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Preparing Porcine Eyes for Confocal Reflectance Microscopy to Visualize the Vitreous Collagen Fiber Network

The vitreous is a clear gel that fills the space between the lens and retina. Its structure is supported by a network of collagen fibers, which likely ...

University of Utah

We performed clinical and genetic characterization of a family with cavitary optic disc anomaly (CODA), an autosomal dominant condition that causes vision loss due to adult-onset maculopathy in the majority of cases. CODA is characterized by a variably excavated optic nerve appearance such as morning glory, optic pit, atypical coloboma, and severe optic nerve cupping.

Progressive optic nerve changes in cavitary optic disc anomaly: integration of copy number alteration and cis-expression quantitative trait loci to assess disease etiology.

To report the first case of stroke in a patient with relentless placoid chorioretinitis.

Stroke Due to Cerebral Vasculitis in a Patient with Relentless Placoid Chorioretinitis.

The purpose of this study was to evaluate the effects of laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) on corneal biomechanical properties.

Corneal biomechanical properties after laser-assisted in situ keratomileusis and photorefractive keratectomy.

To assess the accuracy of macular spectral-domain OCT in detecting complete posterior vitreous detachment (PVD).

Accuracy of Spectral-Domain OCT of the Macula for Detection of Complete Posterior Vitreous Detachment.

To assess whether 6-mm OCT scans, which image the macula, can distinguish complete from partial posterior vitreous detachment (PVD) in comparison with 16.5-mm OCT scans, which image the macula, optic nerve, and mid periphery.

Standard 6-mm Compared with Widefield 16.5-mm OCT for Staging of Posterior Vitreous Detachment.

To report the clinical and refractive outcomes of a modified Yamane technique for scleral fixation of the CT Lucia 602 lens.

Clinical Outcomes and Lens Constant Optimization of the Zeiss CT Lucia 602 Lens Using a Modified Yamane Technique.

Vitreoretinal mechanics plays an important role in retinal trauma and many sight-threatening diseases. In age-related pathologies, such as posterior vitreous detachment and vitreomacular traction, lingering vitreoretinal adhesions can lead to macular holes, epiretinal membranes, retinal tears and detachment. In age-related macular degeneration, vitreoretinal traction has been implicated in the acceleration of the disease due to the stimulation of vascular growth factors. Despite this strong mechanobiological influence on trauma and disease in the eye, fundamental understanding of the mechanics at the vitreoretinal interface is limited. Clarification of adhesion mechanisms and the role of vitreoretinal mechanics in healthy eyes and disease is necessary to develop innovative treatments for these pathologies. In this review, we evaluate the existing literature on the structure and function of the vitreoretinal interface to gain insight into age- and region-dependent mechanisms of vitreoretinal adhesion. We explore the role of vitreoretinal adhesion in ocular pathologies to identify knowledge gaps and future research areas. Finally, we recommend future mechanics-based studies to address the critical needs in the field, increase fundamental understanding of vitreoretinal mechanisms and disease, and inform disease treatments.

Structure and mechanics of the vitreoretinal interface.

To evaluate the completeness of conflict-of-interest self-reporting by ophthalmology researchers and to assess factors associated with self-reporting.

Self-reporting of Conflicts of Interest by Ophthalmology Researchers Compared with the Open Payments Database Industry Reports.

Previous studies found that infants with retinopathy of prematurity (ROP) who were treated for more posterior disease with a greater number of laser spots developed higher myopia. These studies included multiple physicians with variations in laser density. In treatments by a single physician, laser spot count is a better surrogate for area of avascular retina and anterior-posterior location of disease, so that the relationship with myopia can be better assessed.

Association between myopia progression and quantity of laser treatment for retinopathy of prematurity.

Vitreous collagen structure plays an important role in ocular mechanics. However, capturing this structure with existing vitreous imaging methods is hindered by the loss of sample position and orientation, low resolution, or a small field of view. The objective of this study was to evaluate confocal reflectance microscopy as a solution to these limitations. Intrinsic reflectance avoids staining, and optical sectioning eliminates the requirement for thin sectioning, minimizing processing for optimal preservation of the natural structure. We developed a sample preparation and imaging strategy using  grossly sectioned porcine eyes. Imaging revealed a network of uniform diameter crossing fibers (1.1 ± 0.3 µm for a typical image) with generally poor alignment (alignment coefficient = 0.40 ± 0.21 for a typical image). To test the utility of our approach for detecting differences in fiber spatial distribution, we imaged eyes every 1 mm along an anterior-posterior axis originating at the limbus and quantified the number of fibers in each image. Fiber density was higher anteriorly near the vitreous base, regardless of the imaging plane. These data demonstrate that confocal reflectance microscopy addresses the previously unmet need for a robust, micron-scale technique to map features of collagen networks  across the vitreous.

Confocal reflectance microscopy for mapping collagen fiber organization in the vitreous gel of the eye.

Bilateral Cataracts and Posterior Lentiglobus in USP9X Syndrome.

Therapeutic protocols involving subretinal injection, which hold the promise of saving or restoring sight, are challenging for surgeons because they are at the limits of human motor and perceptual abilities. Excessive or insufficient indentation of the injection cannula into the retina or motion of the cannula with respect to the retina can result in retinal trauma or incorrect placement of the therapeutic product. Robotic assistance can potentially enable the surgeon to more precisely position the injection cannula and maintain its position for a prolonged period of time. However, head motion is common among patients undergoing eye surgery, complicating subretinal injections, yet it is often not considered in the evaluation of robotic assistance. No prior study has both included head motion during an evaluation of robotic assistance and demonstrated a significant improvement in the ability to perform subretinal injections compared with the manual approach. In a hybrid ex vivo and in situ study in which an enucleated eye was mounted on a human volunteer, we demonstrate that head-mounting a high-precision teleoperated surgical robot to passively reduce undesirable relative motion between the robot and the eye results in a bleb-formation success rate on moving eyes that is significantly higher than the manual success rates reported in the literature even on stationary enucleated eyes.

Head-mounted surgical robots are an enabling technology for subretinal injections.

To compare the relative risk of retinal detachment between patients with COL2A1 and COL11A1 Stickler syndrome.

Article	Year
Progressive optic nerve changes in cavitary optic disc anomaly: integration of copy number alteration and cis-expression quantitative trait loci to assess disease etiology. BMC medical genetics\| PubMed ID: 31029096	2019
Stroke Due to Cerebral Vasculitis in a Patient with Relentless Placoid Chorioretinitis. Ocular immunology and inflammation\| PubMed ID: 28282738	2018
Corneal biomechanical properties after laser-assisted in situ keratomileusis and photorefractive keratectomy. Clinical ophthalmology (Auckland, N.Z.)\| PubMed ID: 29042748	2017
Accuracy of Spectral-Domain OCT of the Macula for Detection of Complete Posterior Vitreous Detachment. Ophthalmology. Retina\| PubMed ID: 31864940	2020
Standard 6-mm Compared with Widefield 16.5-mm OCT for Staging of Posterior Vitreous Detachment. Ophthalmology. Retina\| PubMed ID: 32442535	2020
Clinical Outcomes and Lens Constant Optimization of the Zeiss CT Lucia 602 Lens Using a Modified Yamane Technique. Clinical ophthalmology (Auckland, N.Z.)\| PubMed ID: 33235431	2020
Structure and mechanics of the vitreoretinal interface. Journal of the mechanical behavior of biomedical materials\| PubMed ID: 35963021	2022
Self-reporting of Conflicts of Interest by Ophthalmology Researchers Compared with the Open Payments Database Industry Reports. Ophthalmology\| PubMed ID: 36332841	2023
Association between myopia progression and quantity of laser treatment for retinopathy of prematurity. PloS one\| PubMed ID: 36584135	2022
Confocal reflectance microscopy for mapping collagen fiber organization in the vitreous gel of the eye. Biomedical optics express\| PubMed ID: 36874496	2023
Bilateral Cataracts and Posterior Lentiglobus in USP9X Syndrome. Ophthalmology\| PubMed ID: 38099911	2024
Head-mounted surgical robots are an enabling technology for subretinal injections. Science robotics\| PubMed ID: 39970246	2025
Relative Risk of Retinal Detachment in COL2A1 Compared with COL11A1 Stickler Syndrome: An Individual Patient Data Meta-Analysis. Ophthalmology. Retina\| PubMed ID: 40825394	2025

Eileen S. Hwang

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