Rat Model of Photochemically-Induced Posterior Ischemic Optic Neuropathy

Summary

The goal of this protocol is to photochemically induce ischemic injury to the posterior optic nerve in rat. This model is critical to studies of the pathophysiology of posterior ischemic optic neuropathy, and therapeutic approaches for this and other optic neuropathies, as well as of other CNS ischemic diseases.

Abstract

Posterior Ischemic optic neuropathy (PION) is a sight-devastating disease in clinical practice. However, its pathogenesis and natural history have remained poorly understood. Recently, we developed a reliable, reproducible animal model of PION and tested the treatment effect of some neurotrophic factors in this model¹. The purpose of this video is to demonstrate our photochemically induced model of posterior ischemic optic neuropathy, and to evaluate its effects with retrograde labeling of retinal ganglion cells. Following surgical exposure of the posterior optic nerve, a photosensitizing dye, erythrosin B, is intravenously injected and a laser beam is focused onto the optic nerve surface. Photochemical interaction of erythrosin B and the laser during irradiation damages the vascular endothelium, prompting microvascular occlusion mediated by platelet thrombosis and edematous compression. The resulting ischemic injury yields a gradual but pronounced retinal ganglion cell dieback, owing to a loss of axonal input - a remote, injury-induced and clinically relevant outcome. Thus, this model provides a novel platform to study the pathophysiologic course of PION, and can be further optimized for testing therapeutic approaches for optic neuropathies as well as other CNS ischemic diseases.

Introduction

In patients over 50 years old, ischemic optic neuropathy (ION) is the most prevalent type of acute optic neuropathy². The condition can present as one of two subtypes according to the source of specific affected blood supply and clinical presentation: anterior (AION) or posterior (PION)³. While the pathogenesis and course of AION have been studied extensively^4-7, PION has remained poorly understood due to its low prevalence, variable presentation, ill-defined diagnostic criteria and lack of an animal model. Furthermore, no treatments have been proven to effectively prevent or reverse vision loss from AION or PION. Therefore, ....

Protocol

All animal procedures were approved by the University of California San Diego and University of Miami institutional animal care and use committees (IACUC) and performed in accordance with the ARVO Statement for the Use of Animals in Ophthalmic and Visual Research. All reagents and instruments used in surgical procedures are sterile.

1. Anesthetize and Prepare the Rat for Surgery

1. Prior to procedure, rats are anesthetized with an intraperitoneal injection of ketamine (60 mg/kg) and xylazine (8 mg/kg) according to body weight. Adequate depth of anesthesia should be determined by a negative response to toe pinch stimulus.
2. Once anesthetized, pu....

Results

The resulting ischemic injury induced by this technique yields a gradual but pronounced death of retinal ganglion cells after ischemic axon injury. This is a clinically relevant outcome similar to that observed in the human disease. FG retrograde labeling is used to quantify RGC survival after PION. The same method is employed to validate a successful model creation as well as to assess the effects of different therapeutic regimens. Figure 1 shows representative confocal images of FG-positive cells in re.......

Discussion

Here we describe in detail a method for inducing PION in a rat model. The most critical part of the protocol is the exposure and irradiation of the optic nerve – to expose the nerve as long as possible while avoiding damage caused by the sharp fine tip forceps or from stretching. In rats, the ophthalmic artery enters the optic nerve ≤1 mm from the optic nerve head. Therefore, irradiation of the optic nerve 3-4 mm away from the optic nerve head should only result in ischemia of the capillaries feeding the nerv.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
532-nm Nd:YAG laser	Laserglow	LRS-532-KM-200-3
Beam chopper	custom-made	custom-made
Mechanical shutter and corresponding shutter drive timer	Vincent Associates	SD-10
25-cm focal length spherical lens	CVI/Melles-Griot	01 LPX 293	plano-convexBK7 glass lens with HEBBARTM antireflection coating
Erythrosin B	MP Biomedicals	190449
Fluorogold	Fluorochrome,LLC
Gelfoam	Cardinal Health	CAH1203421
Polyethylene tubing (PE10)	BD Intramedic	427400
No. 10 Blade	Miltex	4-110
Fine Forceps	F.S.T.	91150-20	Dumont #5 rustless non-magnetic
Forceps with Teeth	F.S.T.	11153-10	Germany stainless
Forceps	F.S.T.	18025-10	Germany stainless
Vannas spring scissors	F.S.T.	2-220	JJECK Stainless
Polyglactin suture	Ethicon	J488G	7-0 suture
hemostat	F.S.T.	12075-12	Germany stainless