Physiology Of Vitreous Flashcards
Largest organ of the eye
Vitreous
Vitreous transmits _____ of light
90%
Location of vitreous
Between lens and the retina
3 zones of the vitreous
Outermost: vitreous cortex (hyaloid cortex)
Center zone: cloquets canal
Intermediate zone: inner to the cortex and surrounds the center canal
Vitreous attachment to the retina
Vitreous attached to ILM of retina by the membrane limitans interna (MLI)
Vitreous base
- Located at ora serrata
- 1.5mm broad annular region
- attached to NPE of ciliary body and the ILM of the peripheral retina
- strongest attachment
- no age declined
What is the strongest vitreal attachment to the retina
Vitreal base at the ora serrata
Wiegers ligament (rettrolental ligament)
- between the posterior surface of the lens and the anterior surface of the vitreous
- firm attachment
- declined with age
- creates burgers space on the back of the lens
- space between vitreous and lens
Peripapillary adehsion of vitreous
- around the edge of the optic disc
- medium attachment
- declined with aging
Weiss ring in vitreal detachment
Macular and peripheral retinal attachment of vitreous
- weak attachment
- findings are controversial for macular attachment
- some individuals may have an attachment 3-5mm posterior to the vitreous base. Attach to retinal blood vessels
Composition of vitreous
- water major component
- collagen type II
- HA
- vitreal cells
- vitamin C
Does have other substances too
Vitreous collagen fibers and HA
The gel structure of the vitreous results from the arrangement of collagen fibrils suspended in a network of HA
Hyalocytes
- majority
- synthesize glycoproteins for the collagen fibrils
- synthesize HA
What cells synthesize HA
Hyalocytes
Vitreal cells
Hyalocytes
Fibrocytes
Macrophages
Vitreous functions
Support for retina
Diffusion barrier
Metabolic barrier
Transparency
Support function of vitreous
- prevents retinal detachment
- reduced mechanical deformation
- supports lens during trauma
- decreases transmission of light at 300-350nm
- mechanical support of limited signicance
Posterior vitreous detachment (PVD)
- 10% of eyes have strong vitreous retina attachments
- vitreous traction can cause retinal tears
- possibility of vitreous hemorrhage’s
- high risk of rhegmatogenous retinal detachment
Normal aging process
Most common pathology of vitreous
PVD
Macular edema
- in some cases
- vitreous-retinal traction
- increase in passive permeability
- decrease in active transport across blood retinal barrier
- increased osmotic pressure
Causes of macular edema
Retinal ischemia
Vitreal traction
Diffusion barrier function of vitreous
- slow diffusion actress vitreous
- bulk flow is limited across veitrous
- prevents topically adminstered substance from reaching the retina
- prevents substances in blood stream from reaching vitreous center
- no diffusion barrier for small molecules
Diffusion in the vitreous
Slow
- bulk flow is limited
- Abx drops cannot pass though the vitreous into the posterior part of the eye
Metabolic buffer of vitreous
Contains a lot of substances like glycogen, glucose, nutrients for retinal metabolism
Reservoir for vitamin C (ascorbic acid)
Vitreous protection from oxidative damage
High levels of vitamin C
Pathological correlation of diffusion barrier nad metabolic buffer of vitreous
In the case of vitrectomy and full PVD
NSC (nuclear sclerotic cataract)
Reduce neovascularixation in the retina
Neovascular glaucoma
What can happen in case of vitrectomy or full PVD
- NSC
- reduce neovascularization in the retina
- neovascular glaucoma
Transparency of vitreous
- low cxn of structural molecules
- low cxn of soluble proteins
- specific collagen/HA configuration
- blood/vitreous barrier
Pathology with vitreous transparency
- synchisis scintillations
- asteroid hyalosis
Synchisis scintillations
Accumulation of cholesterol
Asteroid hyalosis
Accumulation of Ca
What causes gel structure of vitreous?
HA process spacing and support for the collagen
What substances maintains high Cxn in vitreous and can be utilized to protect the retina from metabolic and light induced free radicals
Vitamin C
What are the vitreous functions
Provides a transporter medium
Cushion the globe
Storage are of ions and nutrients for the retina and lens