Our studies show for the first time a progression of both
morphologic and functional changes in the neuronal retina of DBA mice,
and that some of the changes have a comparable time course for the two
parameters. Correspondence in physiological and morphologic
measurements in this mouse glaucoma model indicates the value of
noninvasive ERG measurements in documenting retinal pathophysiology in
rodent glaucoma models.
9
For the DBA mice, changes in a- and b-waves over time correlated highly
for both eyes of individual animals. However, there were significant
interanimal differences in ERG patterns. For example, the mice that
were most severely affected at 5 months of age were not necessarily the
most severely affected at 15 months of age. These interindividual
differences in progression of the pathologic phenotype may have been
due to variations in expression of the different alleles on chromosomes
4 or 6 that are known to be responsible for the anterior segment
disease in DBA mice.
3 5
It is generally accepted that a decrease in the a-wave ERG amplitude is
most likely related to changes in the outer retina, whereas decrease in
b-wave amplitude and lengthening of the implicit time are related to
changes in the INLs and synaptic connections. Previously, a significant
loss of retinal ganglion cells was found in the DBA mouse substrain at
8 to 24 months of age.
2 In the present study we
demonstrate a complex time course of retinal changes in these mice
compared with control C57 mice. In particular, early changes in the IPL
and, to a lesser extent, shortening of rods became evident in DBA
animals at 4 months of age. By this age, there were areas of the
circumference of the eye showing iris synechiae in some mice. It is
possible that mice in this age group have increased eye volume due to a
higher outflow resistance that does not elevate IOP but instead induces
stretching of the globe and inner retina. It is only after the onset of
secondary angle-closure glaucoma associated with increased IOP at 6 to
7 months that structural changes occur in other retinal layers. These
include substantial thinning of the OPL, loss of cells in the GCL, and
some reduction in the number of photoreceptor cells in the ONL
(Table 1) . These latter findings on retinal morphology appear to correlate in
time with the changes in ERG parameters that become significant at 7
months and progress in older DBA mice. Some of the morphologic retinal
changes, especially reduction in thickness of the plexiform layers,
appear not to progress after 10 months of age. This may be accounted
for by the observed degeneration of the ciliary processes reducing
aqueous humor formation, with a decline in IOP from the preceding
elevated levels.
4 In addition, some of the retinal
thinning occurring during the period of 6 to 9 months of age due to
progressive ocular enlargement and stretching of the retina may be
arrested when the IOP decreases again.
A decrease in thickness of the entire retina has also been described in
Japanese quails with sex-linked albinism and
glaucoma.
10 11 These birds show development of
angle-closure with an increase in IOP between 4 and 6 months of age,
due to iris attachment to the posterior cornea. The described
pathologic changes in these quails show a striking similarity to the
findings in the DBA mouse angle-closure glaucoma model documented in
the present study.
The specific causes of the changes in ERG parameters in DBA mice are
not clear. However, because the changes occurred after approximately 4
months of age and progressed with the onset of anterior segment
diseases (posterior iris synechiae occluding aqueous outflow), they
appear to be due primarily to retinal damage, particularly loss in the
nerve fiber ganglion cell and plexiform layers
(Figs. 8B 8C 8E) ,
resulting from increased IOP. In humans, several earlier clinical
studies have reported scotopic ERG changes in advanced
glaucoma.
12 13 14 In a recent study of glaucomatous
subjects,
15 amplitude reductions and peak-time
prolongations of various components of scotopic and photopic ERGs under
different stimulus conditions were found, suggesting widespread outer
retinal dysfunction in human glaucoma. Oscillatory potentials recorded
by flash ERG were as frequently reduced as the pattern ERG amplitudes
were,
16 17 and other components of the flash ERG showed
even more significant changes in glaucomatous eyes in another
study.
18 A general reduction of ERG amplitude was also
reported for ocular hypertensive and glaucomatous
subjects.
19 The much more pronounced ERG changes seen in
the DBA mouse may be due to genetic factors that cause a more rapid
progression of retinal damage from untreated angle-closure glaucoma in
a short-lived animal species with a rod-predominant–retina, compared
with glaucoma in humans.
Few measurements have been reported of changes in the thickness of
retinal layers in glaucomatous eyes other than in the optic nerve fiber
layer and GCL. In patients with primary open-angle glaucoma, Zeimer et
al.
20 reported a decrease in total retinal thickness up to
34% (the thickness of individual retinal layers was not measured in
this study). In human secondary angle-closure glaucoma, thinning of the
outer retinal layers was found, resulting from a decrease in INL
thickness,
21 as was damage to and loss of
photoreceptors.
22 23
To summarize our results, we found that the DBA/2NNia substrain
angle-closure glaucoma mouse showed pathologic changes similar to those
in other secondary glaucomas. Thus, even if the disease is more
extensive than that found in human angle-closure glaucoma, DBA mice
have potential as a model for investigation of posterior segment
alterations in secondary angle-closure glaucoma.