutic agents for glaucoma treatment and management.     

Ocular anatomy and physiology relevant to anaesthesia

An understanding of the anatomy of the orbit is essential for performing regional anaesthesia for ophthalmic surgery. This article will discuss ocular anatomy in terms of the orbit and its contents, its associated muscles, nerves and blood supply, as well as basic ocular physiological principles.     

Modifying subsceral fluid pressure in an experimental model of mitomycin-C diffusion

BACKGROUND: Episcleral application of mitomycin-C (MMC) during glaucoma filtration surgery hinders the post-operative wound healing. Diffusion through the sclera might result in a toxic effect on the ciliary body resulting in reduced aqueous humor production leading to post-operative hypotony. We developed an experimental model to investigate the influence of intraocular pressure on the diffusion of MMC through the sclera and in subscleral compartments. METHODS: Scleral quadrants of 10 human donor eyes were mounted on PMMA tubes filled with saline imitating the intraocular volume. By height variation of a coupled infusion line different intraocular pressures were simulated (0, 8, 23 and 80 mmHg). Additionally the model included a subscleral sponge to mimic the compartment of the ciliary body. The episcleral sides of the scleral quadrants were exposed for 1 min to sponges soaked with 200 microg ml(-1) MMC. An 8-mm-diameter scleral disk was punched out with a trephine and horizontally dissected with a kryotome. The MMC concentrations of scleral layers, epi-and subscleral sponges and the fluid within the tubes were analysed by means of high-performance liquid chromatography. RESULTS: The MMC concentration gradually declined from the episcleral sponge (165 microg ml(-1)) to the superficial (3.3 microg ml(-1)) and deep scleral layers (1.2 microg ml(-1)), and to the subscleral sponge (0.2 microg ml(-1)). We were able to detect very small concentrations of MMC in the fluid within the PMMA tubes (0.01 microg ml(-1)). CONCLUSION: We developed a new experimental in vitro model for investigating transscleral MMC diffusion. The different simulated intraocular pressures had no effect on the concentration gradient through the investigated compartments of our model.     

视网膜对形觉剥夺性近视鸡巩膜MMP-2的调控

目的建立鸡形觉剥夺性动物模型,通过观察用庆大霉素破坏小鸡视网膜后,后极部巩膜基质金属蛋白酶Ⅱ(matrix metalloproteinase-2,MMP-2)的变化,探讨视网膜在形觉剥夺性近视(formdeprivation myopia,FDM)发生、发展中的影响作用。方法48只白色来亨鸡(鸡龄2d,SPF级)分为A、B、C、D4组,每组12只,其中A组、B组在第2d即行双眼半透明眼罩遮盖同时行右眼玻璃体内1次注射庆大霉素400μg;C组仅右眼玻璃体内1次注射庆大霉素400μg不予遮盖,左眼不作处理为自身对照;D组不作任何处理,为正常对照组。在第3周末,对全部小鸡行检影验光测屈光度后,将A、C2组鸡处死,迅速摘除双眼球,测量其前后径。并随机取出2只送病理组织切片;B组摘除双眼眼罩后继续饲养3周,在第6周末对B、D2组行检影验光后将其处死,摘除双眼球测量眼球前后径。用7mm直径环钻钻取后极部巩膜组织,研磨离心后取上清液作为标本,对所有标本采用ELISA(即酶联免疫吸附)试剂盒测定MMP-2活性浓度。所有数据经过EXCEL和SPSS统计软件进行处理。结果第3周末,A、B两组双眼屈光度之间均具有显著性差异(P<0·001),C组和D组双眼屈光度间无显著性差异(P=0·088,0·920),且A、B2组与C组双眼屈光度比较均分别具有显著性差异(P<0·001);A组双眼眼轴测量值具有显著性差异(P<0.01),C组双眼眼轴未见显著性差异(P>0.05),A组与C组比较时,右眼眼轴无显著性差异(P>0.05),而左眼间差异具有显著性(P<0.001);第6周末,B组去遮盖后双眼屈光度及眼轴测量值之间均无显著性差异(P>0.05),且与D组比较差异亦无显著性意义(P>0.05),但B组去遮盖前后双眼屈光度之间具有明显显著性差异(P<0.001)。ELISA结果显示,除了A组双眼后级部巩膜MMP-2含量自身对照及与其他各组比较均有显著性差异外(P<0.001),另外3组之间差异均无显著性意义(P>0.05)。结论视网膜色素上皮层在形觉剥夺性近视的发生发展过程中起着非常重要的作用,破坏视网膜色素上皮层能一定程度的减轻近视的发展程度。     

Melatonin receptor expression in the cornea and sclera

The scornea and sclera have been shown to exhibit circadian rhythms in cellular proliferation, wound healing and extracellular matrix synthesis. The distribution of melatonin Mel1a and Mel1c receptors was examined in the cornea and sclera of the Xenopus laevis eye in order to determine whether melatonin may potentially influence the growth and/or development of these ocular tissues. Sections of adult X. laevis eyes were analyzed by immunocytochemistry and confocal microscopy, using antibodies prepared against specific peptide sequences of the Xenopus Mel1a and Mel1c receptor proteins. Antibodies were pre- incubated with their appropriate antigenic peptides to control for non-specific labelling. Analysis of the distribution of Mel1a and Mel1c receptor immunoreactivity in the Xenopus eye revealed that both the Mel1a and Mel1c receptors were located in the outer fibrous layer (OFL) of the sclera, with Mel1c labelling being the most prominent. Similarly, Mel1a and Mel1c (Mel1c mostly) were also located in cells of the inner fibrous layer (IFL) with Mel1c being most abundant. The chondrocytes of the cartilaginous layer also appeared to express Mel1a, Mel1c, or both receptors. Both Mel1a and Mel1c receptor immunoreactivity were observed in the corneal epithelium and endothelium. Whereas the Mel1a antibody labelled the entire corneal epithelial layer, the Mel1c antibody labelled only the most superficial layer of epithelial cells. Cell processes of fibroblasts of the corneal stroma were immunoreactive for either Mel1a or Mel1c receptors. The identification of Mel1a and Mel1c receptors in restricted distributions in the cornea and sclera suggests that melatonin may play a role in the cellular physiology of these ocular tissues.     

Dimensions of the human sclera: Thickness measurement and regional changes with axial length

Scleral thickness, especially near the region of the optic nerve head (ONH), is a potential factor of interest in the development of glaucomatous optic neuropathy. Our goal was to characterize the scleral thickness distribution and other geometric features of human eyes. Eleven enucleated human globes (7 normal and 4 ostensibly glaucomatous) were imaged using high-field microMRI, providing 80 μm isotropic resolution over the whole eye. The MRI scans were segmented to produce 3-D corneoscleral shells. Each shell was divided into 15 slices along the anterior-posterior axis of the eye, and each slice was further subdivided into the anatomical quadrants. Average thickness was measured in each region, producing 60 thickness measurements per eye. Hierarchical clustering was used to identify trends in the thickness distribution, and scleral geometric features were correlated with globe axial length. Thickness over the whole sclera was 670 ± 80 μm (mean ± SD; range: 564 μm-832 μm) over the 11 eyes. Maximum thickness occurred at the posterior pole of the eye, with mean thickness of 996 ± 181 μm. Thickness decreased to a minimum at the equator, where a mean thickness of 491 ± 91 μm was measured. Eyes with a reported history of glaucoma were found to have longer axial length, smaller ONH canal dimensions and thinner posterior sclera. Several geometrical parameters of the eye, including posterior scleral thickness, axial length, and ONH canal diameter, appear linked. Significant intra-individual and inter-individual variation in scleral thickness was evident. This may be indicative of inter-individual differences in ocular biomechanics.     

苏乐康等抑制细胞转化能力及其机制的探讨

研究了苏乐康、绿茶提取物对~(60)钴γ射线和雌性激素联合诱发叙利亚金黄地鼠胚胎细胞恶性转化的抑制能力,并用脉冲辐解技术,对其抑制机制进行初步探讨。实验结果表明,苏乐康、绿茶提取物对γ射线和雌性激素联合诱发的金黄地鼠胚胎细胞恶性转化的抑制率分别为70.15％(P<0.05)和81.59％(P<0.05),它们的这种抑制能力与其清除超氧阴离子的能力有关,     

带和不带巩膜壳羟基磷灰石义眼台植入临床观察

目的比较不带巩膜壳和带巩膜壳羟基磷灰石义眼台植入术的疗效。方法30例不带巩膜壳羟基磷灰石义眼台植入者、30例带自体巩膜壳义眼台植入者、10例改良带自体巩膜壳义跟台植入者,术后随访1～10 a,对其疗效进行比较,以评价手术效果。结果30例带自体巩膜壳义眼台植入者,术后有5例发生肉芽肿形成,其中4例行义眼台取出术,1例经保守治疗痊愈。30例不带巩膜壳义眼台植入者有1例出现义眼台暴露。10例改良带自体巩膜壳义眼台植入者,无一例出现并发症。结论肉芽肿形成是带自体巩膜壳义眼台植入术后常见并发症,包裹的巩膜壳会影响义眼台血管纤维化,并发生融解和异物反应。改良带自体巩膜壳义眼台植入术可避免这一并发症,又可获得较好的美容效果。     

角巩膜栗刺异物伤诊治分析

目的探讨角巩膜栗刺异物伤的临床特点,治疗方法及其临床效果。方法对71眼角巩膜栗刺异物伤采取剔出或巩膜切开摘出异物。结果巩膜异物1次摘出32眼,2次摘出16眼,3次摘出9眼,11眼经4次摘出,3眼经5次全部摘出。无眼内炎及视力改变。结论栗刺所致巩膜异物多而隐匿,采取恰当方法彻底清除异物是治疗成功的关键。