Lipofuscin-mediated photodynamic stress induces adverse changes in nanomechanical properties of retinal pigment epithelium cells.

Retinal pigment epithelium (RPE) is an important part of the blood-retina barrier (BRB) that separates the retina from the choroid. Although melanin granules contribute to the mechanical stability of the BRB complex, it is unknown if the age pigment lipofuscin affects mechanical properties of the tissue. To address this issue the effect of sub-lethal photic stress mediated by phagocytized lipofuscin granules, isolated from RPE of human donors, on morphology and mechanical properties of ARPE-19 cells was investigated. Nanomechanical analysis using atomic force spectroscopy revealed that irradiation of cells containing lipofuscin granules with blue light induced significant softening of the cells, which was accompanied by substantial reorganization of the cell cytoskeleton due to peroxidation of cellular proteins. Our results indicate that lipofuscin-mediated photic stress can cause significant modification of the RPE cells with the potential to disturb biological function of the BRB complex.

Effects of white light-emitting diode (LED) exposure on retinal pigment epithelium in vivo.

Ageing and alteration of the functions of the retinal pigment epithelium (RPE) are at the origin of lost of vision seen in age-related macular degeneration (AMD). The RPE is known to be vulnerable to high-energy blue light. The white light-emitting diodes (LED) commercially available have relatively high content of blue light, a feature that suggest that they could be deleterious for this retinal cell layer. The aim of our study was to investigate the effects of "white LED" exposure on RPE. For this, commercially available white LEDs were used for exposure experiments on Wistar rats. Immunohistochemical stain on RPE flat mount, transmission electron microscopy and Western blot were used to exam the RPE. LED-induced RPE damage was evaluated by studying oxidative stress, stress response pathways and cell death pathways as well as the integrity of the outer blood-retinal barrier (BRB). We show that white LED light caused structural alterations leading to the disruption of the outer blood-retinal barrier. We observed an increase in oxidized molecules, disturbance of basal autophagy and cell death by necrosis. We conclude that white LEDs induced strong damages in rat RPE characterized by the breakdown of the BRB and the induction of necrotic cell death.

Corneal Crosslinking With Rose Bengal and Green Light: Efficacy and Safety Evaluation.

PURPOSE: To evaluate crosslinking of cornea in vivo using green light activation of Rose Bengal (RGX) and assess potential damaging effects of the green light on retina and iris. METHODS: Corneas of Dutch belted rabbits were de-epithelialized, then stained with Rose Bengal and exposed to green light, or not further treated. Corneal stiffness was measured by uniaxial tensiometry. Re-epithelialization was assessed by fluorescein fluorescence. Keratocytes were counted on hematoxylin and eosin (H&E)-stained sections, and iris cell damage was assessed by lactate dehydrogenase staining. Thermal effects on the blood-retinal barrier (BRB) were assessed by fluorescein angiography and those on photoreceptors, retinal pigment epithelium (RPE), and choriocapillaris by light microscopy and transmission electron microscopy. RESULTS: RGX (10-min irradiation; 150 J/cm) increased corneal stiffness 1.9-fold on day 1 (1.25 ± 0.21 vs. 2.38 ± 0.59 N/mm; P = 0.036) and 2.8-fold compared with controls on day 28 (1.70 ± 0.74 vs. 4.95 ± 1.86 N/mm; P = 0.003). Keratocytes decreased only in the anterior stroma on day 1 (24.0 ± 3.0 vs. 3.67 ± 4.73, P = 0.003) and recovered by day 28 (37.7 ± 8.9 vs. 34.5 ± 2.4, P = 0.51). Iris cells were not thermally damaged. No evidence of BRB breakdown was detected on days 1 or 28. Retina from RGX-treated eyes seemed normal with RPE cells showing intact nuclei shielded apically by melanosomes, morphologically intact photoreceptor outer segments, normal outer nuclear layer thickness, and choriocapillaris containing intact erythrocytes. CONCLUSIONS: The substantial corneal stiffening produced by RGX together with the lack of significant effects on keratocytes and no evidence for retina or iris damage suggest that RGX-initiated corneal crosslinking may be a safe, rapid, and effective treatment.

[The estimation of age-related sensitivity of the retinal pigment epithelium of Japanese quail (Coturnix japonica) to the light damage].

The effect of blue light damage (445-455 nm, 4 J/cm2) to retinal pigment epithelium (RPE) subcellular structures was investigated in 4 age risk groups (9, 25, 40 and 52 weeks) of Japanese quail Coturnix japonica by light and electron microscopy. The indicator of biological aging of RPE was age-related accumulation of lipofuscin granules: 5-6-fold increase in their quantity increasing by 5-6 times in quails at 52 weeks. The main photo-induced changes observed after 24 h of the photo radiation were located in the blood-retinal barrier, such as loss of homogeneity of Bruch's membrane, disorganization of basal processes, deformations of the nuclei and mitochondria shapes. Those effects ofphotobleaching were more expressed in young birds. But for the older 52-week age birds it was not so noticeable, because their retinal pigment epithelium structures had disorders which were similar to those in younger birds after photodamage.

Electromagnetic-pulse-induced activation of p38 MAPK pathway and disruption of blood-retinal barrier.

The blood-retinal barrier (BRB) is critical for maintaining retina homeostasis and low permeability. In this study, we evaluated the effects of electromagnetic pulse (EMP) exposure on the permeability of BRB, alterations of tight junction (TJ) proteins of BRB and if any, involvement of mitogen-activated protein kinase (MAPK) pathway. Male Sprague-Dawley (SD) rats and RF/6A cells which were pretreated with or without MAPKs inhibitors were sham exposed or exposed to EMP at 200kV/m for 200 pulses. The alteration of BRB permeability was examined through fluorescence microscope and quantitatively assessed using Evans blue (EB) and endogenous albumin as tracers. The expressions of TJ proteins and some signaling molecules of MAPK pathway were measured by Western blots. The observations were that EMP exposure resulted in increased BRB permeability concurrent with the decreased expressions of occludin and claudin-5, which were correlated with the increased expressions of phospho-p38, phospho-JNK and phospho-ERK and could be blocked when pretreated with p38 MAPK inhibitor. Thus, the results suggested that the alterations of occludin and claudin-5 may play an important role in the disruption of TJs, which may lead to the transient breakdown of BRB after EMP exposure with the involvement of p38 MAPK pathway through phosphorylation of signaling molecules.

[Cataract extraction and blue light--impact on the retina]. / Kataraktextraktion und Blaulicht--Wirkung auf die Netzhaut.

This review focuses on the scientific background for the use of "yellow artificial lenses". We will address the fact that numerous basic scientific publications point to a rationale for this practice although it is often difficult to derive clear-cut evidence from clinical epidemiological studies for the preventive use of yellow artificial lenses. In the first part we refer to studies showing that especially the shortwave part of the visible spectrum of light can be harmful for the retina and optic nerve. For this, we have screened the literature for the major sources of radical production and for the targets of oxidative stress after impingement of "blue light" on the retina. Furthermore, we can show that many studies in cell and molecular biology, animal experiments and first clinical trials point to a preferential use of yellow-tinted lenses especially in the elderly and AMD patients.

Increased nitric oxide synthase activity is essential for electromagnetic-pulse-induced blood-retinal barrier breakdown in vivo.

PURPOSE: To examine whether electromagnetic pulses (EMPs) affected the permeability of the blood-retinal barrier (BRB), gene expression of occludin and activity of nitric oxide synthase (NOS). METHODS: Sprague-Dawley (SD) rats were used and randomized into EMP and control groups. Retinas were removed immediately, and 2 h or 24 h after EMP radiation. BRB permeability was analyzed by transmission electron microscopy and Evans Blue staining. Retinal NOS activity and concentrations of nitrite and nitrate were measured. Occludin mRNA and protein levels were detected by RT-PCR and Western blotting. RESULTS: Exposure of SD rats to EMP resulted in increased BRB permeability, with the greatest decrease in occludin at 24 h. Moreover, this permeability defect was also correlated with significant increases in the formation of NO and induction of NOS activity in SD rats. Furthermore, we found that treatment with NOS inhibitor N-nitro-L-arginine methyl ester (L-NAME) blocked BRB breakdown and prevented the increase in NO formation and induction of NOS activity, as well as the decrease in occluding expression. CONCLUSION: Taken together, these results support the view that NOS-dependent NO production is an important factor that contributes to EMP-induced BRB dysfunction, and suggests that NOS induction may play an important role in BRB breakdown.

Structural changes in components of the blood-retina barrier in rat retina during photodamage in alloxan diabetes and their correction with ascovertin.

The outer part of the blood-retina barrier was most sensitive to light exposure (6000 lx, 6 h) during photodamage. It was manifested in hemodynamic disturbances, endothelial dysfunction, and focal death of the pigment epithelium. The photo effects increased during alloxan diabetes. The specific area of open vessels decreased, while the number of thrombotic vessels in the choroid increased. Administration of ascovertin improved hemodynamic parameters of the eye and decreased the specific area of focal damage.

Diabetic macular oedema: the effect of photocoagulation on fluorescein transport across the blood-retinal barrier.

BACKGROUND/AIM: The visual loss secondary to diabetic macular oedema can be controlled to some extent by photocoagulation, though the mechanism of action is largely unknown. The purpose of the present study was to quantitate the effect of photocoagulation on the blood-retinal barrier using fluorescein as a tracer of passive and active transport. METHODS: A prospective study of 46 eyes in 34 patients with clinically significant macular oedema (CSMO) examined by vitreous fluorometry before and 6 months after macular photocoagulation treatment. RESULTS: In 23 eyes CSMO was not present at follow up (responding eyes), in another 23 other eyes CSMO was still present (non-responding eyes). With reference to the presence or absence of CSMO at follow up, the passive transport (permeability) for responding eyes decreased after photocoagulation in contrast with an increase in non-responding eyes; the difference between the groups at follow up was significant (p=0.03). The active transport for responding eyes decreased slightly at follow up, while it increased for non-responding eyes; the difference between the groups at follow up was not significant (p=0.09). CONCLUSION: Following photocoagulation a reduction of diabetic macular oedema, defined as disappearance of CSMO, is paralleled by a decrease of the passive permeability while the hypothesis of an increase in the active transport from the retina to the blood could not be supported by this study.

[Immunohistochemical localization of blood-retinal barrier breakdown after argon laser photocoagulation in the monkey retina].

Retinal photocoagulation induces breakdown of the blood-retinal barrier (BRB), but the site of the breakdown is not precisely known. The breakdown and repair of BRB following argon laser photocoagulation were studied in the monkey retina by immunohistochemical localization of serum albumin. Argon laser photocoagulation was performed to obtain ordinary burns as in human use. 1, 3, and 7 days after photocoagulation, serum albumin was observed in the outer retina and retinal pigment epithelium, but not around the retinal blood vessels. The immunostaining disappeared within 14 and 28 days after photocoagulation. The results of this study suggest that photocoagulation induces local breakdown of the outer BRB and that the breakdown is repaired within 14 days.

Blue-light-induced dysfunction of the blood-retinal barrier at the pigment epithelium in albino versus pigmented rabbits.

The purpose of this study was to determine the role of epithelial melanin in blue light phototoxicity of the retina. The first manifestation of the phototoxicity has been shown to be a breakdown of the blood-retinal barrier at the retinal pigment epithelium. The blood-retinal barrier function of six New Zealand albino rabbits was compared to that of four pigmented chinchilla rabbits after exposure to broad-band blue light (400-520 nm). Additionally, the spectral sensitivity of blood-retinal barrier dysfunction was determined by exposing 15 New Zealand albino rabbits to narrow-band blue light with peak intensity at lambda = 408 nm, 418 nm, 439 nm, 455 nm and 485 nm (bandwidth: 11.7-13.5 nm). The blood-retinal barrier function was evaluated with vitreous fluorophotometry. Ultrastructural changes and permeability of the retinal pigment epithelium for horseradish peroxidase were evaluated in the albino rabbits with electron microscopy. Exposure to broad-band blue light up to 832 J cm-2 demonstrated the blood-retinal barrier of albino and pigmented rabbits to be equally sensitive. Electron microscopy of albino rabbits exposed to above-threshold energy demonstrated an increase of inclusion bodies in the retinal pigment epithelium and vacuolation of the cytoplasm. Transcellular passage of intra-arterially administered horseradish peroxidase through the pigment epithelium into the subretinal space was seen. The narrow-band exposures demonstrated that light of 439 nm was more effective than the light of other wavelengths in inducing barrier dysfunction in albino rabbits. This implies that chromophores absorbing at 439 +/- 6 nm were responsible for the phototoxicity in albino rabbits. The results indicate that melanin does not have a damaging nor a protective role in phototoxicity since (1) the presence of melanin is not essential for blue-light-induced photochemical damage to the blood-retinal barrier at the retinal pigment epithelium, and (2) protection from this sort of damage is not greater in melanin containing epithelia than in non-melanin containing epithelia.

Spectral sensitivity of the blood-retinal barrier at the pigment epithelium for blue light in the 400-500 nm range.

To specify the spectral sensitivity of the retinal pigment epithelium (RPE) for blue light damage, pigmented rabbits were exposed to light of 408, 418, 439, 455, 485, and 500 nm (half-peak bandwidth approximately 12 nm). The range of radiant exposure was 15-275 J cm-2 (1.7-19 mW cm-2 for 0.5-5 h). Vitreous fluorophotometry was used to functionally evaluate the blood-retinal barrier at the RPE in vivo, and electron microscopy to visualize RPE ultrastructure in vitro. A significant increase in permeability of the blood-retinal barrier was seen only after exposure to light of 418 nm. Radiant exposure at threshold for permeability increase was 18 J cm-2. Electron microscopy of the RPE demonstrated dispersion and clumping of melanin granules. The results suggest that the RPE is most sensitive to light in the range 412-425 nm, possibly due to damage-mediating chromophores such as cytochrome c oxidase and lipofuscin.

[Changes in the retinal structural elements in the early and late periods after neutron exposure]. / Izmeneniia strukturnykh élementov setchatki v rannie i otdalennye sroki posle neitronnogo vozdeistviia.

Local fractionated exposure of a rabbit eye to fast neutrons of 3 Gy (1.5 x 2) and 7.5 Gy (1.5 x 5) induces early reactions of all structural elements of retina, among which dose-dependent degradation of photoreceptor membrane discs and damages to pigmentoepitheliocytes are of prime importance. Further pathomorphogenesis is connected with the surpassing degeneration of a radial glia with respect to destruction of interneuronal synapses and a minor part of neurons. The postirradiation (one and six months after 7.5 Gy irradiation) changes in the blood-retinal barrier are responsible for the disturbances in the glioneuronal complex.

Breakdown of the blood-retinal barrier after radiofrequency-induced ocular hyperthermia.

To study the possible application of hyperthermia in the treatment of proliferative vitreoretinopathy (PVR), we induced hyperthermia in 15 normal rabbit eyes by a radiofrequency capacitive heating device. The retinal surface of each eye was warmed to a presumed temperature of 41 or 43 degrees C for 30 min. The thermal effect on the blood-retinal barrier (BRB) was evaluated before and 2 h after the hyperthermic regimen by means of vitreous fluorophotometry. Heat treatment to 43 degrees C at the retinal surface for 30 min increased the fluorescein leakage compared with the 41 degrees C treatment. This finding suggests that retinal hyperthermia at 43 degrees C for 30 min may cause breakdown of the BRB.

Dysfunction and repair of the blood-retina barrier following white light exposure: a fluorophotometric and histologic study.

The purpose of this study was to pinpoint the site of blood-retina barrier disruption after white light exposure and determine the course of barrier repair. The retinas of 25 anaesthetized pigmented rabbits were exposed for 1 hr to the light of a xenon arc lamp filtered to eliminate ultraviolet and infrared light. The light intensities selected were near the threshold intensity causing visible retinal lesions in order to evaluate the function of the blood-retina barrier (BRB) in this range. Functional assessment of the BRB was made with vitreous fluorophotometry (VF), and electron microscopy (EM) after intra-arterial administration of horseradish peroxidase (HRP) as tracer. In 11 of the 14 rabbits exposed to threshold intensity (90-110 mW cm-2; retinal field of illumination, 0.64 cm2), a breakdown of the BRB was demonstrated by a 2-40-fold increase in the permeability of the BRB for fluorescein and by transcellular passage of HRP through the retina pigment epithelium (RPE). All 11 rabbits developed oedematous fundus lesions. Within a week, pigmentary alterations of the fundus were seen on ophthalmoscopy, while the BRB permeability for fluorescein and HRP had returned to normal. EM of the retina showed slight swelling of RPE during the period of increased permeability but no alterations of the neuroretina. After functional barrier repair, the RPE cells demonstrated irregularity of the melanin pigment alignment and some loss of the monocellular arrangement. In six rabbits exposed to subthreshold light intensity (65-89 mW cm-2) no fundus lesion developed and EM evaluation of the BRB was normal.2+ remains altered.

Feasibility of targeted drug delivery to selective areas of the retina.

A new method was developed to deliver locally a bolus dose of a drug to the retinal vasculature. The targeted delivery system was based on encapsulating the drug in heat-sensitive liposomes, which are injected intravenously and lysed in the retinal vessels by a heat pulse generated by a laser. To test if substances delivered in the vessels could also penetrate into the surrounding tissue, 6-carboxyfluorescein was encapsulated in liposomes and used as a marker for drug penetration. Moderate argon laser pulses were applied to the retinal vessels of Dutch pigmented rabbits to induce breakdown of the blood-retinal barrier (BRB). A suspension of liposomes at a dose of 2 ml/kg body weight, corresponding to a carboxyfluorescein dose of 12 mg/kg, was injected into the ear vein. The dye was released from the liposomes proximal to the damaged portion of the vessel. Fundus fluorescein angiograms were recorded with a video camera and digitized for subsequent image analysis. The penetration of carboxyfluorescein into the retinal tissue was evaluated by comparing the fluorescence intensity of the area around the damaged vessel with that of an adjacent control area. The dye penetration increased with the numbers of laser applications (P less than 0.001). The leakage was localized distally to the released site and was restricted to areas with a disrupted BRB. The mass of carboxyfluorescein that penetrated gradually spread with time. Both veins and arteries could be used for the targeted delivery. These results indicated that this delivery system, which is fully controllable by laser through the pupil, can deliver drugs inside the vasculature and into the retinal tissue wherever the BRB is disrupted.

[Destruction of anionic sites in blood-retinal barrier after retinal photocoagulation].

The retinal pigment epithelial cells (RPE) have "tight junctions" at the apical side of the lateral wall between neighbouring cells and form physiological blood-retinal barriers. Recently, in addition to physiological barriers, charged barriers, consisting of anionic sites of cell membrane and its basement membrane, have been discussed. We performed weak retinal photocoagulation in rabbit eyes in order to break their charged barriers, and examined the repair process using a cationic probe, polyethyleneimine (PEI). Two days after photocoagulation, RPE cells were broken down and choriocapillaries were occluded with thrombi, and their anionic sites were lost. At one week after photocoagulation, structural reconstruction started from the edge of the photocoagulation area. In this area, proliferated RPE cells covered Bruch's membrane, but their charged barrier did not recover. Two weeks after photocoagulation, proliferated RPE cells covered Bruch's membrane over the entire photocoagulated area, and they obtained anionic charge. The present study revealed that retinal damage induced by weak laser photocoagulation was repaired within two weeks after photocoagulation with respect to the charged barrier.

Transscleral contact retinal photocoagulation with an 810-nm semiconductor diode laser.

Since the 810-nm wavelength has marked transmissibility through the sclera and absorption by melanin, it would be ideal for transscleral photocoagulation. We performed experiments to determine if consistent transscleral chorioretinal lesions could be produced in Dutch belted pigmented rabbits using the 810-nm laser, and if this modality caused less blood-retinal barrier disruption than retinal cryopexy of clinically equivalent treatment areas. The laser applications produced whitish to grayish-white retinal lesions when the surgeon, under direct visualization, used low powers and long durations (5 to 10 seconds), and controlled the treatment duration. Histopathologic evaluation of a lesion demonstrated an intact sclera overlying the chorioretinal lesion. Vitreous protein concentration, which was measured to assess blood-retinal barrier disruption, was significantly less in eyes treated with transscleral photocoagulation than in eyes treated with cryopexy of clinically equivalent treatment areas. We conclude that transscleral 810-nm laser treatment may be a viable clinical alternative to retinal cryopexy.

Fluorophotometric assessment of blood-retinal barrier function after white light exposure in the rabbit eye.

Fluorophotometry was performed in 14 rabbits after exposure of one eye to white light with an energy insufficient to cause visible phototoxic retinal damage as determined by ophthalmoscopy and fundus photography. Fluorescence measurements in the vitreous were performed before and 1 hr after i.v. injection of fluorescein. Ratios between the fluorescein concentrations in the exposed and in the non-exposed fellow eye were calculated after correction for the autofluorescence. The average ratio directly after light exposure had significantly increased (P = 0.005) as compared to pre-exposure values and was maximal one day after exposure (P less than 0.005). Four days after exposure the ratios had returned to pre-exposure values (P greater than 0.05). A significant linear correlation between age and the ratios directly after exposure was found (r = -0.67; P less than 0.01). Signs of phototoxic retinal damage were not found on ophthalmoscopy and fundus photography, nor on light and electron microscopic examination of the retinal pigment epithelium, neuro-retina or retinal capillaries 1 and 4 days after light exposure. A fluorophotometric assessment of the blood-retinal barrier (BRB) function after white light exposure appeared to be a more sensitive parameter of light-induced damage than morphological examination since light exposures at retinal irradiance levels below the threshold for ultrastructural damage resulted in a temporary BRB dysfunction that could be detected by fluorophotometry but not by the other methods.