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Kia M Washington, Yang Li, Bo Wang, Maxine R. Miller, Yolandi van der Merwe, Leon Ho, Michael Steketee, Joel S Schuman, Kevin C Chan, Vijay S. Gorantla, The Whole Eye Transplant Consortium; Viability, Structural Integrity and Aqueous Humor Dynamics are Established in an Orthotopic Whole Eye Transplant Model. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4757.
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© ARVO (1962-2015); The Authors (2016-present)
Approximately 39 million people worldwide suffer from blindness. The permanent nature of vision loss is largely due to the inability of retinal ganglion cells to regenerate. Whole eye transplantation (WET) gives the opportunity to provide viable retinal ganglion cells and an entire optical system to recipients with irreversible vision loss. The purpose of our study is to evaluate viability, structural integrity and aqueous humor dynamics in our orthotopic whole eye transplant model.
Syngeneic transplants were performed in Lewis (RT1l) rats. Donor flaps are composed of ocular tissue anterior to the optic chiasm, the skin of the eyelid and external ear. Recipient sites are prepared by removing a similar region of skin and ocular tissue with the optic nerve cut at the base of the globe. Grafts are transplanted to the recipient, vascular anastomoses are performed, as are nerve appositions between donor and recipient optic nerves. Slit lamp examination, Optical Coherence Tomography (OCT) and histological analysis were performed to evaluate the viability and structural integrity of the transplanted eye. Gadolinium (Gd)-enhanced MRI was employed to evaluate ocular physiology of the transplanted eye.
15 of 22 rats survived the surgical procedure with the maintenance of visual transparency of the anterior eye as evidenced by slit lamp examination. Some peripheral corneal neovascularization was seen in all eyes. OCT confirmed transparency of the cornea and lens, preservation of the retina, and blood flow to the eye. Gd-enhanced MRI revealed the presence of transplanted eye aqueous humor dynamics and intact blood-ocular and aqueous-vitreous barriers. Histology confirmed corneal neovascularization and preserved retinal integrity, with the exception of retinal nerve fiber layer and ganglion cell layer thinning.
We have established a viable orthotopic model for vascularized whole eye transplantation in the rat. Maintenance of structural integrity, viability and aqueous humor dynamics were confirmed. The model is excellent for studying viability, functional return and immunology in WET.
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