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      Collagen Architecture of the Posterior Pole: High-Resolution Wide Field of View Visualization and Analysis Using Polarized Light Microscopy

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          Abstract

          Purpose

          The purpose of this study was to leverage polarized light microscopy (PLM) to visualize the collagen fiber architecture of posterior pole and optic nerve head with micrometer-scale resolution and to identify and quantify major organizational components.

          Methods

          Eight sheep posterior poles were cryosectioned and imaged using PLM. Collagen fiber orientation was determined by using custom scripts, and the resulting orientation maps were inspected and quantified to identify major structural elements and tested for differences in mean fiber orientation and anisotropy, using linear mixed effect models.

          Results

          Images revealed an intricate organization of collagen fibers in the posterior pole. In the lamina cribrosa, interweaving fibers formed large knots and wrapped around nerve fiber pores, with beam insertions into the scleral canal wall that were either narrow and straight or wide. In the peripapillary sclera, three significantly different ( P < 0.0001) components were identified: fibers oriented circumferentially proximal to the canal, radially in the innermost sclera, and unaligned with interweaving fibers. The radial fibers were between 60 and 180 μm thick, extending at least 3 mm from the canal.

          Conclusions

          PLM revealed structural aspects of the lamina cribrosa and sclera that may have important biomechanical roles but that were previously unreported or not characterized quantitatively. In the lamina cribrosa, these roles included wide and narrow beam insertions and details of collagen fibers interweaving and wrapping around the pores. In the sclera, we described regions of circumferential, radial, and unaligned “random” fibers. Although there is consensus that circumferential fibers protect neural tissues by resisting canal expansion, the role of the radial fibers remains unclear.

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          Most cited references42

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          Morphologic changes in the lamina cribrosa correlated with neural loss in open-angle glaucoma.

          We divided 25 glaucomatous human eyes into three groups representing mild (Group 1, seven eyes), moderate (Group 2, 11 eyes), and severe (Group 3, six eyes) optic nerve damage, based on visual field testing or remaining number of optic nerve fibers. The optic nerve head of each eye was examined by scanning electron microscopy. Compression of the successive lamina cribrosa sheets was the earliest detected abnormality, occurring in some eyes before the detection of visual field loss. Backward bowing of the entire lamina cribrosa was a later change and involved its upper and lower poles more than the mid-nerve head. The diameter of the scleral opening at the level of Bruch's membrane did not enlarge in these adult glaucomatous eyes. Mechanical compression of the nerve head occurred early enough to be considered a primary pathogenetic event in glaucomatous damage.
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            Biomechanics of the human posterior sclera: age- and glaucoma-related changes measured using inflation testing.

            The objective of this study was to measure the biomechanical response of the human posterior sclera in vitro and to estimate the effects of age and glaucoma. Scleral specimens from 22 donors with no history of glaucoma and 11 donors with a history of glaucoma were excised 3 mm posterior to the equator and affixed to an inflation chamber. Optic nerve cross-sections were graded to determine the presence of axon loss. The time-dependent inflation response was measured in a series of pressure-controlled load-unload tests to 30 mm Hg and creep tests to 15 and 30 mm Hg. Circumferential and meridional strains were computed from the digital image correlation displacements, and midposterior stresses were determined from pressure and deformed geometry. Among normal specimens, older age was predictive of a stiffer response and a thinner sclera. In the age group 75 to 93, diagnosed glaucoma eyes with axon damage were thicker than normal eyes. Both damaged and undamaged glaucoma eyes had a different strain response in the peripapillary sclera characterized by a stiffer meridional response. Undamaged glaucoma eyes had slower circumferential creep rates in the peripapillary sclera than normal eyes. Glaucoma eyes were not different from normal eyes in stresses and strains in the midposterior sclera. The observed differences in the biomechanical response of normal and glaucoma sclera may represent baseline properties that contribute to axon damage, or may be characteristics that result from glaucomatous disease.
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              Regional differences in the structure of the lamina cribrosa and their relation to glaucomatous optic nerve damage.

              Previously, there was no feature of optic nerve head anatomy or physiology that could explain the greater susceptibility for early damage in some nerve fibers by chronic glaucoma. Using a new technique for scanning electron microscopic examination of human optic nerve heads, regional differences were found in the fine structure of the lamina cribrosa. The superior and inferior parts of the lamina at the level of the sclera appear to contain larger pores and thinner connective tissue support for the passage of nerve-fiber bundles than the nasal and temporal parts of the lamina. Since the superior and inferior laminar zones are the sites of passage for arcuate area ganglion cell axons that are most susceptible to glaucoma damage, the differences found in laminar structure in these locations may explain the characteristic pattern of early glaucomatous field loss.
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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest. Ophthalmol. Vis. Sci
                iovs
                iovs
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                February 2017
                : 58
                : 2
                : 735-744
                Affiliations
                [1 ]Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
                [2 ]Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
                Author notes
                Correspondence: Ian A. Sigal, Laboratory of Ocular Biomechanics, Department of Ophthalmology, University of Pittsburgh Medical Center, 203 Lothrop Street, Room 930, Pittsburgh, PA 15213, USA; ian@ 123456OcularBiomechanics.com .
                Article
                iovs-58-01-17 IOVS-16-20772
                10.1167/iovs.16-20772
                5295768
                28146238
                19f8ab28-259c-4ac9-b976-be1fb36ffb33
                Copyright 2017 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 17 September 2016
                : 18 December 2016
                Categories
                Multidisciplinary Ophthalmic Imaging

                collagen,lamina cribrosa,microscopy,optic nerve head,sclera
                collagen, lamina cribrosa, microscopy, optic nerve head, sclera

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