Preserve the (intraocular) environment: The importance of maintaining normal oxygen gradients in the eye

David C. Beebe, Ying Bo Shui, Carla J. Siegfried, Nancy M. Holekamp, Fang Bai

Research output: Contribution to journalReview articlepeer-review

48 Scopus citations

Abstract

Oxygen levels in the eye are generally low and tightly regulated. Oxygen enters the eye largely by diffusion from retinal arterioles and through the cornea. In intact eyes, oxygen from the retinal arterioles diffuses into the vitreous body. There is a decreasing oxygen gradient from the retina to the lens, established by oxygen consumption by ascorbate in the vitreous fluid and lens metabolism. Age-related degeneration of the vitreous body or removal during vitrectomy exposes the posterior of the lens to increased oxygen, causing nuclear sclerotic cataracts. Lowering oxygen in the vitreous, as occurs in patients with ischemic diabetic retinopathy, protects against cataracts after vitrectomy. Vitrectomy and cataract surgery increase oxygen levels at the trabecular meshwork and with it the risk of open angle glaucoma. Two additional risk factors for glaucoma, African heritage and having a thinner cornea, are also associated with increased oxygen in the anterior chamber angle. Preservation of the vitreous body and the lens, two important oxygen consumers, would protect against nuclear sclerotic cataracts and open angle glaucoma. Delaying removal of the lens for as long as possible after vitrectomy would be an important step in delaying ocular hypertension and glaucoma progression.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalJapanese Journal of Ophthalmology
Volume58
Issue number3
DOIs
StatePublished - May 2014

Keywords

  • Nuclear sclerotic cataract
  • Open angle glaucoma
  • Oxygen toxicity
  • Phaco-vitrectomy
  • Vitrectomy

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