Extralenticular Aspects of Accommodation and Presbyopia

 描述（由申请人提供）：我们寻求继续和推进我们小组对人类反射幅度（眼睛聚焦于近距离物体的最大能力）和反射损失（老花眼，字面意思是"老眼"）的研究，这是世界上最常见的眼部疾病。通过我们小组最近对猴子模型的研究，我们发现了与调节有关的新的晶状体外小带结构（PVZ INS-LE链）的存在。特别是，我们假设这些结构可能在调节过程中作为后透镜赤道的支柱，从而促进晶状体透镜增厚。同样，在猴眼中的初步研究表明，在玻璃体中的池状结构，我们假设在调节过程中的前节和后节之间的液体交换中发挥作用。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尚未完全确定和研究。同样，我们假设年龄相关的睫状肌不动是由于后部限制。我们推测，如果消除了眼后限制，肌肉的活动性可以恢复，并有助于调节人工晶状体（IOL）的功能。我们提出的研究的目标是：1）调查和定义睫状肌后部限制的新参与者，阐明这一点对于保持前向睫状体（FCB）运动和实现下一代可调节IOL的功能至关重要; 2）确定脉络膜/视网膜后向运动的范围（即，视神经区域），其具有对屈光机制和生物力学模型的影响; 3）定义各种眼内结构（即，前玻璃体、玻璃体小带、玻璃体池样结构、PZ INS-LE链、汉诺威氏管）在恒河猴中调节期间的作用及其随年龄的变化（由于与人眼的相似性）;以及4）鉴定用于人类老花眼治疗的生物靶标，尽管不一定是用于人眼中该靶标的治疗性外科手术。我们相信，对这些结构和相关结构的识别和拟议的持续研究将影响对眼睛在生命早期如何调节的理解，从而改变我们对老花眼的理解和治疗。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。

 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.