July 2017
Volume 58, Issue 9
Open Access
Research Highlight  |   July 2017
Alternative Routes to Perfuse the Optic Nerve Head
Author Affiliations
Investigative Ophthalmology & Visual Science July 2017, Vol.58, 3575. doi:10.1167/iovs.17-22492
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      Richard H. W. Funk; Alternative Routes to Perfuse the Optic Nerve Head. Invest. Ophthalmol. Vis. Sci. 2017;58(9):3575. doi: 10.1167/iovs.17-22492.

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      © ARVO (1962-2015); The Authors (2016-present)

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In this issue of IOVS, Yu et al.1 revisit an important topic for vision and glaucoma research—the interrelationship of arterial supply to human retina, choroid, and optic nerve head (ONH). They used microperfusion of human donor eyes with fluorescent probes of different wavelengths and confocal microscopic imaging. 
By this the authors not only could judge the static topography of the vascular connections but also—and this is more—could gain an impression of the dynamic flow interrelationships. The experiments show that the central retinal artery as well as the short posterior ciliary arteries produce double labeling of retinal vessels, choroid, and ONH. The high resolution of the microscopic pictures could add further details to the delicate microvascular network of the ONH region. In this way the authors could broaden the groundbreaking studies of the vascular supply by Hayreh,2 who addressed the interindividual variations decades ago (for review, see Ref. 2). 
The region of the ONH and its surroundings is very critical regarding the metabolic demand for million(s) of axons getting myelinated not before having passed the lamina cribrosa. Already during development of the eye, tissue hormones and growth factors like VEGF normally ensure the blood supply of those regions of extreme metabolic demand. Thereby an intertwined vascular network around the ONH becomes understandable. 
References
Yu PK, McAllister IL, Morgan WH, Cringle SJ, Yu D-Y. Inter-relationship of arterial supply to human retina, choroid, and optic nerve head using micro perfusion and labeling. Invest Ophthalmol Vis Sci. 2017; 58: 3565–3574.
Hayreh SS. The blood supply of the optic nerve head and the evaluation of it – myth and reality. Prog Retin Eye Res. 2001; 20: 563–593.
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