Deformation of the lamina cribrosa and anterior scleral canal wall in early experimental glaucoma
Deformation of the lamina cribrosa and anterior scleral canal wall in early experimental glaucoma
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DOI：
10.1167/iovs.01-1282
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发表时间：
2003-02-01
影响因子：
4.4
通讯作者：
Burgoyne, CF
中科院分区：
文献类型：
--
作者：
Bellezza, AJ;Rintalan, CJ;Burgoyne, CF
目的.目的：验证筛板和前巩膜管壁的病理生理变形是共焦激光扫描断层扫描（CSLT）检测的早期实验性青光眼视神经乳头（ONH）表面改变的基础这一假设。四只正常猴（两只正常眼）和四只早期青光眼猴（一只眼睛有激光诱导的IOP升高，观察到CSLT检测的ONH表面变化开始）的双眼在死亡后立即摘除，并浸泡固定在IOP 0 mm Hg。在另外四只正常猴子和五只患有早期青光眼的猴子中，两只眼睛都被插管，一只正常眼睛的IOP设置为10 mm Hg，另一只（正常或早期青光眼）眼睛的IOP设置为30或45 min Hg。急性IOP升高15 - 80分钟后，对这9只猴进行灌注固定。在所有17只猴子的ONH组织的连续矢状切片图像中，测量前筛板位置、椎板厚度和巩膜管直径。对于每个参数，通过ANOVA方法评估每只猴双眼之间和给药组之间的差异。8只猴眼内眼压0 mm Hg时，与对侧正常眼相比，早期青光眼眼的Bruch膜和前板附着处的筛板向后移位、增厚，巩膜管扩大（塑性变形）。在高眼压正常眼，筛板向后移位相比，在低眼压正常眼，但有没有显着差异，在层厚度或巩膜管直径（正常的顺应性）。与低眼压正常眼和高眼压正常眼相比，高眼压早期青光眼眼的筛板向后移位和增厚，巩膜管扩大（过度顺应性变形）。高眼压早期青光眼眼和对侧低眼压正常眼（高顺应性加塑性变形）之间的椎板位置差异是高眼压正常眼和对侧低眼压正常眼（正常顺应性）之间差异的8倍以上。在患有早期实验性青光眼的年轻成年猴眼中，筛板和前巩膜管壁均存在塑性（永久性）和超顺应性变形。这些发现表明，在实验性青光眼的猴模型中，ONH结缔组织的损伤发生在早期。
PURPOSE. To test the hypothesis that pathophysiologic deformation of the lamina cribrosa and anterior scleral canal wall underlies the onset of confocal scanning laser tomography (CSLT)-detected optic nerve head (ONH) surface change in early experimental glaucoma.METHODS. Both eyes of four normal (two normal eyes) monkeys and four with early glaucoma (one eye with laser-induced IOP elevation, observed until the onset of CSLT-detected ONH surface change) were enucleated immediately after death and immersion fixed at IOP 0 mm Hg. In an additional four normal monkeys and five with early glaucoma, both eyes were cannulated, and IOP set to 10 mm Hg in one normal eye and either 30 or 45 min Hg in the other (normal or early-glaucoma) eye. After 15 to 80 minutes of acute IOP elevation, these nine monkeys were perfusion-fixed. Within images of serial sagittal sections of the ONH tissues in all 17 monkeys, anterior lamina cribrosa position, laminar thickness, and scleral canal diameter were measured. For each parameter, differences between the two eyes of each monkey and between treatment groups were assessed by ANOVA.RESULTS. Within the eyes of the eight monkeys with IOP 0 mm Hg, the lamina cribrosa was posteriorly displaced and thicker and the scleral canal was enlarged at Bruch's membrane and at the anterior laminar insertion in the early-glaucoma eyes compared with the contralateral normal eyes (plastic deformation). Within the high-IOP normal eyes, the lamina cribrosa was posteriorly displaced compared with that in the low-IOP normal eyes, but there were no significant differences in laminar thickness or scleral canal diameter (normal compliance). Within the high-IOP early-glaucoma eyes, the lamina cribrosa was posteriorly displaced and thicker and the scleral canal enlarged, compared with both low-IOP normal eyes and high-IOP normal eyes (hypercompliant deformation). Differences in laminar position between the high-IOP early-glaucoma eyes and the contralateral low-IOP normal eyes (hypercompliant plus plastic deformation) were more than eight times greater than the differences between the high-IOP normal eyes and the contralateral low-IOP normal eyes (normal compliance).CONCLUSIONS. Both plastic (permanent) and hypercompliant deformation of the lamina cribrosa and anterior scleral canal wall are present in young adult monkey eyes with early experimental glaucoma. These findings suggest that damage to the ONH connective tissues occurs early in the monkey model of experimental glaucoma.