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Biomedical subjects

A Tarkkanen

Publications and source records attributed to A Tarkkanen.

At least 19 recordsLinked to original sources

Histopathologic and immunohistochemical analysis of the filtration bleb after unsuccessful glaucoma seton implantation.

PURPOSE: To analyze histopathologically and immunohistochemically the filtration bleb after unsuccessful glaucoma seton implantation. METHODS: A von Denffer implant and two Molteno implants that were nonfunctional at three months, at 11 months, and at five years after implantation, respectively, were compared by evaluating the adjacent bleb with light microscopy and a panel of 11 antibodies to epithelial, mesenchymal, and inflammatory cells. RESULTS: The wall of the filtration bleb three months after implantation consisted of loosely arranged collagenous connective tissue with relatively abundant fibroblasts labeled with monoclonal antibodies (MAbs) V9 and Vim 3B4 to vimentin. At 11 months and at five years, the collagenous layers had become increasingly thick and the fibroblasts scarce. All blebs showed metaplastic myofibroblasts surrounded by tenascin, as identified by MAb 1A4 to alpha-smooth muscle actin and TN2 to tenascin, respectively. One bleb was lined by a monolayer of cells that reacted with MAb CAM 5.2 and CY-90 to cytokeratin 8 and 18, respectively, and was apparently derived from the identically reacting proliferating corneal endothelial cells. Another bleb harbored many macrophages and foreign-body giant cells. Little evidence of chronic inflammation around the seton was detected. CONCLUSIONS: A glaucoma seton may induce several processes that potentially decrease filtration. In addition to formation of a collagenous cyst, presence of myofibroblasts suggests long-standing scar modulation that potentially leads to compaction of the filtration membrane. Furthermore, macrophages and corneal endothelial cells may invade the filtration bleb.

Adult

Clinically successful contact transscleral krypton laser cyclophotocoagulation. Long-term histopathologic and immunohistochemical autopsy findings.

OBJECTIVE: To report long-term histopathologic findings 10 months after contact transscleral krypton cyclophotocoagulation. METHODS: The tissue response in a successfully treated eye was analyzed by light microscopy and a panel of 11 antibodies to epithelial, mesenchymal, and inflammatory cells. RESULTS: A 75-year-old man with uncontrolled angle recession glaucoma was treated with transscleral contact krypton cyclophotocoagulation (17 burns, 3.5 J each) 10 months before his death. The intraocular pressure fell from 28 to 17 mm Hg 6 months after therapy. Confluent scars straddled the posterior pars plicata and the anterior pars plana. The ciliary processes were destroyed, but the sclera and zonules were intact. Vimentin and cytokeratin 8 and 18 persisted in the degenerated ciliary epithelium. The inner connective-tissue layer and the ciliary muscle had atrophied, as shown with antibodies to the HNK-1 epitope, desmin, and alpha-smooth-muscle actin. Macrophages with phagocytized pigment and single T cells were present instead. No unusual inflammatory infiltrate was present in the choroid of either eye. CONCLUSIONS: Clinically effective ablation of ciliary processes is achieved with contact krypton laser. Little chronic inflammation and no signs of sympathetic ophthalmia were present. Atrophy of the ciliary muscle may reduce accommodative capacity in younger patients undergoing cyclophotocoagulation.

Actins

Galactose-containing glycoconjugates of the iris, the aqueous outflow passages and the cornea in capsular glaucoma. A lectin histochemical study.

BACKGROUND: The aim of the study was to compare galactose-containing glycoconjugates of the iris, the aqueous outflow passages and the cornea with exfoliation material in capsular glaucoma. METHODS: Six formalin-fixed, paraffin-embedded human eyes with capsular glaucoma and six control eyes were studied by using a panel of 11 biotinylated lectins to galactose- and N-acetylgalactosamine-containing glycoconjugates. RESULTS: The Gal (beta 1-->3) GalNAc-reactive lectins peanut agglutinin (PNA) and Bauhinia purpurea alba agglutinin (BPA) and the Gal (beta 1-->4)GlcNAc-reactive lectins Ricinus communis agglutinin (RCA-I) and Phaseolus vulgaris erythroagglutinin (PHA-E) gave the strongest label with exfoliation material. Lectin binding to the iris was variable. The binding of PNA, BPA, RCA-I, Erythrina cristagalli agglutinin (ECA), PHA-E and Glycine max agglutinin (SBA) to the subendothelial region of iris blood vessels closely resembled their binding to exfoliation material. RCA-I and PHA-E bound moderately to the aqueous outflow passages. The surface of the corneal epithelium showed positive reaction with most lectins studied, but the keratocytes reacted with RCA-I and PHA-E only. Neuraminidase pretreatment generally increased the reaction intensity. CONCLUSIONS: The findings suggest that the glycoconjugate composition of exfoliation material in the classical locations along the anterior and posterior chamber closely resembles that in the subendothelial region of iris blood vessels.

Aged

Diagnosis and clinical characteristics of ocular Lyme borreliosis.

PURPOSE: To establish a diagnosis, in a group of patients we studied the characteristics of ocular Lyme borreliosis. METHODS: During a two-year period, 236 patients with prolonged external ocular inflammation, uveitis, retinitis, optic neuritis, or unexplained neuro-ophthalmic symptoms were examined for Lyme borreliosis. Antibodies to Borrelia burgdorferi were measured by indirect ELISA and western blot. Cerebrospinal fluid was also analyzed by polymerase chain reaction. RESULTS: Ocular Lyme borreliosis was diagnosed in ten patients on the basis of medical history, clinical findings, and serologic test results. Results of ELISA disclosed that five patients were seropositive, two patients showed borderline reactivity, and three patients were seronegative. Four of the five patients with borderline or negative results by ELISA had a positive result by western blot analysis. In one seropositive patient, polymerase chain reaction verified a gene of B. burgdorferi endoflagellin from the vitreous and cerebrospinal fluid specimen. In five of the six patients with known onset of the Borrelia infection, the ocular disorder appeared as a late manifestation. Abnormalities of the posterior segment of the eye, such as vitreitis, retinal vasculitis, neuroretinitis, choroiditis, and optic neuropathy were seen in six patients. Bilateral paralytic mydriasis, interstitial keratitis, episcleritis, and anterior uveitis were seen in one patient each. CONCLUSIONS: Late-phase ocular Lyme borreliosis is probably underdiagnosed because of weak seropositivity or seronegativity in ELISA assays. Ocular borrelial manifestations show characteristics resembling those seen in syphilis.

Adolescent

Lectin and immunohistochemical comparison of glycoconjugates in the conjunctiva of patients with and without exfoliation syndrome.

AIMS--The study was carried out to search for labelling similar to that of intraocular exfoliation material in the conjunctiva by light microscopy using lectin and immunohistochemistry. METHODS--Ten formalin fixed and paraffin embedded conjunctival biopsy specimens both from patients with and without exfoliation syndrome were studied with a panel of 11 lectins and with three monoclonal antibodies to the HNK-1 carbohydrate epitope, all of which react with intraocular exfoliation material. RESULTS--The lectin binding profile was essentially the same in specimens from patients with and without exfoliation syndrome. The superficial epithelium reacted similarly with Phaseolus vulgaris (PHA-E), Caragana arborescens (CAA), Helix pomatia (HPA), concanavalin A (ConA), and wheat germ (WGA) agglutinins. Binding was also detected with peanut (PNA) and Bauhinia purpurea (BPA) agglutinins, particularly in patients with exfoliation. The basement membrane generally reacted with Ricinus communis (RCA-I), PHA-E, Vicia villosa (VVA), ConA, and Lens culinaris (LCA) agglutinins. The stroma was weakly labelled with RCA-I, PHA-E, ConA, and LCA. Lectin binding to the vascular endothelium was moderate with RCA-I, PHA-E, CAA, ConA, LCA, and WGA. Inconsistent labelling was also detected with PNA, BPA, and Erythrina cristagalli agglutinin (ECA). The subendothelial region reacted weakly but consistently with PHA-E, ConA, and LCA, and inconsistently with PNA. Pretreatment with neuraminidase did not change that pattern. Antibodies to the HNK-1 epitope reacted only with myelinated stromal nerve branches. CONCLUSION--No evidence of abnormal deposits in any specimen was found. The carbohydrate composition of intraocular exfoliation material may differ from that of exfoliation-like fibres often detected in the conjunctiva by electron microscopy.

Antigens, CD

The HNK-1 epitope in the inner connective tissue layer of the human ciliary body in exfoliation syndrome and various types of glaucoma.

Possible changes in the expression of the HNK-1 carbohydrate epitope in the inner connective tissue layer of the human ciliary body, located between the ciliary epithelium and muscle, was studied using 2 formalin-fixed, paraffin-embedded eyes with exfoliation syndrome, 33 eyes with different types of glaucoma, and 21 morphologically normal control eyes. A strong immunoreaction delineating cell process was observed in this layer with monoclonal antibodies HNK-1 and VC1.1 recognizing the HNK-1 epitope in control specimens, whereas partly granular immunoreaction was present in eyes with exfoliation syndrome. Exfoliation material was also immunoreactive. In all types of advanced glaucoma, the immunoreaction was mostly granular in nature and greatly diminished. No difference in HNK-1 immunoreactivity between control and glaucoma eyes was seen in the retina and ciliary epithelium. Elevated intraocular pressure, either directly or by decreasing blood flow to the ciliary body, may cause degenerative or metabolic changes in the inner connective tissue layer cells that bear or secrete molecules sharing the HNK-1 epitope. The partly granular immunoreactivity in eyes with exfoliation syndrome only indicates changes in this epitope even without an increase in intraocular pressure.

Adult

Galactose-containing glycoconjugates of the ciliary body and lens in capsular glaucoma: a lectin histochemical study.

BACKGROUND: This study was carried out in order to obtain information on galactose-containing glycoconjugates in the lens and ciliary body of human eyes with capsular glaucoma and thus on the etiopathogenesis of exfoliation syndrome. METHODS: Six formalin-fixed, paraffin-embedded human eyes with capsular glaucoma and six control eyes were studied using a panel of 11 biotinylated lectins with extended binding sites to galactose- and N-acetylgalactosamine-containing glycoconjugates. Both pepsin and neuraminidase pretreatments were performed. RESULTS: Gal(beta 1-->3)GalNAc-reactive peanut (PNA) and Bauhinia purpurea alba (BPA) agglutinins and Gal(beta 1-->4)GlcNAc GlcNAc-reactive Ricinus communis (RCA-I) and Phaseolus vulgaris (PHA-E) agglutinins reacted strongly with exfoliation material, while binding of Gal(beta 1-->4)GlcNAc-reactive Erythrina cristagalli and GalNAc-reactive soybean, Caragana arborescens, Vicia villosa, Helix pomatia (HPA) and Dolichos biflorus agglutinins was generally weak. In the nonpigmented ciliary epithelium and on the zonular fibers and lamella, at least moderate reaction was detected with PNA, BPA, RCA-I and PHA-E, and these tissues thus resembled exfoliation material in their reactivity. In contrast, the lens epithelium reacted weakly with PHA-E and HPA only, and the lens capsule was never labeled. No qualitative changes were seen after neuraminidase pretreatment. CONCLUSION: The findings suggest that galactose- and N-acetylgalactosamine-containing glycoconjugates in exfoliation material are at least partially produced by the nonpigmented ciliary epithelium, rather than by the lens epithelium. Moreover, PNA, PBA, RCA-I and PHA-E seem to be the most suitable of the lectins tested for detection of exfoliation material in histological specimens.

Acetylgalactosamine

A rapid fluorometric assay for tear fluid plasmin activity.

A rapid (5- to 10-min), sensitive (detection limit 0.6 IU/L), and moderately specific fluorometric plasmin assay for small volume tear fluid samples was developed. Addition of albumin (up to 0.1% final concentration) to the assay buffer improved the sensitivity of the test so that plasmin activity in healthy controls could be detected. pH in the reaction buffer was 8.0, Michaelis-Menten constant for the substrate, H-D-Val-Leu-Lys.7-amido-4-methyl-coumarin (AMC), was 0.28 mM, and final substrate concentration in the reaction buffer was 1 mM. Intra- and interassay imprecisions were 1.6 and 4.4%, respectively at a plasmin level of 10 IU/L. Tear fluid flow was significantly higher in the patients than in the healthy controls, and this dilatory effect must be considered when using plasmin determination for diagnostic purposes. This effect was counteracted by correcting the plasmin activity values by tear fluid flow. Plasmin flux is plasmin activity (microIU) secreted in units of time (min). This parameter showed highly significant differences between the patients and controls. All patients with microbial keratitis, corrosive trauma, ocular trauma, herpetic infection, and other diseases showed highly significant elevation of plasmin flux compared with controls. The highest plasmin flux values (several hundredfold that of controls) were recorded in patients with severe corneal ulcers. Few patient samples showed some involvement of other proteases, which were not inhibited by aprotinin.

Adult

Elevation of tear fluid plasmin activity of contact lens wearers studied with a rapid fluorometric assay.

Tear fluid plasmin activities were measured by a fluorometric assay based on a lyophilized kit with the 7-amido-4-trifluoromethylcoumarin derivative of the tripeptidyl H-D-Val-Leu-Lys as substrate. The rapid, sensitive method can detect proteolytic activity in small volume tear fluid samples. Plasmin activity levels (IU/L) measured from the samples were corrected with tear fluid flows (microliters/min), yielding a parameter called plasmin flux (microIU/min). Correction is important when patients show tearing due to irritation. Tear fluid samples were collected from 32 asymptomatic contact lens (CL) wearers and 27 controls. Plasmin activity values (2.7 +/- 0.3 IU/L) of CL wearers were higher (p < 0.00006) than those of the controls (1.6-0.1). Mean plasmin flow was 12.6 +/- 1.5 microliters/min for CL wearers and higher for controls (6.8 +/- 0.5 microliters/min). The difference was not significant (p = 0.063). Plasmin flux values of CL wearers (30.0 +/- 4.1 microIU/min) were conspicuously higher than those of controls (10.2 +/- 0.7 microIU/min, p < 0.00006). We conclude that elevated tear fluid proteolytic activity may be related to pathological changes associated with CL wear.

Contact Lenses, Hydrophilic

C-reactive protein serum levels in patients with ocular disease.

Hepatocyte derived C-reactive protein (CRP) is a sensitive indicator for inflammatory or infectious processes in a variety of tissues. As several other plasma proteins it is regarded as part of the acute phase response to a variety of tissue damage. CRP is commonly used in general medicine as a tool for the follow-up of especially bacterial infections. However, it has not been widely used in ophthalmology. In the present study CRP values in serum samples from 51 patients with various acute ocular diseases were determined semiquantitatively. High CRP levels were found most frequently in patients with either preseptal cellulitis (83.3%) or endophthalmitis (25.8%) whereas in the serum of patients with keratitis and uveitis, CRP exceeded 20 mg/l in only 18.7% of the cases. In a control group of 10 patients with retinal detachment the mean CRP level was 2.3 mg/l (SD +/- 0.98 mg/ml). The clinical significance and the prognostic value of CRP determinations during ocular diseases are discussed.

C-Reactive Protein

Ocular amyloid deposition in familial amyloidosis, Finnish: an analysis of native and variant gelsolin in Meretoja's syndrome.

PURPOSE: To analyze the deposition of amyloid and its precursors in eyes of patients with familial amyloidosis, Finnish (FAF; Meretoja's syndrome), a hereditary systemic amyloidosis. METHODS: Autopsy eyes from three patients with FAF and ten control eyes were studied by Congo red staining and with antibodies to the nonmutated part of gelsolin (GS-2C4), the mutated gelsolin Asn-187 fragment (AGel), and amyloid-P component (AP). RESULTS: Congo red and antisera to AP and AGel bound to amyloid deposits in the cornea and conjunctiva, the sclera, the perineurium of ciliary nerves, the walls of ciliary vessels, the optic nerve sheaths, the stroma of the ciliary body, and along the choriocapillaris. mAb GS-2C4 bound weakly and focally to most deposits and strongly around the choriocapillaris. It labeled the corneal epithelium and endothelium, keratocytes, scleral fibroblasts, trabecular and lens epithelial cells, the ciliary muscle and epithelium, the iris sphincter and dilator, and stromal cells of the conjunctiva and uveal tract. CONCLUSIONS: Local production, especially in the cornea, conjunctiva, sclera, and ciliary muscle, and systemic deposition, particularly in blood vessles and in the sclera, may contribute to amyloid deposits in FAF. To explain the complex pattern of deposition, microenvironmental factors such as lamellar architecture of the cornea and sclera, altered processing of gelsolin, or blood-tissue barriers must be invoked. In addition to corneal lattice dystrophy type II, the observed deposits help to explain glaucoma in patients with FAF.

Aged

Tear fluid plasmin activity after excimer laser photorefractive keratectomy.

PURPOSE: Elevated tear fluid plasmin activity may correlate with delayed healing of corneal wounds. The present study was performed to establish the tear fluid plasmin activity after photorefractive keratoablation (PRK). METHODS: Tear fluid aspirated with microcapillaries was subjected to a fluorometric plasmin assay using the 7-amido-4-trifluoromethylcoumarin derivate of the tripeptide H-D-Val-Leu-Lys as substrate. RESULTS: Tear fluid flow, plasmin activity, and flow-corrected plasmin excretion rate in tears (plasmin flux) were determined preoperatively and 1, 2, and 7 days after PRK. The preoperative tear fluid flow was 6.55 microliters/min (median; range, 1.8 to 21.8 microliters/min), plasmin activity was 1.29 IU/l (median; range, 0.6 to 6.9 IU/l), and the excretion of plasmin in tears was 11.7 microIU/min (median; range, 1.6 to 41.5 microIU). A statistically significant decrease in tear fluid plasmin activity was found during the follow-up period on the first (0.6 IU/l; range, 0.6 to 1.7 IU/l, P < 0.01) and second (0.65 IU/l; range, 0.6 to 1.49 IU/l, P < 0.01) postoperative days. On the other hand, significant elevation of both tear fluid flow and plasmin flux values occurred during the first two postoperative days. The median plasmin flux values on days 1, 2, and 7 were 57.35 microIU/min (range, 16 to 540 microIU/min, P < 0.01), 40.0 microIU/min (range, 13.3 to 222.8 microIU/min, P < 0.01), and 10.2 microIU/min (range, 2.2 to 90.7 microIU/min, P > 0.05), respectively. CONCLUSION: The marked elevation of tear fluid flow coincided with the persistence of an epithelial defect. However, because of the acceleration of tear fluid flow, proteolytic activity due to plasmin (IU/l) actually decreases. Consequently, the increased excretion of plasmin in tears (plasmin flux) does not lead to highly elevated plasmin activity, which could inhibit wound healing. It seems to be a natural healing response because all corneas were epithelialized normally by or on day 3.

Cornea

Immunoreactivity of exfoliation material for the cell adhesion-related HNK-1 carbohydrate epitope.

OBJECTIVE: To study the presence of the HNK-1 epitope in exfoliation material. METHODS: Twenty-six formalin-fixed, paraffin-embedded human eyes with exfoliation syndrome and 30 control eyes were studied immunohistochemically with monoclonal antibodies HNK-1 and VC1.1 to the HNK-1 epitope. RESULTS: Exfoliation material reacted consistently with antibodies to the HNK-1 epitope. The zonular lamella of the lens, inner surface of the nonpigmented ciliary epithelium, and inner connective tissue layer of the ciliary body were also labeled, but the lens capsule, epithelium, and zonules were not immunoreactive. Several blood vessels of the iris showed granular immunoreaction beneath the endothelium in all exfoliation eyes and in 11 (37%) of 30 control eyes, representing older age groups. CONCLUSIONS: The zonular lamella, nonpigmented ciliary epithelium, or the inner connective tissue layer may be responsible for the HNK-1 epitope in exfoliation material. Since this epitope is shared by many cell-adhesion molecules, its presence in exfoliation material might be of pathogenetic significance to the formation of the deposits.

Adult

Cellular fibronectin and tenascin in an orbital nylon prosthesis removed because of infection caused by Staphylococcus aureus.

An orbital nylon prosthesis was removed because of an infection caused by Staphylococcus aureus that was resistant to antimicrobials. It was processed for histopathology and immunohistochemistry. Within 3 weeks the implant had an extensive ingrowth of fibrovascular tissue containing chronic inflammatory cells, foreign body giant cells, and myofibroblasts. By using the indirect immunofluorescent method, this tissue was found to react with monoclonal antibodies (Mabs) against extradomain A of cellular fibronectin (EDA-cFN) and tenascin (TN). The presence of EDA-cFN and TN within the implant are indicative of an active healing process, since both of these proteins, scarce in adult tissues, have been shown to be reexpressed during tissue regeneration. The findings suggest that fibronectin plays a definite role in bacterial adherence and foreign body infections.

Aged

Congenital intraocular teratoma.

PURPOSE: The clinical and histopathologic findings of an intraocularly located congenital teratoma are reported. METHODS: In addition to routine histologic stainings, the tissue types present and the fate of the neuroectodermal elements of the disorganized eye were analyzed by immunohistochemistry. RESULTS: An otherwise healthy baby girl was born with a large greenish mass replacing the left eye without invading the orbit. The enucleated eye showed a firm polycystic intraocular tumor filling the intraocular space. Normal sclera and a massively distended cornea enclosed the globe. Fairly normal choroid and a disorganized ciliary muscle were present, but the ciliary body and iris had not formed. The tumor was surrounded by maldeveloped remnants of the optic vesicle and consisted of derivatives of all three germinal layers such as adnexal glands, brain, choroid plexi, intestinal and respiratory epithelium, cartilage, adipose tissue, as well as smooth and skeletal muscle. DISCUSSION: The clinical history with presentation at birth, female sex of the patient, and both macroscopic and microscopic findings are typical of a benign orbital teratoma, but the intraocular location is unique. Lack of truly medulloepitheliomatous elements in this case and the absence of derivatives from three germinal layers in all previously reported teratoid medulloepitheliomas of the ciliary body exclude the latter diagnosis. The teratoma may have arisen in the orbit with subsequent entrapment within the developing eye when the embryonic fissure closed.

Anterior Chamber

Immunohistochemical analysis of lattice corneal dystrophies types I and II.

Corneal buttons from four patients with lattice corneal dystrophy (LD) type I, thought to be an isolated corneal amyloidosis, and from six patients with LD type II, part of systemic familial amyloidosis, Finnish type (FAF; Meretoja's syndrome), were studied by immunohistochemistry to determine the differential distribution in the amyloid deposits of amyloid P component (AP), mutated gelsolin specific for FAF, and native gelsolin. In both types of LD, antibodies to AP labelled lattice lines and a discontinuous layer of amyloid deposits under Bowman's layer. In LD type II, particularly, they also reacted with streak-like amyloid deposits between corneal almellae, especially in the limbal region. While the anti-FAF antiserum strongly labelled all amyloid deposits in LD type II, it failed to react unequivocally with them in LD type I. Both in LD type I and in two control specimens representing granular dystrophy, the monoclonal antibody (MAb) GS-2C4 to gelsolin faintly labelled some deposits, while in LD type II it reacted non-homogeneously with most amyloid deposits. In all specimens, MAb GS-2C4 labelled corneal epithelial cells and occasional stromal keratocytes and endothelial cells. The results suggest that Meretoja's syndrome, a systemic disease, can be diagnosed even retrospectively from corneal buttons subjected to histopathological study.

Adult

Identification of a novel element in the human eye: the inner connective tissue layer of the ciliary body characterized with antibodies to the HNK-1 epitope.

PURPOSE: To characterize the nature and the developmental distribution of the HNK-1 epitope in the inner connective tissue layer of the human ciliary body, located between the ciliary epithelium and muscle with two monoclonal antibodies to the HNK-1 epitope common to many cell adhesion molecules. METHODS: Nine fetal (gestational age 13-40 wk) and 32 postnatal human eyes (age 3 mo to 78 yr) were studied by immunohistochemistry with monoclonal antibodies HNK-1 and VC1.1 to the HNK-1 epitope. Antibodies to cytoskeletal elements were used to characterize the cells in this region. RESULTS: The HNK-1-immunopositive cells appeared underneath the pigment epithelium of the pars plicata by the 20th gestational week, spread into the pars plana after the 28th week, and reached the ora serrata during the first year of life. The immunoreaction was constantly present in all adult eyes examined; they were sharply demarcated from the iris, ciliary muscle, and choroid. The HNK-1-positive subepithelial layer was not labeled with monoclonal antibodies V9 or Vim 3B4 to vimentin, monoclonal antibodies CAM 5.2 and CY-90 to cytokeratin 8 and 18, or monoclonal antibodies DE-U-10 and D33 to desmin in adult eyes, but was uniformly positive for vimentin in fetal eyes. The HNK-1 epitope was distributed along cell membranes or adjacent extracellular matrix of stromal cells. CONCLUSION: The HNK-1-positive stromal region is a constant and conspicuous element of the human eye that may have a role in structurally stabilizing the ciliary body, perhaps in relation to accommodation or aqueous secretion.

Adolescent