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Elevated intraocular pressure causes cellular and molecular retinal injuries, advocating a more moderate intraocular pressure setting during phacoemulsification surgery
Ist Teil von
International ophthalmology, 2020-12, Vol.40 (12), p.3323-3336
Ort / Verlag
Dordrecht: Springer Netherlands
Erscheinungsjahr
2020
Quelle
SpringerLink
Beschreibungen/Notizen
Purpose
To evaluate the cellular and molecular retinal injuries induced by various intraocular pressure (IOP) settings in a mouse model of acute ocular hypertension (AOH), and to advise using a more moderate target IOP during phacoemulsification (phaco) surgery.
Methods
A mouse model of AOH that mimics a transient IOP elevation during phacoemulsification cataract surgery was established. Six groups with various settings of target IOP were included. Retinal tissues were assessed with terminal deoxynucleotidyl transferase-mediated 2′-deoxyuridine 5′-triphosphate nick end-labeling (TUNEL) staining for neuron loss, immunofluorescence with Iba1 for microglia activation, and quantitative real-time polymerase chain reaction analysis with tight junction proteins (
claudin-3
and
claudin-5
) or classic inflammation markers (
IL-1β
and
eNOS
) for impairment of the blood–retinal barrier (BRB) and inflammatory injury.
Results
Compared with those in the 45-mmHg IOP group, significantly increased number of neurons loss and increased microglia activation were observed in 90-mmHg IOP group. In addition, the expression of
claudin-3
and
claudin-5
was significantly decreased, while the expression of
IL1-β
and
eNOS
was up-regulated, indicating impairment of the BRB and inflammatory injury in the retina. Furthermore, these findings of neuron loss, microglia activation, and inflammation in the 90-mmHg groups were exacerbated when an IOP-induced retinal injury was established 5 days earlier, while those in the 45-mmHg groups remained almost unchanged.
Conclusions
In conclusion, these results showed that a relatively commonly used high IOP setting (90 mmHg) could induce significantly more serious retinal injury. An IOP setting around 45 mmHg is relatively safe and might be recommended in phaco surgery, especially in patients with advanced glaucoma, previous acute angle closure crisis, or other diseases with fragile retina and optic nerve.