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Christopher John Creveling, Brittany Coats; Changes in Vitreoretinal Adhesion with Age and Region in Human and Sheep Eyes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1158.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal detachment from ocular trauma, age-related vitreous degradation, or other ocular disorders, occurs in 1 of 10,000 people, and does not discriminate between children and adults. The principal mechanism for traumatic detachment is retinal traction mediated by adhesion to the vitreous. Little is quantitatively known about vitreoretinal adhesion, but age- and region-dependent data are necessary to develop accurate models of ocular trauma or vitreous detachment. In this study, we designed a device to quantify vitreoretinal (VR) adhesion and evaluated age- and region-dependent differences in human (n=18) and sheep (n=37) eyes.
The retinal pigment epithelium (RPE) from the equator and posterior pole of sheep eyes (preterm, term, child, and adult), and human eyes (30-80 yrs old) was exposed by cutting a rectangular window into the sclera and choroid. A rigid tab was adhered to the RPE and displaced at a rate of 0.02 mm/s, peeling the retina from the vitreous. A controlled eye rotation was applied simultaneously to ensure a constant 90° peel. A two-way ANOVA evaluated age/region effects on maximum (Fmax) and steady-state (FSS) adhesive force (p<0.05). Light microscopy was used to identify failure locations of peeled specimens.
Fmax in the adult sheep equator (17.54±7.83mN) was significantly greater than in the posterior pole (8.35±2.60mN), and significantly greater than younger ages, regardless of region. A similar trend was seen for FSS, except preterm eyes had higher FSS in the posterior pole (2.79±0.79mN) than in the equator (1.05±0.48mN). Human Fmax was also significantly greater in the equator (7.22±4.05mN) compared to the posterior pole (4.00±2.05mN). Human FSS was affected by age and region, with equator FSS decreasing with age from 3.03±0.21mN to equal the posterior pole FSS (1.22±0.70mN). Peeling occurred at the inner limiting membrane. The presence of blood vessels resulted in nerve fiber layer disruption.
VR adhesion in adult humans and sheep is greater in the equator compared to the posterior pole and reduces with increasing age. No regional effect was found in immature eyes, except in preterm sheep which had greater posterior pole adhesion. These data suggest VR adhesion transitions through various stages of life. Further investigation is needed to characterize transitions through early childhood and adulthood, and to elucidate mechanisms of adhesion with region and age.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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