The multifunctional choroid.
The multifunctional choroid.
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DOI：
10.1016/j.preteyeres.2009.12.002
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发表时间：
2010-03
影响因子：
17.8
通讯作者：
Wallman, Josh
中科院分区：
文献类型：
--
作者：
Nickla, Debora L.;Wallman, Josh
眼睛的脉络膜主要是供应外部视网膜的血管结构。它有几个不同寻常的特征：它含有大的膜衬里的腔隙，至少在鸟类中，它的功能是眼睛淋巴引流的一部分，它可以极大地改变其体积，从而在几天内将脉络膜的厚度改变四倍(在灵长类动物中就更少了)。它含有非血管平滑肌细胞，特别是在中心凹后面，其收缩可能会使脉络膜变薄，从而对抗腔隙扩张引起的增厚。它有内在的脉络膜神经元，也大多在中央视网膜后面，它可能控制这些肌肉，也可能调节脉络膜血流。这些神经元接受交感、副交感和氮能神经支配。脉络膜有几种功能：它的血管系统是视网膜外部的主要供应；从脉络膜到视网膜的氧气流动的障碍可能会导致老年性黄斑变性。脉络膜血流与任何其他器官一样强大，也可以冷却和温暖视网膜。脉络膜除了具有血管功能外，还含有分泌细胞，可能参与调节血管形成和巩膜生长。最后，脉络膜厚度的戏剧性变化使视网膜前后移动，将光感受器带入焦点平面，这一功能体现在配戴负性镜片使焦平面后移时发生的脉络膜变薄，以及配戴正性镜片时发生的增厚。除了聚焦眼睛外，我们认为脉络膜厚度的变化也与巩膜生长的变化相关，因此也与眼睛的生长相关。由于脉络膜厚度的一过性增加伴随着细胞外基质分子合成的长期减少和眼的延长，而试图将脉络膜和巩膜的变化分离的尝试基本上失败了，似乎脉络膜增厚可能从机械上与巩膜大分子的合成有关，因此可能在眼生长的动态平衡控制中发挥重要作用，从而在近视和远视的病因中发挥重要作用。
The choroid of the eye is primarily a vascular structure supplying the outer retina. It has several unusual features: It contains large membrane-lined lacunae, which, at least in birds, function as part of the lymphatic drainage of the eye and which can change their volume dramatically, thereby changing the thickness of the choroid as much as four-fold over a few days (much less in primates). It contains non-vascular smooth muscle cells, especially behind the fovea, the contraction of which may thin the choroid, thereby opposing the thickening caused by expansion of the lacunae. It has intrinsic choroidal neurons, also mostly behind the central retina, which may control these muscles and may modulate choroidal blood-flow as well. These neurons receive sympathetic, parasympathetic and nitrergic innervation. The choroid has several functions: Its vasculature is the major supply for the outer retina; impairment of the flow of oxygen from choroid to retina may cause Age-Related Macular Degeneration. The choroidal blood flow, which is as great as in any other organ, may also cool and warm the retina. In addition to its vascular functions, the choroid contains secretory cells, probably involved in modulation of vascularization and in growth of the sclera. Finally, the dramatic changes in choroidal thickness move the retina forward and back, bringing the photoreceptors into the plane of focus, a function demonstrated by the thinning of the choroid that occurs when the focal plane is moved back by the wearing of negative lenses, and, conversely, by the thickening that occurs when positive lenses are worn. In addition to focusing the eye, more slowly than accommodation and more quickly than emmetropization, we argue that the choroidal thickness changes also are correlated with changes in the growth of the sclera, and hence of the eye. Because transient increases in choroidal thickness are followed by a prolonged decrease in synthesis of extracellular matrix molecules and a slowing of ocular elongation, and attempts to decouple the choroidal and scleral changes have largely failed, it seems that the thickening of the choroid may be mechanistically linked to the scleral synthesis of macromolecules, and thus may play an important role in the homeostatic control of eye growth, and, consequently, in the etiology of myopia and hyperopia.
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