The Cell and Molecular Biology of Glaucoma: Biomechanical Factors in Glaucoma
The Cell and Molecular Biology of Glaucoma: Biomechanical Factors in Glaucoma
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DOI：
10.1167/iovs.12-9483g
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发表时间：
2012-05-01
影响因子：
4.4
通讯作者：
Clark, Abbot F.
中科院分区：
文献类型：
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作者：
Clark, Abbot F.
青光眼是一组异质性疾病，会逐渐损害视神经，导致视力障碍和失明。大多数青光眼的主要危险因素之一是眼内压力（眼内压 [IOP]）。 IOP 参与青光眼的发生和进展。它可以直接影响眼睛中的压力敏感细胞和组织，特别是那些与眼睛青光眼损伤有关的细胞。这些压力敏感细胞和组织是（1）小梁网（TM）；（2）视神经乳头（ONH）中的细胞，包括筛板细胞和视神经乳头星形胶质细胞（ONHA）；（3）ONH周围的视乳头周围巩膜；（4）视网膜神经节细胞（RGC）；（5）视网膜神经节细胞（RGC）。 (5) 视网膜神经纤维层 (RNFL) 和 ONH 中的 RGC 轴突（图 1A）。这些生物细胞和组织经历压力引起的机械变形并对其做出反应，例如拉伸和压缩（即生物力学应力）。此外，TM某些区域的细胞受到房水（眼睛前部的营养液）通过流出通道流动的剪切应力。眼睛会经历正常的眼压生理波动，这些波动是由眨眼、运动、揉眼以及房水产生速率的日常变化引起的，但不会损害眼睛。然而，眼睛的压力敏感组织受到与青光眼相关的长期升高的眼压和异常眼压峰值的病理影响。此外，随着年龄的增长，眼睛会发生分子、形态和生理变化，可能使眼睛更容易受到与青光眼相关的生物力学损伤。
Glaucoma is a heterogeneous group of diseases that pro-gressively damage the optic nerve, leading to visual impairment and blindness. One major risk factor for most forms of glaucoma is the pressure inside the eye (intraocular pressure [IOP]). IOP is involved in both the development and progression of glaucoma. It can directly affect pressure-sensitive cells and tissues in the eye, especially those cells involved in glaucomatous damage to the eye. These pressure-sensitive cells and tissues are (1) the trabecular meshwork (TM);(2) cells in the optic nerve head (ONH), including lamina cribrosa cells and optic nerve head astrocytes (ONHAs);(3) the peripapillary sclera around the ONH;(4) retinal ganglion cells (RGCs); and (5) RGC axons in the retinal nerve fiber layer (RNFL) and in the ONH (Fig. 1A).These biological cells and tissues experience and respond to pressure-induced mechanical deformation, such as stretching and compression (ie, biomechanical stress). In addition, cells in certain regions of the TM are subjected to sheer stress from the flow of the aqueous humor, the nutritive fluid in the anterior portion of the eye, through the outflow pathway. The eye experiences normal physiological fluctuations in IOP caused by eye blinking and movement, eye rubbing, and the daily variations in the rate of aqueous humor production that do not damage the eye. However, the pressure-sensitive tissues of the eye are pathologically affected by the chronically elevated IOP and abnormal IOP spikes associated with glaucoma. In addition, there are molecular, morphologic, and physiological changes in the eye that occur with aging and may make the eye more susceptible to the biomechanical insults associated with glaucoma.