Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States.
Department of Biological Science, University of Pittsburgh, Pittsburgh, PA, United States.
Exp Eye Res. 2022 Jul;220:109105. doi: 10.1016/j.exer.2022.109105. Epub 2022 May 12.
Our goal was to identify the factors with the strongest influence on the minimum lamina cribrosa (LC) oxygen concentration as potentially indicative of conditions increasing hypoxia risk. Because direct measurement of LC hemodynamics and oxygenation is not yet possible, we developed 3D eye-specific LC vasculature models. The vasculature of a normal monkey eye was perfusion-labeled post-mortem. Serial cryosections through the optic nerve head were imaged using fluorescence and polarized light microscopy to visualize the vasculature and collagen, respectively. The vasculature within a 450 μm-thick region containing the LC - identified from the collagen, was segmented, skeletonized, and meshed for simulations. Using Monte Carlo sampling, 200 vascular network models were generated with varying vessel diameter, neural tissue oxygen consumption rate, inflow hematocrit, and blood pressures (arteriole, venule, anterior boundary, and posterior boundary). Factors were varied over ranges of baseline ±20% with uniform probability. For each model we first obtained the blood flow, and from this the neural tissue oxygen concentration. ANOVA was used to identify the factors with the strongest influence on the minimum (10th percentile) oxygen concentration in the LC. The three most influential factors were, in ranked order, vessel diameter, neural tissue oxygen consumption rate, and arteriole pressure. There was a strong interaction between vessel diameter and arteriole pressure whereby the impact of one factor was larger when the other factor was small. Our results show that, for the eye analyzed, conditions that reduce vessel diameter, such as vessel compression due to elevated intraocular pressure or gaze-induced tissue deformation, may particularly contribute to decreased LC oxygen concentration. More eyes must be analyzed before generalizing.
我们的目标是确定对最小视盘筛板(LC)氧浓度有最强影响的因素,这些因素可能表明存在增加缺氧风险的情况。由于直接测量 LC 血液动力学和氧合作用尚不可行,我们开发了 3D 特定于眼睛的 LC 脉管系统模型。正常猴子眼睛的脉管系统在死后进行了灌注标记。通过视神经头部的连续冷冻切片,使用荧光和偏振光显微镜分别对脉管系统和胶原蛋白进行成像。从胶原蛋白中确定包含 LC 的 450μm 厚区域内的脉管系统被分割、骨架化并进行网格划分以进行模拟。使用蒙特卡罗采样,生成了 200 个具有不同血管直径、神经组织耗氧量、流入红细胞压积和血压(小动脉、小静脉、前边界和后边界)的血管网络模型。因素在基线±20%的范围内以均匀的概率变化。对于每个模型,我们首先获得血流,然后从血流中获得神经组织氧浓度。方差分析用于确定对 LC 中最小(第 10 个百分位数)氧浓度有最强影响的因素。三个最具影响力的因素按排名顺序依次为血管直径、神经组织耗氧量和小动脉压。血管直径和小动脉压之间存在强烈的相互作用,当另一个因素较小时,一个因素的影响更大。我们的结果表明,对于分析的眼睛,例如由于眼内压升高或注视引起的组织变形导致血管压缩而导致血管直径减小的情况,可能特别导致 LC 氧浓度降低。在推广之前,必须对更多的眼睛进行分析。