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A neurotrophic model of the development of the retinogeniculocortical pathway induced by spontaneous retinal waves.

The development of the retinogeniculate pathway or the geniculocortical pathway, or both, occurs either before birth or before eye opening in many species. It is widely believed that spontaneous retinal activity could drive the segregation of afferents into eye-specific laminae or columns and the refinement of initially diffuse receptive fields and the emergence of orderly, retinotopic organization. We show that a recent computational model that generates a phenomenologically accurate representation of spontaneous retinal activity can indeed drive afferent segregation and, more particularly, topographic and receptive field refinement in the retinogeniculocortical system. We use a model of anatomical synaptic plasticity based on recent data suggesting that afferents might compete for limited amounts of retrograde neurotrophic factors (NTFs). We find that afferent segregation and receptive field formation are disrupted in the presence of exogenous NTFs. We thus predict that infusion of NTFs into the lateral geniculate nucleus should disrupt normal development and that the infusion of such factors into the striate cortex should disrupt receptive field refinement in addition to the well known disruption of ocular dominance column (ODC) formation. To demonstrate that the capacity of our model of plasticity to drive normal development is not restricted just to spontaneous retinal activity, we also use a coarse representation of visually evoked activity in some simulations. We find that such simulations can exhibit the formation of ODCs followed by their disappearance, reminiscent of the New World marmoset. A decrease in interocular correlations stabilizes these ODCs. Thus we predict that divergent strabismus should render marmoset ODCs stable into adulthood.

Animals↗

Molecular recapitulation: the growth of the vertebrate retina.

In postembryonic lower vertebrates, the ciliary marginal zone (CMZ) of the retina is a continuously growing zone in the central nervous system. By studying the cellular and molecular biology of the cells in this region, we have discovered that the CMZ can be divided into several zones, from peripheral to central, which reflect different stages of development of retinal stem cells. Based on the behavior of the cells and on the genes expressed in different regions, we propose here that cellular development in the CMZ recapitulates in space what happens in embryonic retinal development in time.

Animals↗

Development and plasticity of retinal X and Y axon terminations in the cat's lateral geniculate nucleus.

The technique of injecting single retinogeniculate fibers with horseradish peroxidase enables the terminal arbors of physiologically identified axons to be fully characterized morphologically. We have used this technique to study the postnatal development of retinal X and Y cell arbors within the cat's lateral geniculate nucleus, and the plasticity of these arbors following a variety of manipulations that perturb normal development. These experiments suggest quite specific sequences and mechanisms for the development of individual X and Y retinogeniculate axons. Retinal X axons appear to innervate the lateral geniculate nucleus before Y axons do, and are probably specified innately to their appropriate target lamina A or A1. By 3-4 weeks postnatally, X axons from each eye develop exuberant terminal arbors within the A laminae that by 12 weeks get pruned to the narrow adult form by later developing Y axon arbors from the same eye. The Y arbors progressively expand to form their characteristic broad terminal zones during this period. The laminar location of Y arbors depends on interactions between axons from the two eyes, and their transverse extent on the presence of normal afferent activity in retinogeniculate fibers.

Animals↗

A unifying theory of refractive error development.

While retinal defocus is believed to be myopigenic in nature, the underlying mechanism has remained elusive. We recently constructed a theory of refractive error development to investigate its fundamental properties. Our Incremental Retinal-Defocus Theory is based on the principle that the change in retinal-defocus magnitude during an increment of genetically-programmed ocular growth provides the requisite sign for the appropriate alteration in subsequent environmentally-induced ocular growth. This theory was tested under five experimental conditions: lenses, diffusers, occlusion, crystalline lens removal, and prolonged nearwork. Predictions of the theory were consistent with previous animal and human experimental findings. In addition, simulations using a MATLAB/SIMULINK model supported our theory by demonstrating quantitatively the appropriate directional changes in ocular growth rate. Thus, our Incremental Retinal-Defocus Theory provides a simple and logical unifying concept underlying the mechanism for the development of refractive error.

Computer Simulation↗

Vitrectomy and silicone oil tamponade as an initial surgery for retinal detachment after acute retinal necrosis syndrome.

PURPOSE: To show the feasibility of vitrectomy and silicone oil tamponade as an initial surgical procedure for retinal detachments with multiple tears that develop after the fulminant type of acute retinal necrosis syndrome. METHODS: In a prospective noncomparative interventional case series, vitrectomy, silicone oil tamponade, and encircling scleral buckling with a solid silicone, combined with phacoemulsification and intraocular lens implantation (except for one pseudophakic patient [Case 2]), were performed in three consecutive patients during the four-year period from 1999 to 2002. These patients had developed retinal detachment with multiple retinal tears after the resolution of acute retinal necrosis syndrome. As an initial standard treatment for acute retinal necrosis syndrome, all patients received maximum-dose intravenous acyclovir (1500 mg daily) for two weeks combined with intravenous prednisolone tapered from 200 mg daily. RESULTS: Case 1 was a 65-year-old woman who developed retinal detachment 44 days after the onset of acute retinal necrosis syndrome; Case 2, a 79-year-old man, developed retinal detachment 51 days after the onset; and Case 3, a 59-year-old man, developed retinal detachment 70 days after the onset. Before surgery, all patients showed multiple tears scattered on the detached atrophic retina extending over the entire midperipheral fundus with vitreoretinal adhesions and vitreous opacity. The retina was reattached during the initial surgery. The patients showed no recurrence of retinal detachment and maintained a visual acuity of 20/200 or 20/100 during the one- to three-year follow-up period. CONCLUSIONS: Vitrectomy and silicone oil tamponade could be a treatment option as the initial surgical procedure for retinal detachments that develop after the fulminant type of acute retinal necrosis syndrome.

Aged↗

Ingrowth and ramification of retinal fibers in the developing optic tectum of the chick embryo.

Onset, temporal sequence, and pattern of ingrowth of retinal fibers into the developing optic tectum of the chicken were investigated with histological procedures including the Golgi technique. Invading fibers could first be detected by stage 34 (eight days of incubation) at a specific locus which is the central area of the optic tectum. Compared to other tectal regions the central area is distinguished at this time by its advanced cytoarchitectural development and by the maturation of dendrites of radial cells located within superficial laminae. Immediately after their arrival at the central area some fibers can be observed invading the outer tectal layers and forming side branches. These observations permit the conclusion that fibers do not wait at their termination site for several days, as has been suggested earlier. Retinal axons start to invade the tectum at the site which is most advanced in its structural development. This early maturation of neurons in a specific tectal region might be a sufficient explanation for the central retinal fibers connecting to neurons of this area, which, propter hoc, is called the central tectal area.

Age Factors↗

Progressive outer retinal necrosis and acute retinal necrosis in fellow eyes of a patient with acquired immunodeficiency syndrome.

PURPOSE: To describe an unusual concurrence of acute retinal necrosis and progressive outer retinal necrosis in fellow eyes of a patient with acquired immunodeficiency syndrome (AIDS). METHODS: Interventional case report. In a 37-year-old man with AIDS and herpes zoster keratitis in the right eye, progressive outer retinal necrosis developed in the right eye and acute retinal necrosis developed in the left eye. RESULTS: Disparate presentations of retinitis persisted in each eye, and retinal detachment and vision loss ensued in both eyes despite antiviral therapy. CONCLUSION: Distinct features of acute retinal necrosis and progressive outer retinal necrosis do not necessarily reflect systemic factors, and they may be variant manifestations of the same underlying infection.

Acquired Immunodeficiency Syndrome↗

Normal vascular development in mice deficient in endothelial NO synthase: possible role of neuronal NO synthase.

PURPOSE: Nitric oxide formation by nitric oxide synthase (NOS) has been implicated in vascular injury and retinal neovascularization during oxygen-induced retinopathy. However, the role of NOS in normal retinal vascular development and growth has not been studied. The purpose of these experiments was to characterize the expression of NOS in relation to vascular development and to determine the effect of deleting endothelial NOS (eNOS) on this process. METHODS: Retinal vascular development was analyzed in 150 eNOS+/+ and eNOS-/- mice ranging from 1 day to 6 months old by using a combination of morphometric and biochemical approaches. The pattern of vascular development was analyzed in retinal tissue sections and whole-mount preparations labeled with fluorescein-conjugated Griffonia simplicifolia lectin. Analysis of vascular density and arterial diameter were performed with the lectin-labeled whole-mounts using computer-assisted morphometry. NO production was quantified by measuring retinal levels of nitrate/nitrite accumulation using the Greiss reaction. Western blotting techniques with isoform-specific NOS antibodies were used to evaluate differences in levels of NOS protein expression. Retinal distribution of nNOS was characterized using nNOS immunocytochemistry and NADPH diaphorase histochemistry. RESULTS: These analyses showed that the rate and pattern of retinal vascular development in eNOS-/- mice were comparable with those in wild-type control mice. Measurement of vascular density showed no significant differences between the two strains. The amount of NO production in the eNOS-/- retina was also equivalent to that in the eNOS+/+ retina. Analysis of nNOS expression within the eNOS+/+ and eNOS-/- mice showed similar levels of total nNOS protein in the two strains. Inducible NOS was not detected in either strain. Studies of nNOS distribution showed intense labeling of the deep capillary plexus in the eNOS-/- retina. This was not seen in the wild-type retinas. The number of neuronal cells showing NADPH-diaphorase activity was also significantly increased in the eNOS-/- mice. CONCLUSIONS: Development of the retinal vasculature occurs normally without eNOS. The observations of similar levels of NO production, perivascular redistribution of nNOS and increased numbers of NADPH-diaphorase reactive neurons in the eNOS-/- retinas suggest that increases in vascular-associated nNOS activity compensate for the eNOS deficiency in the developing mutant retina.

Animals↗

Murine cytomegalovirus retinitis during MAIDS: Susceptibility correlates with elevated intraocular levels of interleukin-4 mRNA.

PURPOSE: To determine if murine cytomegalovirus (MCMV)-infected eyes of mice with murine acquired immunodeficiency syndrome (MAIDS) that are destined to develop MCMV retinitis display elevated intraocular levels of interleukin-4 (IL-4) mRNA when compared with uninfected eyes of mice with MAIDS and unmanipulated, uninfected, eyes of normal healthy mice. METHODS: Groups of C57BL/6 mice with MAIDS and normal C57BL/6 mice were infected uniocularly with MCMV by subretinal MCMV injection. IL-4 levels in individual spleens collected five days later from groups of MAIDS mice and normal mice were assessed by quantitative ELISA. MCMV-infected eyes and uninfected contralateral eyes from another group of mice with MAIDS were also collected at five days postinfection and individually subjected to competitive RT-PCR assay and real-time RT-PCR assay for detection and quantification of IL-4 mRNA. Unmanipulated eyes from normal C57BL/6 mice served as controls. RESULTS: IL-4 mRNA was detected at a level of 9.7 +/- 3.4 pg mRNA per 1000 ng total RNA in 100% of MCMV-infected eyes of mice with MAIDS by competitive RT-PCR assay, but could not be detected in any of the uninfected eyes of MAIDS mice. In comparison, the more sensitive technique of real-time RT-PCR assay detected copies of IL-4 cDNA in both MCMV-infected eyes and uninfected eyes of MAIDS mice. MCMV-infected eyes showed a 16-fold increase in the number of IL-4 cDNA copies when compared with uninfected eyes. Neither technique detected IL-4 mRNA in unmanipulated eyes of normal mice. As expected, spleen cells from mice with MAIDS expressed significantly greater levels of IL-4 when compared with spleen cells from normal mice. CONCLUSIONS: MCMV-infected mice with MAIDS exhibited an expected preferential activation of Th2 cells as determined by increased levels of IL-4 in spleen cells when compared with spleen cells of normal mice. MCMV-infected eyes destined to develop retinitis during MAIDS also showed increased levels of detectable IL-4 mRNA when compared with uninfected eyes of mice with MAIDS. It is therefore possible that IL-4 synthesis by Th2 CD4+ T cells during retrovirus-induced immunosuppression serves to inhibit the perforin cytotoxic pathway that subsequently allows susceptibility to MCMV retinitis during MAIDS.

Animals↗

Prognostic value of new retinal tears associated with the development of postoperative proliferative vitreoretinopathy.

We prospectively evaluated for the presence of new retinal tears 60 eyes of 60 patients who developed recurrent retinal detachment complicated by proliferative vitreoretinopathy (PVR) after surgery for primary rhegmatogenous retinal detachment. New retinal tears associated with the development or recurrence of postoperative PVR were disclosed in 27 eyes (45%). New tears were categorized into two distinct groups: (1) peripheral new tears and (2) posterior new tears. Peripheral new tears were disclosed in 11 eyes. They were invariably located at the posterior edge of the vitreous base and showed a prevalence in the inferior quadrants. The prognosis for permanent retinal reattachment after reoperation was not influenced by the presence of peripheral new tears. Posterior new tears were disclosed in 19 eyes. They were located in the mid-periphery or close to the posterior pole. They were more frequent in grade D PVR (57.7%) compared with grade C PVR (11.7%) (P less than 0.01). Posterior new tears were associated with a poor prognosis. In grade D PVR the anatomic success rate following repeated surgery was only 13.3% (2/15 eyes), whereas all eyes with grade D PVR and no posterior new tears were successfully reattached (P less than 0.001). Failures to reattach the retina were related to recurrent PVR. It is concluded that the development of posterior new tears in postoperative PVR reflects a severe and active PVR process.

Adolescent↗

Postnatal development of type I retinal ganglion cells in hamsters: a lucifer yellow study.

The postnatal development of a population of superior colliculus projecting retinal ganglion cells with large somata in hamsters aged from postnatal day (P) 4 to adult was studied by the intracellular injection of Lucifer Yellow. This population of cells was interpreted as Type I cells based on their large soma sizes and dendritic morphology resembling that of mature Type I cells. In addition to the growth of the soma and the dendritic field, transient morphological features such as intraretinal axon collaterals and exuberant dendritic spines, but not somatic spines, were frequently observed on this population of cells in hamsters during development. None of them exhibited any intraretinal axon collaterals after P7. The number of transient spine-like processes on dendrites increased from P4 onwards to reach a peak at P16, decreased abruptly within a few days after the peak, and stabilised to reach the adult level by P30. These developing cells attained the maximum number of dendritic branches by P16 and there seems to be little, if any, reduction in the number of branch points after this time point. In addition, the length of individual branches of dendrites was not increased excessively during development and then shortened during maturation. Thus, the dendritic remodeling of these cells after P16 seems to be mainly the increase of the length of dendrites and the removal of exuberant dendritic spines.

Animals↗

Evolution of neovascularization in sickle cell retinopathy. A prospective fluorescein angiographic study.

With prospective observations we have documented by fluorescein angiography the development of retinal neovascularization in the eyes of patients with sickle cell-hemoglobin C disease (hemoglobin SC). In each patient, arteriolarvenular (AV) anastomoses occurred before the development of neovascular sea fans. To our knowledge, this report constitutes the first such documentation in the literature. New sea fans from AV anastomoses appeared throughout an average interval of 18 months (range, 8 to 36 months) in approximately 21% of young adults with hemoglobin SC. Each year approximately 14% of young patients with hemoglobin SC may develop retinal neovascularization.

Adolescent↗

[Treatment of cytomegalovirus retinitis in AIDS with an intraocular sustained-release ganciclovir implant].

Active cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS) was treated with an intraocular sustained-release ganciclovir implant. A total number of 19 implants were performed in 15 eyes of 9 AIDS patients. The intraocular sustained-release ganciclovir was effective in preventing reactivation of CMV retinitis in 15 of the 19 implants, ineffective in 3, and undetermined in 1. All ineffective cases had been resistant to ganciclovir therapy before the implants. Vision after the therapy was maintained at better than 0.5 except for one eye. There were no serious ocular complications caused by the therapy. Among 5 patients with unilateral CMV retinitis, 2 unaffected eyes developed CMV retinitis during this therapy. In addition, another patient developed presumed CMV infection in other systemic organs. Based on these data, the intraocular sustained-release ganciclovir implant was considered to be useful for the treatment of CMV retinitis in AIDS.

AIDS-Related Opportunistic Infections↗

Evidence that the bifunctional redox factor / AP endonuclease Ref-1 is an anti-apoptotic protein associated with differentiation in the developing retina.

Retinal cell differentiation leads to resistance to apoptosis induced by inhibition of protein synthesis, suggesting the accumulation of anti-apoptotic proteins. The redox factor/AP endonuclease Ref-1 (APE, APEX, HAP1) affects both DNA repair and the activity of various transcription factors, and controls sensitivity to genotoxic insults. We studied the expression of Ref-1 in the retina and brain of developing rats. Ref-1 immunoreactivity increased progressively within the nucleus of differentiating retinal cells, whereas it decreased in the developing hippocampal formation. During both natural and experimentally-induced cell death, Ref-1 disappeared from the nucleus of apoptotic cells. Degradation of Ref-1 in axotomized ganglion cells preceded the morphological characteristics of apoptosis. The sensitivity to apoptosis triggered by either thapsigargin or okadaic acid was the highest in photoreceptors, that contain the least Ref-1 among differentiated retinal cells. In both these differentiated cell types, inhibition of protein synthesis prevented the loss of Ref-1 and rescued the neurons. The data suggest that Ref-1 is an anti-apoptotic protein associated with cell differentiation in the retina.

Animals↗

Course of retinopathy in children and adolescents with insulin-dependent diabetes mellitus: a ten-year study.

The prevalence and development of retinal changes were longitudinally documented from 1978 to 1987 in 112 insulin-dependent diabetic children by means of fluorescein angiography and fundus photography. At the end of the study period, 43 patients (38.4%) developed retinal changes, most of which were classified as minimal. Age, diabetes duration, puberty and long-term metabolic control were found to be independent factors affecting the development of retinopathy.

Age Factors↗

[HIV-associated retinal microangiopathy and the development of AIDS-defined infections. The Bern Angiopathy Study].

BACKGROUND: HIV-associated retinal microangiopathy is understood as a sign of uveovascular barrier breakdown and associated with an increasing risk to develop opportunistic infections. Hence no controlled studies have been available, the underlying study was undertaken to validate this clinical impression. PATIENTS AND METHODS: HIV-positive patients with or without clinical signs of retinal angiopathy were included into this study and followed up longitudinally with fotodocumentation, laser-flare and, sporadically, fluorescein angiography to quantify the disturbance of their uveovascular barrier. The data were correlated to the CD4 cell counts and the development of opportunistic infections. RESULTS: 104 patients have been included into one of four groups: patients without signs over ocular vascular disease (group 1, n = 46), with newly diagnosed HIV-associated microangiopathy (group 2, n = 37), with angiopathy for more than six months (group 3, n = 16), and with viral retinitis (group 4, n = 5). We found no difference in the flare between patients with and without angiopathy (p = 0.3), but a significant increase after the development of retinitis (p < 0.001). In contrast, the presence and duration of angiopathy were associated with a reduction in CD4 cell counts (p = 0.03). Using fluorescein angiography, we found vascular occlusions on the capillary level without leakages corresponding to a not relevant disruption of the retinovascular barrier. CONCLUSIONS: In HIV-associated retinal microangiopathy, there exists no relevant disturbance of the uveovascular barrier. The association of angiopathy with a reduction of CD4 cells is more likely a sign of immuncomplex-associated rather than infectious etiology. The analysis of drug effects on the course of angiopathy during a recovery of the cellular immunity will provide further etiological information in the progress of this study.

AIDS-Related Opportunistic Infections↗

Müller cells in developing rats with inherited retinal dystrophy.

Morphology and enzymes of Müller cells in the developing retina of RCS (Royal College of Surgeons) rats were investigated. RCS (rdy/rdy) rats with inherited retinal dystrophy were studied and RCS (-/+) rats served as normal controls. Rats underwent intracardiac perfusion with 4% paraformaldehyde and the eyes were enucleated on postnatal days P1, 4,10, 21, 35, and 100. Eyes were then fixed with 4% paraformaldehyde, and silver enhancing technique was applied to show glutamine synthetase (GS) and glial fibrillary acidic protein (GFAP). For solubilized retinas, Western blot analysis and enzyme-linked immunosorbent assay (ELISA) were performed to detect GS and GFAP in the extracts. Immunohistochemistry showed GS expression first on P10. It increased later in both normal and dystrophic retinas. GFAP was not expressed in normal retinas, but Müller cells of dystrophic retinas were stained on P35 and P100. GS immunoblots were recognized on P21 and later in both normal and dystrophic retinas with similar densities, while GFAP immunoblots were observed only on P35 and P100, and only in dystrophic retinas. ELISA demonstrated increased GS concentrations with the development in both normal and dystrophic retinas, but no significant difference was observed between them. GFAP concentrations had no significant difference on P21 between both groups, those of normal ones remained unchanged later, while those of dystrophic rats were remarkably increased on P35 and P100. Müller cells might be affected following the progressive degeneration of photoreceptor cells and react to the glio-neuronal relationship.

Animals↗

Automated detection of ocular alignment with binocular retinal birefringence scanning.

We previously developed a retinal birefingence scanning (RBS) device to detect eye fixation. The purpose of this study was to determine whether a new binocular RBS (BRBS) instrument can detect simultaneous fixation of both eyes. Control (nonmyopic and myopic) and strabismic subjects were studied by use of BRBS at a fixation distance of 45 cm. Binocularity (the percentage of measurements with bilateral fixation) was determined from the BRBS output. All nonstrabismic subjects with good quality signals had binocularity >75%. Binocularity averaged 5% in four subjects with strabismus (range of 0-20%). BRBS may potentially be used to screen individuals for abnormal eye alignment.

Automation↗