Tektas Ozan-Yueksel, Lütjen-Drecoll Elke, Scholz Michael
Institute of Anatomy II, University of Erlangen-Nuremberg, Erlangen, Germany.
Invest Ophthalmol Vis Sci. 2010 Oct;51(10):5083-91. doi: 10.1167/iovs.09-5101. Epub 2010 May 19.
To analyze the vasculature and extracellular matrix changes in the prelaminar region (PreLR) of the optic nerve head (ONH) and in the peripapillary sclera of eyes with primary open-angle glaucoma (POAG) and age-matched control eyes.
In histologic sagittal sections of 46 eyes with POAG and 45 control eyes (donor ages, 20-96 years), the peripapillary sclera and penetrating vessels were investigated ultrastructurally and with antibodies against elastin, podocalyxin, and α-actin. Within the PreLR, the number and density of capillaries and the thickness of their connective tissue sheaths (CTSs) were quantified. The composition of the CTS was analyzed by using antibodies against collagen types I, III, IV, and VI, and elastin. Areas within the PreLR containing capillaries with thick or thin CTSs were determined.
There were no glaucomatous changes in the peripapillary elastic fibers and in the arterial capillaries in the periphery of the PreLR. In the center of the PreLR, the capillaries gained a CTS that was significantly thicker in POAG eyes than in control eyes, and the area containing capillaries with thick CTSs was significantly larger. These data did not correlate with axon counts.
Lack of glaucomatous changes in elastic fibers of the scleral suspension of the ONH seems to prevent occlusion of penetrating vessels. In the PreLR, thickening of the capillary CTS and enlargement of the area containing capillaries with thickened CTS could increase diffusion time and may impair nutrition of the neuronal tissue.
分析原发性开角型青光眼（POAG）患者及年龄匹配的对照者眼睛的视神经乳头（ONH）板层前区域（PreLR）和视乳头周围巩膜的血管系统及细胞外基质变化。
对46只POAG眼睛和45只对照眼睛（供体年龄20 - 96岁）的组织学矢状切片，采用超微结构观察以及抗弹性蛋白、足突细胞黏蛋白和α - 肌动蛋白抗体进行研究。在PreLR内，对毛细血管的数量和密度及其结缔组织鞘（CTS）的厚度进行定量分析。通过抗I、III、IV和VI型胶原蛋白以及弹性蛋白抗体分析CTS的组成。确定PreLR内含有厚CTS或薄CTS毛细血管的区域。
视乳头周围弹性纤维和PreLR周边的动脉毛细血管未见青光眼性改变。在PreLR中心，POAG眼睛的毛细血管获得的CTS明显比对照眼睛厚，且含有厚CTS毛细血管的区域明显更大。这些数据与轴突计数无关。
ONH巩膜悬韧带弹性纤维缺乏青光眼性改变似乎可防止穿通血管闭塞。在PreLR中，毛细血管CTS增厚以及含有增厚CTS毛细血管区域扩大可能会增加扩散时间，并可能损害神经元组织的营养供应。
