Apoptotic cell death in retinal degenerations

Apoptosis is a regulated mode of single cell death that involves gene expression in many instances and occurs under physiological and pathological conditions in a large variety of systems. We briefly summarize major features of apoptosis in general and describe the occurrence of apoptosis in the retina in different situations that comprise animal models of retinitis pigmentosa, light-induced lesions, histogenesis during development, and others. Apoptosis can be separated into several phases: the induction by a multitude of stimuli, the effector phase in which the apoptotic signal is transmitted to the cellular death machinery, the excecution period when proteolytic cascades are activated, and the phagocytic removal of cellular remnants. Control mechanisms for retinal apoptosis are only beginning to be clarified. Potential apoptotic signal transducers were investigated in our laboratory, including metabolites of arachidonic acid and downstream mediators of signaling molecules such as transcription factors. Work in our laboratory revealed an essential role of the immediate-early gene product c-Fos in light-induced apoptosis. c-Fos is a member of the AP-1 family of transcription factors and, together with other members of this family, it may regulate apoptosis in the central nervous system. Expression of the c-fos gene in the retina can be evoked by light exposure and follows a diurnal rhythm. Future studies will have to clarify how light can control the expression of specific genes, and specifically, the role of c-fos and other genes of retinal apoptosis including potential target genes and signaling pathways.

Intact sheets of fetal retina transplanted to restore damaged rat retinas

PURPOSE

The aim of this study was to establish a model for morphologic retinal reconstruction after destruction of photoreceptors.

METHODS

Rat embryos were prelabeled by injection of bromodeoxyuridine (BrdU) into timed pregnant rats on 2 to 6 consecutive days. Pieces of fetal retinas (embryonic day [E] 17 to E22) were embedded in growth factor-reduced matrigel for protection and stored in medium on ice. With the use of a custom-mnade implantation tool, trimmed embedded pieces were placed into the subretinal space of albino rats whose photoreceptors had been damaged by continuous exposure to blue light for 3 to 4 days.

RESULTS

Donor cells were unequivocally identified by the BrdU label. Approximately 25% of transplants in the subretinal space developed parallel layers, with photoreceptor outer segments facing the host pigment epithelium. Transplants developed rosettes if host pigment epithelium had been damaged, if trauma to the donor tissue occurred during preparation or transplantation, and if the donor tissue was misplaced into the choroid or into the epiretinal space on top of the host retina. If the surgery was performed more than 4 weeks after the light damage, continued degeneration of the host retina caused secondary pigment epithelium damage, and transplants did not develop parallel layers of photoreceptor outer segments.

CONCLUSIONS

After transplantation to the subretinal space of a degenerated retina, gel-protected fetal retina can develop parallel layers and photoreceptor outer segments in contact with host pigment epithelium. Transplants can develop good fusion with the inner retina of a photoreceptor-deficient recipient.

Vertebrate photoreceptor cell development and disease

Photoreceptors provide an excellent model for studies of vertebrate neuronal differentiation, and many human diseases resulting in blindness primarily affect photoreceptors. There is therefore great interest in studying the cellular and molecular mechanisms of photoreceptor development. This article discusses our current understanding of this process, including the recent discovery of the homeodomain transcription factor Crx and its potential role in diseases affecting human vision.

Retinal degeneration associated with vitamin E deficiency in hunting dogs

A group of Walker Hounds and Beagles that were fed a diet of table scraps were examined because of slow, progressive loss of vision. Clinical and microscopic features of the disease were correlated to the dogs' micronutrient status. Sensory retinal degeneration, predominantly in the central tapetal fundus, was found in all dogs, and severity of changes varied with age of the dog. Plasma, serum, and tissue concentrations of vitamin E were low in affected dogs (10 to 40% of control values). Lipofuscin accumulation was found on microscopic examination in retinal pigment epithelium, smooth muscle cells of the intestinal tract, and neurons of the CNS. Findings were consistent with nutritional vitamin E deficiency and oxidative injury to photoreceptors of the retina. Changes in these dogs were similar to those described for central progressive retinal atrophy and equine lower motor neuron disease, suggesting these diseases may share a common pathogenesis to vitamin E deficiency.

Indocyanine green angiographic findings of lacquer cracks in pathologic myopia

Lacquer cracks are thought to represent healed mechanical breaks in the retinal pigment epithelium, Bruch's membrane, and choriocapillaris complex. In this study, we analyzed the indocyanine green (ICG) angiographic features of lacquer cracks and compared them with findings using fluorescein angiography. Complete ophthalmologic examinations, fluorescein angiography, and ICG angiography were performed in 29 consecutive patients (37 eyes) with lacquer cracks. Fluorescein angiograms of the cracks revealed linear hyperfluorescence in all 37 eyes. Using ICG angiography, we observed linear hypofluorescence in all 37 eyes. In 15 of 37 eyes, the length of the hypofluorescent lesion detected by ICG angiography was longer than the hyperfluorescent lesion observed by fluorescein angiography. In 17 of 37 eyes, more lacquer cracks were observed by ICG angiography than by fluorescein angiography. These findings indicate that ICG angiography can detect the development of the lesion more precisely, and may provide useful information for diagnosing pathologic myopia.

Light history and age-related changes in retinal light damage

PURPOSE

To determine the effects of age and long-term light- or dark-rearing environments on acute, intense-light-mediated retinal degeneration.

METHODS

Male albino rats were maintained in a dim cyclic light environment or in darkness for as long as 1 year. When aged 2, 4, 8, and 12 months, some rats were given the synthetic antioxidant dimethylthiourea (DMTU) by intraperitoneal injection and were exposed to intense visible light for as long as 24 hours. Uninjected control rats were exposed to light at the same time. Other rats were treated with light of lower intensity for various periods. Two weeks after intense-light treatment, photoreceptor cell degeneration was estimated by determining the level of rhodopsin and by measuring the content of photoreceptor cell DNA. Light-induced changes in retinal DNA were analyzed immediately after exposure by neutral gel electrophoresis and by 8-hydroxy-deoxyguanosine measurements. Expression of the antioxidative stress protein heme oxygenase-1 (HO-1) was determined by northern blot analysis of mRNA in retinal extracts.

RESULTS

At all ages, rats reared in cyclic dim-light conditions had lower rhodopsin levels than did rats reared in darkness; photoreceptor cell DNA levels were unaffected by the rearing environment. Senescent losses in rhodopsin and retinal DNA were significant after rats were 12 months old. Dim-light-reared rats exhibited an age-related increase in retinal light damage susceptibility, whereas dark-reared rats were equally susceptible to damage at all ages. In both types of rats, the mechanism of light-induced cell death involved an apoptotic process, visualized by the pattern of DNA fragments on electrophoretic gels. The process also induced the expression of HO-1 mRNA. Photoreceptor cell loss determined by biochemical measurement, DNA fragmentation, and HO-1 induction were dramatically reduced by the administration of DMTU.

CONCLUSIONS

The age-related increase in susceptibility to retinal light damage in rats is influenced by their long-term daily light history. Decreasing retinal irradiance by dark-rearing eliminates the age-related increase in light damage, suggesting a correlation between light environment and retinal gene expression associated with damage. In all rats, retinal light damage resulted in a pattern of DNA fragmentation consistent with apoptotic cell death and in an increased expression of HO-1 mRNA. Antioxidant treatment greatly reduced apoptosis and HO-1 expression. This indicates that light damage involves an oxidative process that may also trigger apoptosis in the retina. The rat aging model may provide useful insights into the role of light environment associated with retinal degeneration in an aging human population.

[Role and place of ophthalmological methods in the diagnosis of lesions of the main vessels of the brain]

The study was aimed at detecting changes in visual functions and organ of vision in patients with involvement of the main vessels of the head and injuries to this vessels in patients with expressed ischemic diseases of the organ of vision. Twenty-four patients with occlusive disorders of the carotid arteries and 22 with retinal and ocular nerve diseases with the ischemic component were examined. The share of carotid artery abnormalities in the second group was 27.3%. Total efficacy of ophthalmological methods of diagnosis in the group with carotid artery involvement was 89.4%, this demonstrating high efficacy of ophthalmological methods for the diagnosis of involvement of the main cerebral vessels. Static quantitative perimetry proved to be the most effective method. It permits reliable detection of the slightest changes and assess the efficacy of surgical treatment.

Continuous exposure to bright light upregulates bFGF and CNTF expression in the rat retina

PURPOSE

To examine mRNA expression of neurotrophic factors in the retina after exposure to bright light.

METHODS

Male adult Sprague-Dawley rats were exposed to light of 115-130 ft-c. Retinas were collected after 1, 2, 4 or 7 days of exposure. Northern blot analysis was performed to determine mRNA levels for the following factors and their receptors: basic fibroblast growth factor (bFGF), ciliary neurotrophic factor (CNTF), acidic fibroblast growth factor (aFGF), brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1) and glial fibrillary acidic protein (GFAP). Expression of bFGF, CNTF and GFAP was localized by in situ hybridization.

RESULTS

Exposure to light of 115-130 ft-c resulted in a substantial increase in bFGF and CNTF expression that persisted during the entire 7-day period of exposure. The peak expression of bFGF was almost 9-fold at day 2. The increase in CNTF mRNA reached a maximum of 6-fold at day 4. A small increase (50%) in IGF-1 mRNA was also seen at day 4. Among the receptors, an elevation of 3-fold in FGF receptor 1 (FGFR-1) was observed at day 2. There was also a small increase (70%) in IGF-1 receptor (IGF-1R) at day 2. In addition, the expression of GFAP showed a rapid elevation of about 8-fold by day 1 and 9-fold by day 2, and 18-fold by day 4. There was, however, no significant alteration in the expression of aFGF and BDNF. In situ hybridizations showed that the elevation of bFGF, CNTF and GFAP occurred across the entire retina with especially prominent increases over specific layers for each gene.

CONCLUSIONS

Continuous exposure to bright light upregulates bFGF, CNTF, FGFR-1 and GFAP expression in the rat retina. The pattern of induced expression closely resembles that induced by mechanical injury, implying a common underlying mechanism.

Long-term follow-up of Stargardt's disease and fundus flavimaculatus

OBJECTIVE

To understand better the shared characteristics of Stargardt's macular dystrophy (SMD) and fundus flavimaculatus (FF) by reviewing the clinical morphologic and retinal function changes in a large group of affected patients.

DESIGN

The study design was a retrospective case review.

PARTICIPANTS

Fifty-two patients with SMD and 48 patients with FF were observed from 1 to 22 years.

INTERVENTION

Visual acuity (VA), visual fields (VFs), fundus photographs (FPs), fluorescein angiography (FA), electro-oculography (EOG), and electroretinography (ERG) were studied at various intervals.

MAIN OUTCOME MEASURES

Changes of VA, VF, FP, FA, EOG ratio, and ERG amplitudes and implicit time at different periods in patients with SMD and patients with FF were measured.

RESULTS

Visual acuity decreased gradually in both the SMD and FF groups, and once the 20/200 level was reached, little further change occurred. The yellowish flecks associated with these entities faded with time, and areas of retinal pigment epithelial (RPE) and choriocapillary atrophy developed. In advanced longstanding disease, retinal vessel attenuation and peripheral pigmentary changes were noted. Ninety-four percent of patients with FF were noted to have macular dystrophy at their last visit. Patients who had only central lesions did not have peripheral lesions develop. Intrafamilial variation in the funduscopic pattern was shown in four families. The EOG ratio was abnormal in 2.6% of the patients with SMD and in 48.6% of the patients with FF. An abnormal scotopic ERG was noted in 21.1% of the patients with FF and in none of the patients with SMD. The photopic ERG was abnormal in 32.4% of the patients with FF and in 5.4% of the patients with SMD. In patients with FF, a statistical dependence was noted between the duration of the disease and the ERG results, but no such correlation was seen in the SMD group.

CONCLUSIONS

Morphologic changes and retinal function deterioration are more severe in patients with FF than in patients with SMD. The duration of the disease has a greater effect on patients with FF than on patients with SMD. These clinical morphologic and physiologic data may be used to supplement laboratory molecular biologic studies and aid in the further classification of these entities.

Protection of mouse photoreceptors by survival factors in retinal degenerations

PURPOSE

To examine the protective effect of a number of survival factors on degenerating photoreceptors in mutant mice with naturally occurring inherited retinal degenerations, including retinal degeneration (rd/rd), retinal degeneration slow (rds/rds), nervous (nr/nr), and Purkinje cell degeneration (pcd/pcd), in three different forms of mutant rhodopsin transgenic mice and in light damage in albino mice.

METHODS

Various survival factors were injected intravitreally into one eye of mice at or soon after the beginning of photoreceptor degeneration, with the opposite eye serving as the control, and the eyes were examined histologically at later ages. The survival factors included brain-derived neurotrophic factor (BDNF), neurotrophin-3, neurotrophin-4, ciliary neurotrophic factor (CNTF), Axokine (a mutein of CNTF), leukemia inhibitory factor, basic fibroblast growth factor, and nerve growth factor and insulin-like growth factor II, either alone or in various combinations.

RESULTS

Photoreceptor degeneration was slowed in rd/rd and nr/nr mutant mice and in Q344ter mutant rhodopsin mice by certain forms of CNTF; the degeneration in Q344ter mice was slowed by Axokine and by leukemia inhibitory factor; and the degeneration in a few nr/nr mice was slowed by BDNF. The other agents were ineffective in these mice, and none of the agents were effective in the other mutants and other mutant rhodopsin transgenic mice. However, light damage experiments that compared agent effectiveness in albino mice versus rats suggested a significant delivery problem with the very small mouse eye, thereby making the interpretation of negative findings equivocal in mutant mice. Basic fibroblast growth factor failed to protect the mouse retina from the damaging effects of constant light, whereas it showed a strong protective effect in the rat, indicating an important species difference.

CONCLUSIONS

The slowing of degeneration in the rd/rd and Q344ter mutant mice demonstrated that intraocularly injected survival factors can protect photoreceptors from degenerating in animal models with the same or similar genetic defects as those in human inherited retinal degenerations.

Excitotoxic neurodegeneration induced by deprivation of oxygen and glucose in isolated retina

PURPOSE

Ischemic neurodegeneration contributes to many retinal diseases. An isolated retina model has been used to examine the neuronal cell death induced by deprivation of oxygen and glucose (simulated ischemia) as a model for ischemic disease.

METHODS

Neurodegeneration in the isolated chick embryo retina was induced by simulated ischemia and assessed using biochemical (lactate dehydrogenase release) and morphologic (light microscopy) techniques.

RESULTS

Simulated ischemia led to lactate dehydrogenase release gradually in a period of 6 to 24 hours. Light microscopic observations demonstrated morphologic cell degeneration well before lactate dehydrogenase release occurred. N-Methyl-D-aspartate (NMDA) and non-NMDA receptor blockers individually provided partial protection, and the combination was fully protective. No protection was provided if the antagonists were added after simulated ischemia. When NMDA receptors were blocked by MK-801, cyclothiazide, an inhibitor of desensitization at non-NMDA receptors, enhanced lactate dehydrogenase released after 1 or 2 hours of simulated ischemia. Low concentrations of glucose effectively prevented lactate dehydrogenase release, despite anoxic conditions.

CONCLUSIONS

The isolated retina provided a convenient system to characterize quantitatively ischemic cell death. Retinal ischemic neurodegeneration is an excitotoxic process that involves overactivation of NMDA and non-NMDA glutamate receptors. Blockade of both of these receptor subtypes was necessary for complete neuroprotection. Receptor desensitization played a protective role. If even low concentrations of glucose were delivered to an ischemic retina in vitro, substantial neuroprotection could be achieved. This may have implications for the management of acute retinal ischemic episodes.

Light-induced variations of retinal sensitivity in rats

PURPOSE

ERG responses were measured as a function of Ganzfeld luminance to evaluate functional damage induced by light on rat retinas.

METHODS

Wistar rats were exposed to a fluorescent light of 1700 lux for 12 h, 24 h, 48 h and 72 h. We recorded ERGs before and one night after exposure, then 3, 8, 15, 22 and 29 days later. The b- and PIII-wave amplitudes were plotted against luminance for each group at each recovery time.

RESULTS

The retinal damage induced by a pupillary illuminance of 1700 lux ranged from low to severe as exposure duration increased from 12 h to 72 h, respectively. We observed an effect immediately after light exposure but no improvement during the recovery period. The b-wave amplitude was reduced by 40, 60, 80 and 90 percent after 12, 24, 48 and 72 h of light exposure, respectively; the PIII-wave amplitude was reduced by 30, 40, 70 and 90 percent after these respective exposures. The Ganzfeld luminance eliciting a 50 microV b-wave amplitude increased significantly with exposure duration, but the luminance eliciting the maximal b-wave amplitude was not dependent on this duration. Hence we suggest that the ERG decrease is due to a reduction in photoreceptor number.

CONCLUSIONS

We present a full analysis of the electrophysiological parameters recorded from light-exposed or non-exposed rats. This model is a useful tool to study in vivo retinal degeneration.

Exclusion of PPEF as the gene causing X-linked juvenile retinoschisis

X-linked juvenile retinoschisis (RS) is a progressive vitreoretinal degeneration localised in Xp22.1-p22.2. A human homologue of the retinal degeneration gene C (rdgC), a gene that in Drosophila melanogaster prevents light-induced retinal degeneration, was localised in the RS obligate gene region. We have tested the gene, designated PPEF in humans, as a candidate gene in RS patients using RT-PCR and the protein truncation test on RNA and SSCP on DNA. No mutations were identified, making it highly unlikely that PPEF is the gene implicated in RS. The data presented facilitate mutation analysis of the PPEF gene in other diseases which have been or will be localised to this region.

Expression of c-fos and c-jun mRNA following transient retinal ischemia: an approach using ligation of the retinal central artery in the rat

The expression of the proto-oncogenes c-fos and c-jun was examined by in situ hybridization at various timepoints following transient retinal ischemia by means of ligation of the retinal central artery in the rat. Ischemia of 90-minute duration resulted in the degeneration of neurons in both the ganglion cell layer and the inner nuclear layer at 48 hours after reperfusion. The expression of c-fos and c-jun messenger RNA throughout the entire inner nuclear layer was transiently coinduced following 90-minute retinal ischemia with a peak at 1 hour after reperfusion. This expression was also found in the ganglion cell layer at 3 hours after reperfusion. Weak signals for c-fos and c-jun mRNA were observed at 24 hours after reperfusion and returned to near control levels by 48 hours. c-jun protein expression was detected in the ganglion cell layer, the middle of the inner nuclear layer, and optic nerve head at 3 hours, but not 1 hour, after lethal ischemia/reperfusion; however, c-fos protein expression was not detected after reperfusion. Whereas no neuronal degenerative changes were found at 7 days after 30-minute ischemic retina, c-fos and c-jun messenger RNA were also induced at 1 hour postreperfusion. To our knowledge, this study is the first report to show expression patterns of immediate-early genes after retinal ischemia/reperfusion. These results suggest that changes in expression of c-fos and c-jun after transient retinal ischemia are similar to those after transient brain ischemia, and the selective occlusion of the central retinal artery will provide a useful model for studying ischemic neuronal degeneration in vivo in the rat retina.

MR changes in the calcarine area resulting from retinal degeneration

PURPOSE

To study MR images for atrophic changes in the calcarine area resulting from retinal degeneration.

METHODS

MR images from nine patients with retinal degeneration confirmed by ophthalmologic examination and from 30 healthy volunteers were reviewed. The causes of retinal degeneration were hereditary pigmentary degeneration of the retina (four patients), high myopia (two patients), and chorioretinal atrophy (three patients); all patients had visual disturbances and visual field abnormalities. To estimate the morphological changes of the calcarine area, the widths of the right and left calcarine fissures were measured on T1-weighted sagittal images and compared with images from age-matched control subjects.

RESULTS

The calcarine fissures were significantly dilated in the patients with retinal degeneration. The anterior and middle points, which represent the peripheral visual field center, were more dilated than the posterior point.

CONCLUSION

The MR findings suggested calcarine atrophy related to retinal degeneration. Transneuronal degenerative changes may occur in the calcarine area after retinal degeneration.

[The effect of long-term ionizing radiation exposure on retinal function]

An experimental investigation designed to study the nervous tunic of eyeball of those animals who had been exposed to low levels of radiation for a long time revealed dystrophic-destructive changes in cellular elements of the above tunic. Its ganglial layer exhibited most marked changes such as destruction of gangliocytes against the background of pronounced pericelmomer edema. Changes in the system of photoreceptors were characterized by suppression of protein-synthesizing function of cells and, to a lesser extent, energy-producing one. An important observation is to our mind practically complete absence of processes of intracellular regeneration, which fact is a bad prognostic sign in respect of recovery of morphofunctional status of retina of the eye. Probability of development of dystrophic events in retina of those individuals having been under combined exposure to low levels of radiation gets higher.

[Contribution of biomechanical and hemodynamic factors to the genesis of chorioretinal dystrophies in myopia]

The bloodflow is decreased in myopic eyes with dystrophic changes in the center and at the periphery, this decrease being in proportion with the severity of the changes. Our study was aimed at elucidating the contribution of the scleral and hemodynamic factors to the genesis of myopic and chorioretinal dystrophies. A total of 295 patients with progressive myopia were examined. The sagittal and frontal sizes of the eye were reliably increased and the rheographic coefficient lowered in complicated progressive myopia as against the condition without complications. The biomechanical factor plays the main role in the pathogenesis of dystrophies.

Genistein, a protein tyrosine kinase inhibitor, ameliorates retinal degeneration after ischemia-reperfusion injury in rat

PURPOSE

The authors sought to determine the effect of genistein, a naturally occurring protein tyrosine kinase inhibitor, in a model of ischemia-reperfusion injury in the rat retina.

METHODS

Ischemia-reperfusion injury was induced by temporary optic nerve ligation. A dose of 0.034 mg, 0.34 mg, and 3.4 mg of genistein or dimethyl sulfoxide (DMSO) alone was injected intraperitoneally 1 hour before the ligation of the optic nerve and just after the start of reperfusion. After 48 hours of reperfusion, the effect of genistein on overall protein tyrosine phosphorylation in the retina was studied using Western blot analysis. After 168 hours, the effect of increasing doses of genistein on retinal degeneration was examined by quantitative morphometric analysis of histologic sections of the retina.

RESULTS

The authors found that tyrosine phosphorylation was increased after 48 hours of reperfusion in the ischemia-reperfusion-injured eyes treated with DMSO alone. A severe inner retinal degeneration was observed in the animals treated with DMSO alone after 168 hours of reperfusion. The treatment with 3.4 mg genistein inhibited the increase in tyrosine phosphorylation and protected the eyes significantly from the induced ischemic retinal degeneration by morphometric analysis of the mean thickness of the inner limiting membrane to the outer limiting membrane, the inner plexiform layer, and the inner nuclear layer (P < 0.02). Treatments with lower amounts of genistein (0.034 mg and 0.34 mg) did not show a significant protection of retinal degeneration after the injury.

CONCLUSIONS

Systemic administration of high dose of genistein, a dietary-derived isoflavone, can ameliorate an ischemia-reperfusion-induced retinal degeneration. Genistein may be useful to prevent neuronal degeneration in the inner retina as a result of ischemic injury.

[Cancer-associated retinopathy]

A variety of paraneoplastic syndromes affect the central nervous system including eye. So far, two types of retinopathy are known to be associated with patients with malignancies, cancer-associated retinopathy (CAR), and melanoma-associated retinopathy (MAR). CAR is associated with epithelial cancers, mostly lung small cell carcinoma, and is characterized by retinitis pigmentosa-like retinal degeneration. Usually CAR can be found before an underlying primary cancer is diagnosed. MAR is associated with cutaneous malignant melanoma and is characterized by the relatively sudden onset of photophobia and nyctalopsia. The flash electroretinogram (ERG) of MAR patients shows a negative waveform, reduced b-wave amplitude, and reservation of a-wave amplitude, suggesting that bipolar cells may be affected. CAR and MAR are believed to result from an autoimmune response. In CAR, a calcium binding protein called recoverin, a 70 kDa protein, and neurofilaments are the retinal antigens recognized by the patient's serum. In contrast, the retinal antigens in MAR have not yet been identified, although patient sera specifically recognized retinal bipolar cells in immunocytochemistry.

Ocular growth in newborn rabbit eyes implanted with a poly(methyl methacrylate) or silicone intraocular lens

PURPOSE

To examine eye growth in lensectomized infant rabbits implanted with a poly(methyl methacrylate) (PMMA) or a silicone intraocular lens (IOL).

SETTING

S:t Eriks Eye Hospital, Karolinska Institute, Stockholm, Sweden.

METHODS

Two groups of 3-week-old rabbits were used. In Group 1 (n = 13), lensectomy was performed in both eyes. In one randomly selected eye, a +30 diopter (D) heparin-surface-modified (HSM) PMMA IOL was implanted in the capsular bag; the other eye was left aphakic. In Group 2 (n = 10), a +21 D HSM PMMA IOL was implanted in one randomly selected eye and a +21 D silicone IOL was implanted in the other. Axial length, corneal diameter, corneal thickness, and intraocular pressure (IOP) were measured in all eye preoperatively and 1, 2, and 3 months after surgery. The wet mass of the after-cataract was measured 3 months after surgery. The ciliary body with the ciliary processes and the peripheral retina were examined histologically after formalin fixation. The two IOL types were compressed to 7.0 MM, corresponding to the diameter of the 3-week-old rabbit lens.

RESULTS

In Group 1, the axial length was significantly decreased in the eye with an HSM PMMA IOL compared with the fellow aphakic eye (P < .01, two-way analysis of variance [ANOVA]). No significant difference in corneal diameter, corneal thickness, or IOP was found between the eyes. The wet mass of the dissected after-cataract was significantly less in the eye implanted with an IOL. Two animals had an elevated IOP with secondary glaucoma in their aphakic eye and were excluded from the study. In Group 2, axial length in eyes with the HSM PMMA IOL was less than in the eyes with the silicone IOL (P < .25, two-way ANOVA). No difference in corneal diameter, corneal thickness, or IOP was found. The amount of after-cataract was not altered. Histologically, the eyes with the HSM PMMA IOL showed retinal degeneration, neovascularization of the ciliary body accompanied by a large number of inflammatory cells, and tumid ciliary processes. The eyes with the silicone IOL showed only minor changes. The aphakic eyes presented even less histological change. The compression test demonstrated that three time the compression force was needed to squeeze the HSM PMMA lens than the silicone IOL.

CONCLUSION

The results suggest that in the young rabbit eye, implanting a regular size HSM PMMA IOL destroys intraocular tissues and reduces eye growth significantly. Replacing the PMMA IOL with a silicone IOL improves the ocular growth.

The interphotoreceptor matrix, a space in sight

The interphotoreceptor matrix (IPM) has in recent years been receiving much attention due to its delicate localization between the photoreceptors and the retinal pigment epithelium (RPE). The IPM is a resilient, structure forming and hydrophilic matrix composed of large glycoproteins and proteoglycans, which occupies the subretinal space between the photoreceptors. The IPM is most likely assembled with components synthesized by all the surrounding cell types: the photoreceptor cells, the RPE cells, and the Müller cells. It has been implied to be involved in the development and maintenance of photoreceptors, and as a major factor in retinal adhesion. Therefore, it has been thoroughly studied also in several models of photoreceptor degeneration. Comparative studies have revealed some remarkably consistent features between different species, such as the presence of the rod and cone specific matrix domains. Studies made in the IPM of several species have measured large fluctuations in ion concentrations as a result of changes in illumination. In some species, these ionic fluctuations coincide with the intriguing dynamic redistributions of IPM constituents that can be visualized with histochemical techniques. It can be hypothesized that because of the intensive biochemical activity and the frequent changes in metabolic states of rods and cones the IPM may act as a kind of "buffer." These studies have brought a new extracellular aspect to photoreceptor studies and a new perspective to photoreceptor-RPE research.

[A preliminary study of biochemistry of patients with crystalline retinopathy]

PURPOSE

To investigate the pathogenesis and biochemical changes of crystalline retinopathy by detecting and analyzing the levels of trace elements (Cu++ and Zn++), blood-lipids and free amino acids in the serum of patients.

METHODS

Blood samples of 10 patients with crystalline retinopathy and 30 normal subjects were collected. The levels of serum Cu++ and Zn++ were detected by using flame atomic absorption spectrometry, while cholesterol and triglyceride were detected by direct colordeveloping process and acetyl-acetone developing process respectively and serum amino acids by the Beckman amino acid analyzer.

RESULTS

In comparison with the normal control group, the level of Zinc in serum was much decreased in the crystalline retinopathy group, while Cu++/Zn++ ratio and total cholesterol level in serum were significantly increased. In 3 out of 4 patients the level of taurine is lower than that of control group.

CONCLUSION

The decrease of serum trace elements and taurine and the increase of cholesterol may be one of the important factors for the pathological changes of crystalline retinopathy. The administration of trace elements e. g. Zn++ and taurine might be a new therapy for the patients.

Effects of basic fibroblast growth factor on the retinal degeneration of the mi(vit)/mi(vit) (vitiligo) mouse: a morphologic and electrophysiologic study

Basic fibroblast growth factor (bFGF) has been shown to rescue dying photoreceptor cells in the RCS rat, a model with a genetic defect of the RPE that impairs outer segment phagocytosis. The purpose of the present study was to determine whether intravitreal injection of bFGF would have a similar effect on photoreceptor cell death in the vitiligo (C57BL/6-mi(vit)/mi(vit)) mouse. This mutant mouse loses photoreceptor cells slowly over many months. Experimental evidence suggests that the primary cellular site of the defect is the RPE. In the present study, bFGF was prepared with and without heparin in PBS and injected intravitreally into vitiligo mice at ages 2, 4, 6, 8 and 13 weeks, surrounding the onset of photoreceptor cell death. Non-injected, PBS-injected and heparin/PBS injected mice served as controls. Scotopic ERG's were performed on one group of mice prior to killing. Mice were killed 4, 6 or 10 weeks following the injection and the eyes were processed for histology and analysed. The amplitude of the b-wave was significantly smaller in mice injected with bFGF/PBS than in PBS-injected and non-injected eyes regardless of the time of injection or duration following injection. Histological examination revealed that the number of rows of photoreceptor cells did not differ significantly between bFGF-injected, vehicle- or non-injected mice. Although slight improvement in the attachment of outer segments to RPE was observed in 4 week mutants injected with bFGF/heparin/PBS, a similar result was obtained in heparin/PBS injected mutants. In mice injected with bFGF without heparin, detachment was severe and gross disruption of neural retina was observed. There were significantly more macrophages and photoreceptor cells in the subretinal space in bFGF injected mice. It appears that at the dosages and times administered, bFGF does not improve the electrophysiological functioning of the retina nor retard the degeneration of the retina in the vitiligo mouse as it does in the RCS rat.

Evidence for glaucoma-induced horizontal cell alterations in the human retina

In this study we investigated changes to horizontal cells in human retinae affected by glaucoma. Glaucoma is characterized by raised intraocular pressure and is responsible for retinal ganglion cell and, possibly, photoreceptor degeneration. It was therefore assumed that horizontal cells might also be affected. The carbocyanine dye DiI was placed at discrete points on fixed, whole-mounted retinae obtained from normal and glaucomatous patients. After allowing 6-24 weeks for intramembranous diffusion within the lipid layers of the nerve cells and, therefore, fluorescent labeling, we measured horizontal cell soma and dendritic field sizes. Selected cells were then embedded in Araldite and cut at 4 microns. Horizontal cells in glaucomatous eyes appeared larger and had a granulated outline as compared with cells from normal retinae. Analysis of the mean cell soma size indicated that cells were 26% larger in the glaucomatous retinae and that this increase was significantly different from that seen in normal retinae (P < 0.05). The dendritic field size was unaffected (P > 0.05). As seen in cross section there was a clear loss of photoreceptor outer segments, and shrunken silhouettes of photoreceptor inner segments with pyknotic nuclei were observed. It is proposed that the increase in some size is indicative of horizontal cell responses that are likely to culminate in degeneration as a result of heightened intraocular pressure. In addition, this paper provides further evidence that photoreceptors are affected by advanced glaucoma.