Corneoscleral stiffening increases IOP spike magnitudes during rapid microvolumetric change in the eye.
Corneoscleral stiffening increases IOP spike magnitudes during rapid microvolumetric change in the eye.
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DOI：
10.1016/j.exer.2017.08.015
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发表时间：
2017-12
影响因子：
3.4
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Clayson K;Pan X;Pavlatos E;Short R;Morris H;Hart RT;Liu J
控制稳态眼压的因素已被广泛研究；然而，人们对 IOP 的动态方面知之甚少。临床研究表明，眼压（IOP）波动可能与青光眼风险相关。本研究旨在研究角巩膜生物力学特性的硬化如何影响快速微体积变化引起的眼压峰值。在对中央角膜或后巩膜的圆形区域（直径 11 毫米）进行外部处理之前和之后，对猪眼（总共 n = 25）进行体积输注。对照组处理区域浸入磷酸盐缓冲盐水（PBS）40 min，化学交联组处理区域浸入4%戊二醛/PBS 40 min。假治疗眼睛的子集也在升高的稳态眼压下接受体积输注。角膜（增加 27.5%，p < 0.001）或巩膜（增加 14.3%，p < 0.001）局部化学交联后，眼压峰值的幅度增加，其中角膜交联比巩膜交联具有更强的效果（p = 0.018）。我们还观察到，将稳态 IOP 从 15 mmHg 提高到 25 mmHg 会导致 IOP 峰值幅度显着增加 63.9% (p < 0.001)。这些结果表明，在相同的体积变化下，增加角巩膜硬度可以显着增加眼压峰值幅度。角膜硬度似乎对眼压尖峰幅度有很大影响，并且可能在调节快速体积压力动态方面发挥重要作用。由于眼壳的“表观”硬度增加，稳态眼压的增加也会导致更大的眼压波动，这表明眼压大小与其波动之间存在潜在的相互作用。角巩膜特性可能代表了理解和管理青光眼风险的额外途径，并值得未来的研究。
Factors governing the steady-state IOP have been extensively studied; however, the dynamic aspects of IOP are less understood. Clinical studies have suggested that intraocular pressure (IOP) fluctuation may be associated with glaucoma risk. This study aims to investigate how stiffening of corneoscleral biomechanical properties affects IOP spikes induced by rapid microvolumetric change. Porcine eyes (n = 25 in total) were subjected to volumetric infusions before and after external treatment of a circular area (11 mm diameter) in either the central cornea or posterior sclera. The treated area in the control group was immersed in phosphate-buffered saline (PBS) for 40 min, while the treated area of the chemical crosslinking group was immersed in 4% glutaraldehyde/PBS for 40 min. A subset of the sham-treated eyes was also subjected to volumetric infusions at a raised steady-state IOP. The magnitude of IOP spikes increased after localized chemical crosslinking of either the cornea (27.5% increase, p < 0.001) or the sclera (14.3% increase, p < 0.001) with corneal crosslinking having a stronger effect than scleral crosslinking (p = 0.018). We also observed that raising the steady-state IOP from 15 to 25 mmHg resulted in marked increase in IOP spike magnitudes by 63.9% (p < 0.001). These results suggested that an increased corneoscleral stiffness could significantly increase IOP spike magnitudes at the same volumetric change. Corneal stiffness appeared to have a strong impact on the IOP spike magnitude and may play a major role in regulating rapid volume-pressure dynamics. An increase in steady-state IOP also resulted in larger IOP fluctuations due to the increased “apparent” stiffness of the ocular shell, suggesting a potential interaction between the magnitude of IOP and its fluctuations. Corneoscleral properties may represent additional pathways for understanding and managing glaucoma risk and warrant future investigation.
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