Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA.
Diagnostic Imaging Services Lead, UCSF Health, Wayne and Gladys Valley Center for Vision, 490 Illinois St., San Francisco, CA, 94158, USA.
Exp Eye Res. 2022 Sep;222:109124. doi: 10.1016/j.exer.2022.109124. Epub 2022 Jun 7.
The ciliary muscle (CM) powers the accommodative response, and during accommodation the CM pulls the choroid forward in the region of the ora serrata. Our goal was to elucidate the accommodative movements of the choroid in the optic nerve region in humans and to determine whether these movements are related to changes in the lens dimensions that occur with aging, in the unaccommodated and accommodated state. Both eyes of 12 human subjects (aged 18-51 yrs) were studied. Homatropine (1 drop/5%) was used to relax the ciliary muscle (unaccommodated or "resting" eye) and pilocarpine was used to induce the maximum accommodative response (2 drops/4%) (accommodated eye). Images of the fundus and choroid were collected in the region of the optic nerve (ON) via Spectralis OCT (infrared and EDI mode), and choroidal thickness was determined. Ultrasound biomicroscopy (UBM; 50 MHz, 35 MHz) images were collected in the region of the lens/capsule and ciliary body. OCT and UBM images were collected in the resting and accommodated state. The unaccommodated choroidal thickness declined significantly with age (p = 0.0073, r = 0.73) over the entire age range of the subjects studied (18-51 years old). The choroidal thickness was significantly negatively correlated with lens thickness in the accommodated (p = 0.01) and the unaccommodated states (p = 0.005); the thicker the lens the thinner the choroid. Choroid movements around the optic nerve during accommodation were statistically significant; during accommodation the choroid both thinned and moved centrifugally (outward/away from the optic nerve head). The accommodative choroid movements did not decline significantly with age and were not correlated with accommodative amplitude. Measurement of the choroidal thickness is possible with the Spectralis OCT instrument using EDI mode and can be used to determine the accommodative changes in choroidal thickness. The choroidal thickness decreased with age and during accommodation. It may be that age-related choroidal thinning is due to changes in the geometry of the accommodative apparatus to which it is attached (i.e., ciliary muscle/lens complex) such that when the lens is thicker, the choroid is thinner. Accommodative decrease in choroidal thickness and stretch of the retina/choroid may indicate stress/strain forces in the region of the optic nerve during accommodation and may have implications for glaucoma.
睫状肌(CM)为调节反应提供动力,在调节过程中,CM 将脉络膜向前拉到锯齿缘区域。我们的目标是阐明人类视神经区域脉络膜的调节运动,并确定这些运动是否与未调节和调节状态下随年龄增长而发生的晶状体尺寸变化有关。研究了 12 名人类受试者(年龄 18-51 岁)的双眼。使用毛果芸香碱(1 滴/5%)松弛睫状肌(未调节或“休息”眼),并用匹罗卡品诱导最大调节反应(2 滴/4%)(调节眼)。通过 Spectralis OCT(近红外和 EDI 模式)在视神经(ON)区域采集眼底和脉络膜图像,并确定脉络膜厚度。在晶状体/囊和睫状体区域采集超声生物显微镜(UBM;50MHz,35MHz)图像。在休息和调节状态下采集 OCT 和 UBM 图像。在整个研究对象的年龄范围内(18-51 岁),未调节的脉络膜厚度随年龄显著下降(p=0.0073,r=0.73)。在调节和未调节状态下,脉络膜厚度与晶状体厚度呈显著负相关(p=0.01 和 p=0.005);晶状体越厚,脉络膜越薄。调节时视神经周围的脉络膜运动具有统计学意义;调节时脉络膜变薄并向心移动(向外/远离视神经头)。调节性脉络膜运动随年龄增长没有显著下降,与调节幅度无关。使用 Spectralis OCT 仪器的 EDI 模式可以测量脉络膜厚度,并可用于确定脉络膜厚度的调节变化。脉络膜厚度随年龄增长而下降,在调节过程中也会下降。可能是由于与它相连的调节装置(即睫状肌/晶状体复合体)的几何形状发生了变化,导致随着晶状体变厚,脉络膜变薄,导致与年龄相关的脉络膜变薄。脉络膜厚度在调节过程中的减少和视网膜/脉络膜的拉伸可能表明在调节期间视神经区域存在应力/应变力,这可能对视神经病变有影响。