Torsion-Induced Traumatic Optic Neuropathy (TITON): A Physiologically Relevant Animal Model of Traumatic Optic Neuropathy.

Traumatic optic neuropathy (TON) is a common cause of irreversible blindness following head injury. TON is characterized by axon damage in the optic nerve followed by retinal ganglion cell death in the days and weeks following injury. At present, no therapeutic or surgical approach has been found to offer any benefit beyond observation alone. This is due in part to the lack of translational animal models suitable for understanding mechanisms and evaluating candidate treatments. In this study, we developed a rat model of TON in which the eye is rapidly rotated, inflicting mechanical stress on the optic nerve and leading to significant visual deficits. These functional deficits were thoroughly characterized up to one week after injury using electrophysiology and immunohistochemistry. The photopic negative response (PhNR) of the light adapted full field electroretinogram (LA ffERG) was significantly altered following injury. This correlated with increased biomarkers of retinal stress, axon disruption, and ganglion cell death. Together, this evidence suggests the utility of our model for mimicking clinically relevant TON and that the PhNR may be an early diagnostic for TON. We also found indirect evidence that ketamine, which was used for anesthesia, may ameliorate TON. Future studies will utilize this animal model for evaluation of candidate treatments.

In Vivo Assessment of an Antioxidant Hydrogel Vitreous Substitute.

The vitreous humor undergoes liquefaction with age, resulting in complications that may require a vitrectomy, or surgical removal of the vitreous from the eye. Silicone oil, a common vitreous substitute, lacks properties similar to the natural vitreous. In particular, it lacks antioxidants that may be necessary to reduce oxidative stress in the eye. The purpose of this study was to evaluate antioxidant-loaded hydrogel vitreous substitutes in a pilot in vivo study. Ascorbic acid and glutathione were loaded into synthesized PEGDA hydrogels. Following vitrectomy, experimental antioxidant hydrogels or silicone oil were injected into one eye of rabbits, while the other eye served as untreated or sham control. Ophthalmic assessments, including electroretinography, were performed. Levels of glutathione and ascorbic acid were higher in the eyes treated with the antioxidant-loaded hydrogel vitreous substitute, although this was not found to be significant after 28 days. There were no statistically significant differences between groups with respect to clinical examination, and ocular health scores, electroretinograms, and histology were normal. These results indicate minimal concerns for the hydrogel formulation or high levels of antioxidants. Future research will assess the capability of vitreous substitutes to prolong antioxidant release, with the goal of minimizing cataract after vitrectomy.

Oxidative stress in the brain and retina after traumatic injury.

The brain and the retina share many physiological similarities, which allows the retina to serve as a model of CNS disease and disorder. In instances of trauma, the eye can even indicate damage to the brain via abnormalities observed such as irregularities in pupillary reflexes in suspected traumatic brain injury (TBI) patients. Elevation of reactive oxygen species (ROS) has been observed in neurodegenerative disorders and in both traumatic optic neuropathy (TON) and in TBI. In a healthy system, ROS play a pivotal role in cellular communication, but in neurodegenerative diseases and post-trauma instances, ROS elevation can exacerbate neurodegeneration in both the brain and the retina. Increased ROS can overwhelm the inherent antioxidant systems which are regulated via mitochondrial processes. The overabundance of ROS can lead to protein, DNA, and other forms of cellular damage which ultimately result in apoptosis. Even though elevated ROS have been observed to be a major cause in the neurodegeneration observed after TON and TBI, many antioxidants therapeutic strategies fail. In order to understand why these therapeutic approaches fail further research into the direct injury cascades must be conducted. Additional therapeutic approaches such as therapeutics capable of anti-inflammatory properties and suppression of other neurodegenerative processes may be needed for the treatment of TON, TBI, and neurodegenerative diseases.