Evaluation of neural innervation in the human conventional outflow pathway distal to Schlemm's canal.
Evaluation of neural innervation in the human conventional outflow pathway distal to Schlemm's canal.
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DOI：
10.1016/j.exer.2022.109132
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发表时间：
2022-08
影响因子：
3.4
通讯作者：
Fautsch, Michael P
中科院分区：
文献类型：
--
作者：
Hann, Cheryl R;Bentley, Michael D;Vercnocke, Andrew;Roy Chowdhury, Uttio;Fautsch, Michael P
人眼的远端流出通路由施累姆管外壁、收集通道以及深巩膜、中巩膜和外巩膜血管组成。它是房水返回静脉系统之前的最后一个转运区域。虽然小梁网、巩膜骨刺和施莱姆管内壁已被广泛分析，以确定它们对房水流出的贡献，但远端流出路径的作用尚未完全了解。从施莱姆氏管发出的收集通道以前被认为是房水的被动导管。然而，最近的研究表明，许多收集器通道都包含随压力变化而移动的瓣状附件。这些发现以及证明巩膜外层血管神经支配的研究引发了关于远端流出通路中的其他结构是否受到神经调节以及这如何影响房水流出的问题。本研究通过显微计算机断层扫描和 3 维重建、相关光学显微镜、免疫组织化学和透射电子显微镜评估了施累姆管外壁和收集通道的神经支配，以及深巩膜、中巩膜和外巩膜脉管系统。周围、自主神经和感觉神经纤维被发现存在于施累姆氏管外壁内皮、收集通道内皮附近以及远端流出脉管系统的不同区域中。与没有收集器通道的区域相比，包含收集器通道的区域更容易识别出神经。这些关于神经解剖学的发现表明，房水流出在传统流出路径的近端和远端区域存在主动神经调节。
The distal outflow pathway of the human eye consists of the outer wall of Schlemm’s canal, collector channels, and the deep-scleral, mid-scleral and episcleral vessels. It is the last region of transit for aqueous humor before returning to the venous system. While the trabecular meshwork, scleral spur, and inner wall of Schlemm’s canal have been extensively analyzed to define their contributions to aqueous outflow, the role of the distal outflow pathway is not completely understood. Collector channels, emanating from Schlemm’s canal were previously thought to be passive conduits for aqueous humor. However, recent studies have shown many collector channels contain flap-like appendages which move with changes in pressure. These findings, along with studies demonstrating innervation of episcleral vessels, have led to questions regarding whether other structures in the distal outflow pathway are under neural regulation and how this may influence aqueous humor outflow. This study evaluates the innervation of the outer wall of Schlemm’s canal and collector channels, along with the deep-scleral, mid-scleral and episcleral vasculature with microcomputed tomography and 3-dimensional reconstruction, correlative light microscopy, immunohistochemistry, and transmission electron microscopy. Peripheral, autonomic, and sensory nerve fibers were found to be present adjacent to Schlemm’s canal outer wall endothelium, collector channel endothelium, and in the different regions of the distal outflow vasculature. Nerves were more commonly identified in regions that contained collector channels when compared to regions without collector channels. These findings regarding the neural anatomy suggest an active neural regulation of aqueous humor outflow throughout the proximal and distal regions of the conventional outflow pathway.