Transpupillary collagen photocrosslinking for targeted modulation of ocular biomechanics.
Transpupillary collagen photocrosslinking for targeted modulation of ocular biomechanics.
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DOI：
10.1016/j.biomaterials.2021.120735
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发表时间：
2021-04
期刊：
影响因子：
14
通讯作者：
Prausnitz MR
中科院分区：
文献类型：
--
作者：
Gerberich BG;Hannon BG;Hejri A;Winger EJ;Schrader Echeverri E;Nichols LM;Gersch HG;MacLeod NA;Gupta S;Read AT;Ritch MD;Sridhar S;Toothman MG;Gershon GS;Schwaner SA;Sánchez-Rodríguez G;Goyal V;Toporek AM;Feola AJ;Grossniklaus HE;Pardue MT;Ethier CR;Prausnitz MR
青光眼的中心视力威胁事件是视网膜神经节细胞（RGCs）的功能障碍和丧失，被认为是由局部组织变形促进的。在这里，我们试图通过选择性地硬化乳头周围巩膜（即紧挨着视神经头的巩膜区域）来减少视神经头附近的组织变形。以前的巩膜硬化研究用于治疗青光眼或近视，要么使用泛巩膜硬化（非区域选择性），要么使用区域选择性硬化，限制进入后眼球。我们提出了一种方法，选择性硬化乳头周围巩膜使用经上乳头环形光束激活亚甲基蓝管理的球后注射。与之前在眼睛中进行光交联的方法不同，这种方法通过使用红光来避免紫外线的破坏性影响。这种有针对性的光交联方法在治疗后6周成功地使乳头周围巩膜硬化，通过全球膨胀测试测量。具体而言，在同一只眼睛内，治疗组与未治疗组的巩膜相比，应变减少了47% (n=7, p<0.05)，治疗组与未治疗组的乳头周围巩膜相比，应变减少了54% （n=7, p<0.05）。治疗后RGCs（视神经轴突计数/密度和分级）、视网膜功能（视网膜电图）和视网膜组织学特征显示，光交联与一些眼部毒性有关。我们的结论是，上乳头光交联方法可以选择性地针对乳头周围区域的巩膜硬化，这可能在未来的青光眼治疗中有用。
The central vision-threatening event in glaucoma is dysfunction and loss of retinal ganglion cells (RGCs), thought to be promoted by local tissue deformations. Here, we sought to reduce tissue deformation near the optic nerve head by selectively stiffening the peripapillary sclera, i.e. the scleral region immediately adjacent to the optic nerve head. Previous scleral stiffening studies to treat glaucoma or myopia have used either pan-scleral stiffening (not regionally selective) or regionally selective stiffening with limited access to the posterior globe. We present a method for selectively stiffening the peripapillary sclera using a transpupillary annular light beam to activate methylene blue administered by retrobulbar injection. Unlike prior approaches to photocrosslinking in the eye, this approach avoids the damaging effects of ultraviolet light by employing red light. This targeted photocrosslinking approach successfully stiffened the peripapillary sclera at 6 weeks post-treatment, as measured by whole globe inflation testing. Specifically, strain was reduced by 47% when comparing treated vs. untreated sclera within the same eye (n=7, p<0.05) and by 54% when comparing the peripapillary sclera of treated vs. untreated eyes (n=7, p<0.05). Post-treatment characterization of RGCs (optic nerve axon counts/density, and grading), retinal function (electroretinography), and retinal histology revealed that photocrosslinking was associated with some ocular toxicity. We conclude that a transpupillary photocrosslinking approach enables selective scleral stiffening targeted to the peripapillary region that may be useful in future treatments of glaucoma.
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影响因子：
4.4
作者：
Guidry, C;Bradley, KM;King, JL
通讯作者：
King, JL
影响因子：
4.4
作者：
Kwok, Sheldon J. J.;Forward, Sarah;Yun, Seok-Hyun
通讯作者：
Yun, Seok-Hyun
影响因子：
3.1
作者：
Alarcon, Emilio;Maria Edwards, Ana;Scaiano, J. C.
通讯作者：
Scaiano, J. C.
影响因子：
1.8
作者：
LAMB, TD
通讯作者：
LAMB, TD
影响因子：
3.5
作者：
Banfi, S;Caruso, E;Monti, E
通讯作者：
Monti, E