A histological examination of the mouse and rat eyeball is a powerful tool in the field of experimental ophthalmology. It can provide new information related to changes in the ocular structures in the course of ophthalmic diseases, which would otherwise not be observed in clinical settings. The described protocols present a simple method of conducting a histological analysis of the retina. The subtleties of the procedure needed to process anterior tissues, such as the cornea, are not described here.
In the presented study, enucleation was performed after euthanizing the animals because, aside from the eyeballs, other tissues (blood, kidneys) were harvested for research purposes. However, enucleation can also be performed on live animals under anesthesia. Wilding et al. have described the procedure14, and we would like to refer readers to this work to see photos of the enucleation procedure.
Although the protocols for mouse and rat eyeballs' slide preparation are similar, the principal difference between mouse and rat eyeballs to consider while preparing slides is their size. The rats' eyeballs have an 8x - 10x greater volume compared to mice, while the average axial length of a mouse eyeball is about 3.2 mm, and the axial length of a rat eyeball typically oscillates around 6.91 mm15,16. This facilitates the need to cut the rats' eyeballs in half for better reagent penetration into the tissue during processing. Also, the time needed for reagent penetration into the rat tissue is longer than for mouse eyeballs. While cutting the rat eyeballs in half, it is important to use a sharp blade, as the firm, frozen lens may prove to be an obstacle.
Another point worth discussing is the fixation of tissues after harvesting from the animals. In the presented protocol, eyeballs, after enucleation, were fixed with PFA and immersed in solutions of sucrose. Sucrose acts as a cryoprotectant, as it protects cells of large tissues from damage by ice crystals that form during freezing17. Freezing the tissue enables researchers to store the tissue longer and also use it for various examinations in the future, including a histopathological analysis with a microtome (like presented), a histopathological analysis with a cryotome, and immunolabelling for assessment using confocal microscopy. For example, when cutting a rat eyeball in half (step 2.4.1), if the cut is performed efficiently and quickly (within 5 - 10 s), and the eye has no time to thaw, then one half of the eyeball may be used for histopathology, and another may be put back into the freezer for future immunolabelling. We do not recommend performing immunolabelling on tissues previously infiltrated with paraffin due to possible changes in the conformation of the protein epitopes after paraffin fixation. However, if a group of researchers is only planning to perform a histopathological analysis using a microtome, a simpler, standard method of fixing tissues for paraffin embedding can be used - for example, instead of performing steps 1.2.1 - 1.4.1 for mice or steps 2.2.1 - 2.4.2 for rats, place the tissues in a 10% solution of PFA for 24 h, and then store them in PBS in 4 °C until processing. Sucrose will then not be needed as a cryoprotectant, as the tissues will not be frozen. Using this proposed method, the freezing process will be avoided, which may prove beneficial and lead to obtaining slides of higher quality. Freezing of the eyeballs, although it provides researchers with more freedom in choosing the time to perform the histopathological examination, is a step that can potentially decrease sample quality and lead to retinal detachment. However, one should remember that if storing tissues at 4 °C, their biological stability will be shorter, and the tissues should be analyzed within 4 weeks. Also, while working with rat eyeballs, step 2.4.1 (cutting the eyeballs in half) will be much more difficult to perform on an unfrozen eyeball.
The presented methodology was developed based on the methodology described by Chai et al.18, Igarashi et al.19, Zhang et al.20, and Dorfman et al.21, on personal experience, and a method of trial and error. The method of measuring the thickness of the retina and the individual layers is described based on the methodology presented by Chai et al.16 and Barber et al.18,22. The retinal RGC counting method was developed from a review of the work of Chai et al.16, Zhang et al.18, Steinle et al.19, and Dorfman et al.18,20,21,23. Overall, the preparation of histopathological slides of eyeballs differs from a standard formalin-fixed paraffin-embedded tissue slide preparation because the eyeball is spherical and, therefore, more difficult to handle, cut, and section. Also, the sclera is a barrier for reagent infiltration into tissue. While preparing histological slides of eyeballs, one has to work more delicately and in a precise manner while being careful not to damage the delicate structures of the inner part of the eyeball. Modifications of this protocol may include the use of the methacrylate embedding technique instead of paraffin embedding, which may reportedly provide better morphological results. However, very few researchers have used this method for assessment of the retina24,25.
This protocol is not free from bias. The biggest problem that our team struggled with was retinal tearing and retinal detachment. Especially prone to tearing was the retina of rat eyeballs, as they had to be cut in half before slide preparation, and therefore the retina was more prone to damage. Due to retinal detachment, this protocol cannot be used for the assessment of the choroid, the retinal pigment epithelium, or the photoreceptor segment layer. However, our team believes that this protocol can be used to assess the inner retina (from the ILM to ELM). To minimize the amount of retinal tearing and detachment, each step of the protocol should be performed carefully, slowly, and with precise movements.
Histopathological analysis of the retina is not part of standard human diagnostics but is a widely used method in preclinical research. The results of the histopathological evaluation of the retina in preclinical studies can be related to and discussed with the results of optical coherent tomography (OCT)26, which is an examination that shows a cross-section through the retina during an in vivo examination that can be performed in a clinical setting, among humans in clinical trials. OCT, however, is a less detailed examination. Therefore, the information we can draw from histological studies conducted as part of preclinical research is irreplaceable and necessary for developing medical knowledge.