Extralenticular Aspects of Accommodation and Presbyopia

调节和老花眼的晶状体外方面

• 批准号: 9198869
• 负责人: PAUL L KAUFMAN
• 金额: $ 62.49万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9198869
• 关键词: Affect; Age; Anterior; Architecture; Biological; Choroid; Ciliary Body; Ciliary Muscle; Contrast Media; Data; Eye; Fiber; Functional disorder; Fundus photography; Goals; Human; Image; Injection of therapeutic agent; Intraocular lens implant device; Life; Link; Liquid substance; Macaca mulatta; Measures; Microspheres; Modeling; Monkeys; Movement; Muscle; Operative Surgical Procedures; Optic Disk; Optic Nerve; Play; Postdoctoral Fellow; Presbyopia; Reporting; Research; Retina; Role; Structure; Therapeutic; Tissues; age related; anterior chamber; base; biomechanical model; experimental study; fluid flow; insight; lens; lens capsule; next generation; nonhuman primate; novel; public health relevance; response; therapeutic target

 DESCRIPTION (provided by applicant): We seek to continue and advance our group's study of human accommodative amplitude (the maximum ability of the eye to focus on near objects) and accommodative loss (presbyopia, literally "old eye") the most common ocular affliction in the world. Through our group's recent research in the monkey model, we have made the significant discovery of the existence of new extralenticular-zonular structures (PVZ INS-LE strands), which are linked to accommodation. In particular, we hypothesize that these structures may act as a strut to the posterior lens equator during accommodation and thereby facilitate accommodative lens thickening. Likewise, preliminary studies in the monkey eye suggest cistern-like structures in the vitreous, which we hypothesize play a role in fluid exchange between the anterior and posterior segments during accommodation. Despite these novel discoveries, it is clear that aspects of accommodation and the definitive mechanisms that result in presbyopia are yet to be fully determined and studied. Likewise, we hypothesize that age-related immobility of the ciliary muscle is due to posterior restriction. We postulate that, if cerain posterior restrictions are eliminated, mobility of the muscle can be restored and can facilitate th function of accommodating intraocular lenses (IOLs). The goals of our proposed research are: 1) To investigate and define the new players in the posterior restriction of the ciliary muscle, elucidation of which may be crucial in preserving forward ciliary body (FCB) movement and in enabling the function of the next-generation accommodating IOLs; 2) Determine the posterior extent of choroid/retina accommodative movement (i e., optic nerve region) with implications for accommodative mechanism and biomechanical models; 3) Define the role that the various intraocular structures (i.e., anterior hyaloid, vitreous zonule, vitreous cistern-like structure, PZ INS-LE strand, Hannover's Canal) play during accommodation and their change with age in the rhesus monkey (due to similarities to the human eye); and 4) To identify a biological target for human presbyopia therapy, albeit not necessarily a therapeutic surgical procedure for that target in the human eye. We believe the identification of, and proposed continued research of, these and associated structures will affect the understanding of how the eye accommodates earlier in life, and thereby change how we understand and treat presbyopia. The energy and excitement in our group is high, based upon our recent progress and the promises they hold for those with presbyopia.

 描述(由申请人提供)：我们寻求继续并推进我们团队对人类调节幅度(眼睛聚焦于近物体的最大能力)和调节性丧失(老花眼，字面意思是“老眼”)的研究，这是世界上最常见的眼病。通过我们团队最近对猴子模型的研究，我们已经有了一个重大的发现，即存在与调节有关的新的豆状核外带状结构(PVZ INs-le strands)。特别是，我们假设这些结构在调节过程中可能对晶状体赤道后部起支撑作用，从而促进调节性晶状体增厚。同样，对猴眼的初步研究表明，玻璃体中的池状结构，我们假设它在调节过程中在前段和后段之间的液体交换中发挥了作用。尽管有这些新的发现，但很明显，调节的各个方面以及导致老花眼的确切机制还没有完全确定和研究。同样，我们假设与年龄相关的睫状肌不动是由于后部的限制。我们推测，如果消除某些后部限制，肌肉的活动度可以恢复，并有助于调节人工晶状体(IOL)的功能。我们提出的研究目标是：1)调查和确定睫状肌后限制的新角色，阐明这些新的角色可能对维持睫状体前向运动和下一代调节性人工晶状体的功能至关重要；2)确定脉络膜/视网膜调节运动的后部范围(即视神经区)，并对调节机制和生物力学模型产生影响；3)确定各种眼内结构(即前玻璃体、玻璃体小带、玻璃体池样结构、PZ虹膜、汉诺威管)在调节过程中所起的作用及其在恒河猴中随年龄的变化(由于与人眼相似)；以及4)确定治疗人类老花眼的生物靶点，尽管该靶点在人眼中不一定是治疗性的手术。我们相信，对这些结构和相关结构的识别和拟议的继续研究将影响对眼睛在生命早期如何适应的理解，从而改变我们理解和治疗老花眼的方式。基于我们最近的进展和他们对老花眼患者的承诺，我们小组的能量和兴奋是很高的。