Abstract

Objective Glaucoma is a leading cause of severe visual impairment and blindness. Although high intraocular pressure (IOP) is an established risk factor for the disease, the role of abnormal ocular vessel function in the pathophysiology of glaucoma gains more and more attention. We tested the hypothesis that elevated intraocular pressure (IOP) causes vascular dysfunction in the retina. Methods High IOP was induced in one group of mice by unilateral cauterization of three episcleral veins. The other group received sham surgery only. Two weeks later, retinal vascular preparations were studied by video microscopy in vitro. Reactive oxygen species (ROS) levels and expression of hypoxia markers and of prooxidant and antioxidant redox genes as well as of inflammatory cytokines were determined. Results Strikingly, responses of retinal arterioles to stepwise elevation of perfusion pressure were impaired in the high-IOP group. Moreover, vasodilation responses to the endothelium-dependent vasodilator, acetylcholine, were markedly reduced in mice with elevated IOP, while no differences were seen in response to the endothelium-independent nitric oxide donor, sodium nitroprusside. Remarkably, ROS levels were increased in the retinal ganglion cell layer including blood vessels. Expression of the NADPH oxidase isoform, NOX2, and of the inflammatory cytokine, TNF-α, was increased at the mRNA level in retinal explants. Expression of NOX2, but not of the hypoxic markers, HIF-1α and VEGF-A, was increased in the retinal ganglion cell layer and in retinal blood vessels at the protein level. Conclusion Our data provide first-time evidence that IOP elevation impairs autoregulation and induces endothelial dysfunction in mouse retinal arterioles. Oxidative stress and inflammation, but not hypoxia, appear to be involved in this process.

Highlights

  • Glaucoma is a leading cause of blindness characterized by progressive loss of retinal ganglion cells (RGC) and their axons [1]

  • We found that reactivity to acetylcholine, an endothelium- and eNOS-dependent vasodilator in retinal arterioles [44, 45], was compromised whereas the reactivity to the nitric oxide donor, SNP, which induces vasodilation in an endothelium-independent manner was preserved, indicative of endothelial dysfunction

  • The findings of our study are striking because they reveal for the first time that elevated intraocular pressure (IOP) causes endothelial dysfunction in ocular blood vessels

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Summary

Introduction

Glaucoma is a leading cause of blindness characterized by progressive loss of retinal ganglion cells (RGC) and their axons [1]. Elevated intraocular pressure (IOP) is a major risk factor for the onset and progression of the disease, other risk factors, such as vascular dysfunction/dysregulation and autoimmunological mechanisms, have been implicated in the pathophysiology [2,3,4]. It has been shown in patients that glaucoma may progress despite normalization of IOP [5]. Once initiated, molecular and morphological events, which are poorly understood, appear to take place independently from acute IOP levels. It has been demonstrated that elevated IOP causes oxidative stress, inflammation, and tissue damage in the retina and optic nerve [6]. Support for a link between oxidative stress and ocular vascular damage in glaucoma comes from studies reporting that levels of reactive oxygen species (ROS) and of markers for vascular endothelial

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