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Tenascin-R inhibits regrowth of optic fibers in vitro and persists in the optic nerve of mice after injury.

Tenascin-R, an extracellular matrix constituent expressed by oligodendrocytes and some neuronal cell types, may contribute to the inhibition of axonal regeneration in the adult central nervous system. Here we show that outgrowth of embryonic and adult retinal ganglion cell axons from mouse retinal explants is significantly reduced on homogeneous substrates of tenascin-R or a bacterially expressed tenascin-R fragment comprising the epidermal growth factor-like repeats (EGF-L). When both molecules are presented as a sharp substrate border, regrowing adult axons do not cross into the tenascin-R or EGF-L containing territory. All in vitro experiments were done in the presence of laminin, which strongly promotes growth of embryonic and adult retinal axons, suggesting that tenascin-R and EGF-L actively inhibit axonal growth. Contrary to the disappearance of tenascin-R from the regenerating optic nerve of salamanders (Becker et al., J Neurosci 19:813-827, 1999), the molecule remains present in the lesioned optic nerve of adult mice at levels similar to those in unlesioned control nerves for at least 63 days post-lesion (the latest time point investigated), as shown by immunoblot analysis and immunohistochemistry. In situ hybridization analysis revealed an increase in the number of cells expressing tenascin-R mRNA in the lesioned nerve. We conclude that, regardless of the developmental stage, growth of retinal ganglion cell axons is inhibited by tenascin-R and we suggest that the continued expression of the protein after an optic nerve crush may contribute to the failure of adult retinal ganglion cells to regenerate their axons in vivo.

Animals↗

Potential role of Pax-2 in retinal axon navigation through the chick optic nerve stalk and optic chiasm.

The degree of fiber decussation at the optic chiasm differs between species, ranging from complete crossing in lower vertebrates to highly complex patterns of intermingling of the fibers from the two eyes seen in mammals and birds. Understanding the genetic control of fiber guidance through the chiasm is therefore important to unravel the developmental mechanisms within the visual system. Here we first report on early stages of chiasm formation, with pioneering axons from the left eye consistently arriving earlier than their counterparts from the right eye. This initial left-right asymmetry is transient and no functional significance is assigned to it yet. Secondly, we examined formation of the chiasm in relation with the expression of the transcription factor Pax-2 along the ventral eye cup and optic nerve stalk. Finally, in order to examine causal involvement of Pax-2 in chiasm formation, the gene was overexpressed along the neuraxis and in the eye cup at embryonic stages preceding the exit of axons from the eye, and hence arrival of axons at the chiasm. When studied with neuroanatomical tracing, Pax-2 overexpression resulted in visibly anomalous decussation of axons at the chiasm. A likely consequence of this perturbation was erroneous arrival of axons at the tectum, as observed by anterograde staining from the retina. These data suggest that balanced expression of Pax-2 results in the correct formation of the chick chiasm at early stages by imposing accurate pathfinding within the optic stalk and the midline.

Animals↗

Optic pathway glioma associated with orbital rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia in a child with neurofibromatosis-1.

Neurofibromatosis-1 (NF-1) is a multisystem disorder presenting with a variety of clinical and imaging manifestations. Neural and non-neural tumours, and unusual benign miscellaneous conditions, separately or combined, are encountered in variable locations. We present a 2(1/2)-year-old boy with NF-1 who demonstrated coexisting optic pathway glioma with involvement of the chiasm and optic nerve, orbital alveolar rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia.

Child, Preschool↗

Effect of transcorneal electrical stimulation in patients with nonarteritic ischemic optic neuropathy or traumatic optic neuropathy.

PURPOSE: To determine whether transcorneal electrical stimulation (TES) can improve the visual function of patients with nonarteritic ischemic optic neuropathy (NAION) or traumatic optic neuropathy (TON). METHODS: Eight consecutive patients at the Osaka University Hospital were studied. TES (600-800 microA, 20 Hz, 30 min) was applied once each to three eyes with NAION and to five eyes with TON, using a contact lens-type stimulating electrode. The primary outcome measurement was the change in visual acuity at 1 to 3 months after TES. An improvement in visual acuity was defined as a change of > or =0.3 log (minimum angle of resolution) (logMAR) units. The side effects of TES were also investigated. RESULTS: After TES application, the visual acuity improved in two patients with NAION and in four patients with TON. Visual acuity did not worsen in any of the eyes. Only a mild superficial punctuate keratopathy was observed in all eyes immediately after TES, and it healed by the next day. CONCLUSIONS: Visual acuity can be improved after TES without major complications in some patients with NAION or TON. These results suggest that TES should be considered as a new treatment for eyes with optic neuropathy.

Adolescent↗

The effects of electrical stimulation of the optic nerves and anterior optic chiasm on the circadian activity rhythm of the Syrian hamster: involvement of excitatory amino acids.

The circadian pacemaker of the suprachiasmatic nuclei (SCN) is entrained to the environmental light-dark cycle via the retinohypothalamic tract (RHT). It is unknown whether light activates or suppresses firing of the retinal ganglion cells which mediate photic entrainment. We therefore electrically stimulated the optic nerves and the anterior optic chiasm of hamsters with free-running activity rhythms in continuous darkness. These electrical stimulations are thought to induce a release of neurotransmitter at the RHT terminals. Electrical stimulation mimicked the phase dependent shifts induced by light pulses. The phase shifts were significantly larger than the shifts induced by sham stimulation in the same animals or by electrical stimulation in animals with an electrode outside the optic nerves and chiasm. Our results indicate that the retinal ganglion cells which project to the SCN are activated by light. Intraperitoneal administration of MK-801, a non-competitive antagonist of the NMDA-receptor, attenuated the phase delays induced by electrical stimulation in the early subjective night. This suggests that an excitatory amino acid mediates the effects of light upon the circadian pacemaker.

Amino Acids↗

Regrowth of optic fibers and behavioral recovery after optic chiasm transection.

We studied the effect of optic chiasm midline transection on visually guided behavior and retinotectal fiber regrowth in frogs. After complete transection, frogs do not respond to visually presented prey and looming stimuli. Beginning about 2 months later there is recovery of visual function. However, unlike recovery after optic nerve transection, animals respond as if the stimulus were not at its actual position, but at the symmetric position in the contralateral field. For instance, if a prey stimulus is located 5 cm away from the recovered frog at an eccentricity of 40 degrees to the left of the midline, the animal will respond as if the stimulus were 5 cm away at 40 degrees right. Further, these animals typically respond to looming stimuli not by jumping away from the stimulus, but by either colliding with the stimulus or jumping toward the side from which the stimulus approaches. These behaviors persist throughout the testing period, up to 17.5 months postlesion. Electrophysiological recordings reveal that visual activity in the optic tectum is retinotopically organized but driven primarily by stimuli to the ipsilateral eye. HRP histochemistry reveals that some regenerated retinal fibers are found to cross at the midline of the chiasm. Thus, the midline is not impenetrable to crossing retinal fibers. Frogs with cut of 3/4 of the chiasm respond normally to prey stimuli initially but later respond as if the stimuli are at mirror image locations. In these animals most retinotectal fibers project to the ipsilateral tectum despite the presence of intact contralaterally projecting retinotectal fibers during the recovery period.

Animals↗

Optic disc structure in anterior ischemic optic neuropathy.

The etiology of anterior ischemic optic neuropathy (AION), when not associated with giant cell arteritis, is usually unknown. Clinical, pathologic, and experimental studies have not determined a cause. The optic disc appearance in both the involved and normal fellow eye was studied in 51 patients with acute nonarteritic AION. The number of discs (both involved and fellow) without a physiologic cup was significantly greater than would be expected from normal population studies. The etiology of nonarteritic AION may be related to the anatomic configuration of the optic nerve.

Eye↗

Optic canal decompression in indirect optic nerve trauma.

BACKGROUND: The proper management of neurogenic visual loss after blunt head trauma is controversial. Non-treatment, corticosteroids, and surgical decompression of the optic canal are all currently considered to be reasonable alternatives. The goal of this study was to identify factors affecting improvement in patients treated with canal decompression. METHODS: A retrospective analysis of 31 cases in which transethmoidal decompression of the optic canal had been performed for neurogenic visual loss after closed head trauma was conducted. Each patient was alert and free of injury to the globe when evaluated before surgery. Surgery was performed within 6 days of injury, and all were given perioperative steroids. RESULTS: Visual acuity improved in 22 (71%) patients, with 6 (19%) regaining visual acuity of 20/40 or better. The mean improvement from preoperative visual deficit was 42.0% +/- 6.6%, with a median improvement of 45.2%. Both univariate and multivariate analysis suggested that vision improved more in patients who were younger than 40 years of age than in patients who were 40 years of age or older. Interval between injury and surgery, preoperative visual acuity, and the presence of optic canal fracture did not affect outcome. CONCLUSION: Any future randomized trials of therapy should stratify patients based on age. Enrollment of patients with no light perception or who experienced delay between injury and treatment may be reasonably considered.

Adolescent↗

Stratus optical coherence tomography for evaluating optic disc pits associated with maculopathy before and after vitrectomy: two case reports.

Optic disc pit (ODP) can be either congenital or acquired. Congenital ODP is typically unilateral, and the visual acuity and visual field are normal unless associated with macular serous detachment, which occurs in about 25-75% of cases. Acquired ODP is known as an important risk factor for progressive visual field loss in glaucoma. The fundus finding of congenital ODP includes oval depression involving the optic disc, with or without macular serous detachment. We used third-generation Stratus optical coherence tomography (Straus OCT) to investigate the possible pathogenesis of ODP associated with maculopathy and to monitor the anatomic changes before and after treatment.

Adolescent↗

Optic nerve head blood flow measurements in non-arteritic anterior ischaemic optic neuropathy.

PURPOSE: To determine whether a decrease in blood flow, measured by the Heidelberg retiinal flowmeter, can characterise a disc at risk and predict the occurrence of non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS: Blood flow, volume and velocity were measured in the optic nerve heads of 14 unaffected fellow eyes of patients with unilateral NAION, and compared with those of the affected eyes and of the eyes of 7 age-matched healthy controls. RESULTS: The affected eyes were found to differ from the unaffected eyes in all three haemodynamic parameters. Flow (measured in arbitrary units) is the most important parameter to be taken into consideration. Blood flow was significantly lower in affected than in unaffected eyes (upper rim, p < 0.05; lower rim, p < 0.025). It was also significantly lower in the unaffected eyes than in the healthy control eyes (p < 0.005, upper and lower rims), and in the affected eyes than in the control eyes (p < 0.00005, upper and lower rims). CONCLUSION: Decreased blood flow in the optic nerve head may indicate a risk for NAION and be considered a characteristic of the disc at risk.

Aged↗

Comparison of retinal nerve fibre layer measurements using optical coherence tomography versions 1 and 3 in eyes with band atrophy of the optic nerve and normal controls.

AIMS: To compare retinal nerve fibre layer (RNFL) measurements were carried out with two different versions of an optical coherence tomography device in patients with band atrophy (BA) of the optic nerve and in normal controls. METHODS: The RNFL of 36 eyes (18 with BA and 18 normals) was measured using an earlier version of an optical coherence tomography device (OCT-1). The measurements were repeated using a later version of the same equipment (OCT-3), and the two sets of measurements were compared. RESULTS: Using OCT-1, the peripapillary RNFL thickness (mean+/-SD, in microm) in eyes with BA measured 80.42+/-6.94, 99.81+/-14.00, 61.69+/-13.02, 101.70+/-12.54, and 57.36+/-16.52 corresponding to the total RNFL average, superior, temporal, inferior, and nasal quadrants, respectively. Using OCT-3, the corresponding measurements were 63.11+/-6.76, 81.22+/-13.34, 39.50+/-8.27, 86.72+/-15.16, and 45.05+/-8.03. Each of these measurements was significantly smaller with OCT-3 than with OCT-1. In normal eyes, RNFL average and temporal quadrant OCT-3 values were significantly smaller than OCT-1 values, but there was no significant difference in measurements from the superior, inferior, and nasal quadrant. CONCLUSIONS: RNFL measurements were smaller with OCT-3 than with OCT-1 for almost all parameters in eyes with BA and in the global average and temporal quadrant measurements in normal eyes. Investigators should be aware of this fact when comparing old RNFL measurement with values obtained with later versions of the equipment.

Adult↗

[Optic nerve damage following craniocerebral trauma. A critical analysis of trans-ethmoid decompression of the optic nerve].

Over a period of 10 years 39 patients who suffered an optic nerve compression after a craniocerebral trauma underwent transethmoidal decompression surgery. The operation was performed bilaterally on 5 patients. Fifty per cent of the patients involved suffered a blunt head or brain injury, the others a brain concussion or space-occupying haemorrhage. At the side of optic nerve compression we found specific signs and symptoms, such as negative or sluggish direct light reaction of the pupil, a wound on the lateral side of the eyebrow, bleeding from the nose, eyelid haematoma, maximum of skull fractures and intracranial haematomas. Since the coincidence of radiological and intraoperative findings was only 67%, the ophthalmological findings such as lack of direct pupil reaction with preserved consensual light reaction or progressive loss of vision after a corresponding traumatic incident are our guideline for performing transethmoidal decompression of the optic nerve. In comparison with the results of conservative therapy as published in the literature, we achieved restitution of the visual function in about 10% more of the cases.

Adolescent↗

[Histopathology of the retina, optic fascicle and lateral geniculate body in chronic, bilateral symmetric ischemic Schnabel's cavernous optic atrophy].

The paper is a unique pathological description of a bilateral, symmetric, anterior, temporal ischemic optic neuropathy with the morphological characteristics of cavernous optic atrophy initially described by Schnabel in glaucomatous eyes. The 80-year-old woman had suffered from cardiac insufficiency and diabetes mellitus for many years. She died from sepsis and circulatory collapse due to ischemic colitis, intestinal perforation, and peritonitis. There was widespread arteriosclerosis but no evidence of giant-cell arteritis. Cell loss was demonstrated in both retinas, the chiasm, and in the central lateral geniculate body. These represent a retrograde, descending and ascending optic atrophy, with transsynaptic degeneration in the LGB. A small craniopharyngioma was found by chance in the infundibulum. Neither clinically nor morphologically were there any signs of glaucoma.

Aged↗

T cell immunity to copolymer 1 confers neuroprotection on the damaged optic nerve: possible therapy for optic neuropathies.

We recently reported that the posttraumatic spread of degeneration in the damaged optic nerve can be attenuated by the adoptive transfer of autoimmune T cells specific to myelin basic protein. However, it would be desirable to obtain immune neuroprotection free of any possible autoimmune disease. In an attempt to obtain disease-free immune neuroprotection, we used the synthetic four-amino acid polymer copolymer 1 (Cop-1), which is known not to be encephalitogenic despite its cross-reactivity with myelin basic protein. We show here that active immunization with Cop-1 administered in adjuvant, as well as adoptive transfer of T cells reactive to Cop-1, can inhibit the progression of secondary degeneration after crush injury of the rat optic nerve. These results have implications for the treatment of optic neuropathies.

Animals↗

Automatic recovery of the optic nervehead geometry in optical coherence tomography.

Optical coherence tomography (OCT) uses retroreflected light to provide micrometer-resolution, cross-sectional scans of biological tissues. OCT's first application was in ophthalmic imaging where it has proven particularly useful in diagnosing, monitoring, and studying glaucoma. Diagnosing glaucoma is difficult and it often goes undetected until significant damage to the subject's visual field has occurred. As glaucoma progresses, neural tissue dies, the nerve fiber layer thins, and the cup-to-disk ratio increases. Unfortunately, most current measurement techniques are subjective and inherently unreliable, making it difficult to monitor small changes in the nervehead geometry. To our knowledge, this paper presents the first published results on optic nervehead segmentation and geometric characterization from OCT data. We develop complete, autonomous algorithms based on a parabolic model of cup geometry and an extension of the Markov model introduced by Koozekanani, et al. to segment the retinal-nervehead surface, identify the choroid-nervehead boundary, and identify the extent of the optic cup. We present thorough experimental results from both normal and pathological eyes, and compare our results against those of an experienced, expert ophthalmologist, reporting a correlation coefficient for cup diameter above 0.8 and above 0.9 for the disk diameter.

Algorithms↗

Optical coherence tomography versus automated perimetry for follow-up of optic neuritis.

PURPOSE: To evaluate the usefulness of optical coherence tomography (OCT) for follow-up of optic neuritis (ON) compared with subjective visual function tests. METHODS: Twelve patients with ON underwent a complete ophthalmological evaluation at initial diagnosis, including best corrected visual acuity (VA), visual fields testing and OCT examination. These examinations were repeated periodically over 6 months. Retinal nerve fibre layer (RNFL) thickness evolution was analysed and correlated with VA and visual field mean deviation. RESULTS: Six months after ON, mean RNFL in the affected eye decreased significantly compared with that in the fellow eye (24.54%). A significant correlation was found between RNFL thinning and final VA (r = 0.807, p = 0.005), with a 1-line drop in VA for every 5.4-micro m decrease. All patients with an altered visual field had an abnormal RNFL value; of the seven patients with normal visual fields, 57% had an abnormal RNFL value (p < 5%). CONCLUSIONS: Optical coherence tomography can detect axonal damage as early as the third month after an isolated initial episode of ON, even in the presence of normal visual fields. Mean RNFL thinning is correlated with final VA.

Adult↗

Fiber optic probes for biomedical optical spectroscopy.

Fiber optic probes are a key element for biomedical spectroscopic sensing. We review the use of fiber optic probes for optical spectroscopy, focusing on applications in turbid media, such as tissue. The design of probes for reflectance, polarized reflectance, fluorescence, and Raman spectroscopy is illustrated. We cover universal design principles as well as technologies for beam deflecting and reshaping.

Equipment Design↗

Use of a multiseparation fiber optic probe for the optical diagnosis of breast cancer.

We explore the effects of the illumination and collection geometry on optical spectroscopic diagnosis of breast cancer. Fluorescence and diffuse reflectance spectroscopy in the UV-visible spectral range are made with a multiseparation probe at three illumination-collection separations of 735, 980, and 1225 microm, respectively, from 13 malignant and 34 nonmalignant breast tissues. Statistical analysis is carried out on two types of data inputs: (1) the fluorescence and diffuse reflectance spectra recorded at each of the three illumination-collection separations and (2) the integrated fluorescence (at each excitation wavelength) or diffuse reflectance over the entire spectrum at all three illumination-collection separations. The results show that using the integrated fluorescence intensities recorded at a single excitation wavelength at all three illumination-collection separations can discriminate malignant from nonmalignant breast tissues with similar classification accuracy to that using spectral data measured at several excitation wavelengths with a single illumination-collection separation. These findings have significant implications with respect to the design of an optical system for breast cancer diagnosis. Examining the intensity attenuation at a single wavelength rather than spectral intensities at multiple wavelengths can significantly reduce the measurement and data processing time in a clinical setting as well as the cost and complexity of the optical system.

Breast Neoplasms↗