Age-related posterior ciliary muscle restriction - A link between trabecular meshwork and optic nerve head pathophysiology.
Age-related posterior ciliary muscle restriction - A link between trabecular meshwork and optic nerve head pathophysiology.
复制标题
与年龄相关的后睫状肌肉限制 - 小梁网与视神经头部病理生理学之间的联系。
DOI：
10.1016/j.exer.2016.07.007
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发表时间：
2017-05
影响因子：
3.4
通讯作者：
Kaufman PL
中科院分区：
文献类型：
--
作者：
Croft MA;Lütjen-Drecoll E;Kaufman PL
睫状肌在控制灵长类动物的调节和流出设施方面发挥着重要作用。睫状肌和脉络膜在功能上形成弹性网络，从小梁网一直延伸到眼睛后部，并最终附着到围绕视神经的弹性纤维环和神经穿过的筛板。睫状肌控制弹性网络的调节运动。随着年龄的增长，睫状肌的活动性受到逐渐无弹性的后部附着物的限制，并且后部的限制使得收缩逐渐等长；增加视神经区域的张力。此外，流出能力也随着年龄的增长而下降，角膜缘角巩膜轮廓向内弯曲。与年龄相关的肌肉运动丧失和角膜缘角巩膜轮廓的改变都可能损害小梁网的基础功能。此外，最近对非人类灵长类动物的研究表明，中央玻璃体一直向后移动回到视神经区域，这表明朝向视神经的流体流和压力梯度。因此，在调节期间视神经区域上可能存在压力和张力峰值，并且这些压力和张力峰值可能随着年龄而增加。这一系列事件可能与青光眼性视神经病变有关。总之，我们的假设是，青光眼和老花眼实际上可能通过脉络膜相互关联，视神经的损伤可能是由调节性眼压和脉络膜张力“尖峰”造成的，而这种损伤可能会随着年龄的增长而增加。
The ciliary muscle plays a major role in controlling both accommodation and outflow facility in primates. The ciliary muscle and the choroid functionally form an elastic network that extends from the trabecular meshwork all the way to the back of the eye and ultimately attaches to the elastic fiber ring that surrounds the optic nerve and to the lamina cribrosa through which the nerve passes. The ciliary muscle governs the accommodative movement of the elastic network. With age ciliary muscle mobility is restricted by progressively inelastic posterior attachments and the posterior restriction makes the contraction progressively isometric; placing increased tension on the optic nerve region. In addition, outflow facility also declines with age and limbal corneoscleral contour bows inward. Age-related loss in muscle movement and altered limbal corneoscleral contour could both compromise the basal function of the trabecular meshwork. Further, recent studies in non-human primates show that the central vitreous moves posteriorly all the way back to the optic nerve region, suggesting a fluid current and a pressure gradient toward the optic nerve. Thus, there may be pressure and tension spikes on the optic nerve region during accommodation and these pressure and tension spikes may increase with age. This constellation of events could be relevant to glaucomatous optic neuropathy. In summary, our hypothesis is that glaucoma and presbyopia may be literally linked to each other, via the choroid, and that damage to the optic nerve may be inflicted by accommodative intraocular pressure and choroidal tension “spikes”, which may increase with age.