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Visual system Oculus et structurae pertinentes

Visual system Oculus et structurae pertinentes. David Kachlík. Odilo Redon. Orbita = Orbit. tetrahedral pyramid tilted dorsally aditus x apex 10 openings + their contetnt m. orbitalis M ülleri – smooth muscle in the fissura orbitalis inferior

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Visual system Oculus et structurae pertinentes

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  1. Visual systemOculus et structurae pertinentes David Kachlík

  2. Odilo Redon

  3. Orbita = Orbit tetrahedral pyramid tilted dorsally aditus x apex 10 openings + their contetnt m. orbitalis Mülleri – smooth musclein the fissura orbitalis inferior content: eyeball, oculomotor muscles, fat pad and related structures

  4. Orbita – osseous walls • cranially: pars orbitalis o. frontalis (fovea trochlearis + spina trochlearis, incisura/foramen frontalis/supraorbitalis, fossa glandulae lacrimalis), ala minor o. sphenoidalis (fissura orbitalis sup.) • medially: processus frontalis maxillae (fossa sacci lacrimalis), os lacrimale, lamina orbitalis o. ethmoidalis (foramen ethmoidale ant. et post.), ala minor o. sphenoidalis • laterally: facies orbitalis o. zygomatici (foramen zygomaticoorbitale), facies orbitalis alae majoris o. sphenoidalis

  5. Orbita – osseous walls • caudally: facies orbitalis o. zygomatici, facies orbitalis corporis maxillae (sulcus et canalis infraorbitalis, fissura orbitalis inf.), processus orbitalis o. palatini • aditus orbitae → apex orbitae • orbita is divided by theoretical planes into 3 levels

  6. Orbita – related structures medially: cellulae ethmoidales (via very thin lamina orbitalis ossis ethmoidalis) caudally: sinus maxillaris cranially:fossa cerebri anterior dorsally:sinus cavernosus + fossa pterygopalatina

  7. Visual system bulbus oculi = eyeball structurae pertinentes oculi = related structures of the eye topography: regio orbitalis development

  8. Eyeball tunica fibrosa (externa) tunica vasculosa (media) tunica interna (nervosa) corpus vitreum (vitreous body) + lens

  9. Eyeball polus anterior, posterior equator x meriadiani axis bulbi externus, internus axis opticus (= „linea visus“)

  10. Tunica fibrosa (externa) sclera cornea

  11. Tunica fibrosa (externa)Sclera dense connective tissue (= reticulum trabeculare), collagen fibres, fibroblasts, ground substance lamina episcleralis, substantia propria, lamina fusca lamina cribrosa (entrance of n. II.) 5/6th of the eyeball surface, ø 2,2 cm sinus venosus sclerae (canalis Schlemmi s. Lauthi) sulcus sclerae – sclerocorneal junction = limbus corneae (angulus sclerocornealis)

  12. Tunica fibrosa (externa)Cornea perfectly transparent, non-vascular limbus, vertex 5 layers epithelium anterius cornae (stratified squamous ep.) lamina limitans anterior (Bowman´s membrane) substantia propria corneae lamina limitans posterior (Descement´s membrane) epithelium posterius corneae („endothelium“) 11 x 12 mm - physiological astigmatism

  13. Tunica vasculosa (media) = Uvea choroidea corpus ciliare (ciliary body) iris

  14. Tunica vasculosa (media)= Choroidea lamina suprachoroidea (= lamina fusca sclerae) spatium perichoroideum lamina vasculosa (choroideal stroma) larger vessels, connective tissue, smooth muscle cells, nerves lamina choriocapillaris capillaries lamina basalis = Bruch´s membrane BM of pigment epithelium and capillaries + connective tissue

  15. Tunica vasculosa (media)= Corpus ciliare annular shape, triangular profile processus + plicae ciliares orbiculus (external part), corona (internal part) smooth musculus ciliaris fibrae meridionales, radiales, circulares, longitudinales

  16. Tunica vasculosa (media)= Corpus ciliare stroma m. ciliaris: parasympathetic accomodation  focus at near (focus at far is assured with the elastic choroidea) capillaries and nerves supplying the muscle epithelial cover – production of humor aquosus BL – continuation of Bruch´s membrane pigment epithelium – (continuation of pigm. epith. of retina) cilliary canal nonpigment epithelium (continuation of sensory epith. of retina) BL fibrae zonulares – fixation of lens

  17. Tunica vasculosa (media)= Iris annular and flat shape function of photograph stop (shutter) margo ciliaris (external), m. pupillaris (internal) pupilla anulus iridis major + minor (containing circulus arteriosus iridis major + minor) m. sphincter pupillae (parasymp.) – miosis (circular) m. dilatator pupillae (symp.) – mydriasis (radiate)

  18. Tunica vasculosa (media)= Iris plicae iridis, stroma iridis anterior surface no epithelium cover fibroblasts and melanocytes (colour) dentate line – remnant of membrana pupillaris Wachendorfi posterior surface 2 layers of pigment epithelium internal pigment external myoepithelial m. sphincter pupillae m. dilatator pupillae

  19. Lens polus anterior, posterior axis, equator, radii (seams in shape of Y and inverted-Y) capsula lentis substantia lentis – cortex, nucleus zonula ciliaris Zinni fibrae zonulares spatia zonularia catharact - replacement

  20. Lens transparen biconvex nonvascular structure capsula lentis – similar to BL epithelium lentis – unilayered cubic anterior surface only substantia lentis cortical – contains oblong cells (fibres) with organels and nucleus nuclear – cellular fibres without organels and nucleus cells contain specific proteins (filensin, crystallins)

  21. Accomodation focus at near contraction of m. ciliaris fibrae zonulares relax lens bulges parallel contraction of m. sphincter pupillae (= miosis) focus at far vessels tonus keeps fibrae zonulares tightened lens is flatened contraction of m. dilatator pupillae (= mydriasis)

  22. Corpus vitreum = Vitreous body membrana, stroma, humor vitreus 99% of water hyaluronic acid, collagen fibres cells – hyalocytes – during development only! no regeneration ! – in trauma flows out and replaced with aqueous humor canalis hyaloideus Cloqueti – remnant of fetal arteria hylaloidea fossa hyaloidea maintains the internal eyeball pressure, compress retina to the choroidea

  23. Humor aquosus= Aqeous humor produced by corpus ciliare absorbed in angulus iridocornealis 0,2-0,3 ml of pellucid and colourless fluid daily production - 3 ml content: 0,7-1,2% NaCl, glucose and urea traces (0,1%), no proteins! corresponds to the lymph inside the eyeball intraocular pressure: 14-17 mmHg  intraocular pressure  compression of retina  glaucoma

  24. Camerae bulbi = Chambers of eyeball camera postrema s. vitrea between corpus ciliare, lens and retina contains corpus vitreum spatium retrozonulare camera posterior between iris, lens and corpus ciliare contains and produces humor aquosus camera anterior between cornea and iris angulus iridocornealis contains and absorbs humor aquosus

  25. Angulus iridocornealis = Iridocorneal angle in site of sclerocorneal junction trabecular net in the posterior wall = spatia anguli i.c. = Fontana´s spaces no direct connection to Schlemm´s canal reabsorption of humor aquosus maintains the intraocular pressure !!! no application of parasympatheticolytics in patient with glaucoma !!!

  26. OCTOptic coherent tomographymeasurements of light reflexion

  27. Break

  28. Tunica interna (nervosa)= Retina pars caeca pars iridica pars ciliaris ora serrata pars optica – 11 layers pigment part sensory part

  29. Tunica interna (nervosa)Retina– pigment part unilayered cubic epithelium cells with thight junctions apical cell parts contain melanin granules encompass the external segments of sensory cells interfotoreceptor matrix nutrition of cells, regeneratin of fotopigment, degradation of membranous discs

  30. Tunica interna (nervosa) Retina – sensory part light-sensitive neurons (transducers) rods and cones trasmission neurons (integraters) bipolar and ganglionic cells association neurons horizontal and amacrinne cells suppoting cells (glia) Müller´s cells

  31. Tunica sensoria (interna)Rods = Bacilli synaptic disc axon nucleus internal segment GA, ER, MIT; synthesis of ATP and rhodopsin external segment membranous discs with fotopigment migrate externally until the separate black and white vision

  32. Tunica sensoria (interna)Rods = Coni synaptic foot fotopigment - iodopsin external segment membranous discs with fotopigment communicate with environment colour vision– 3 types of cones „blue“ – 420 nm „green“ – 535 nm „red“ – 565 nm

  33. Tunica sensoria (interna)Transmisison neurons (Integraters) Bipolar cells rod-like bipolar cells cone-like bipolar cells – dwarf x diffused contacts with ganglionic cells Ganglionic cells diffused type – contact with more bipolare cells dwarf type – contact with dwarf bipolare cell axons of ganglionic cells form nervus opticus

  34. Tunica sensoria (interna)Association neurons only neuritic processes – in both directions horizontal cells contacts with rods and cones amacrinne cells contacts with bipolar and ganglionic cells modification and synchronization of signal

  35. Tunica sensoria (interna)Supporting cells Müller´s cells macroglia their BL = membrana limitans interna zonulae adherentes with rods and cones = membrana limitans externa

  36. Tunica sensoria (interna)Layers of optic part of retina 11 layers !!!  do not be frightened  !!!

  37. Tunica sensoria (interna)Layers of optic part of retina stratum pigmentosum (1.) stratum nervosum (2.-10.) stratum segmentorum externorum et internorum(2.) stratum limitans externum (3.) stratum nucleare externum (4.) stratum plexiforme externum (5.) stratum nucleare internum (6.) stratum plexiforme internum (7.) stratum ganglionicum (8.) stratum neurofibrarum (9.) stratum limitans internum (10.)

  38. Tunica interna (nervosa)Specific spots of retina discus n. optici (= blind spot) n. II leaves the eyeball no light-sensitive cells  excavatio disci

  39. Tunica sensoria (interna)Specific spots of retina fovea centralis („macula lutea; yellow spot“) distant layers diverted laterally sharpest and most brilliant colour vision spot cones only (100.000 cones)  foveola (2500 cones)

  40. OCTOptic coherent tomography

  41. OCT

  42. OCT ABRUPTIO RETINAE

  43. Arterial supply of the eye a. carotis interna a. ophtalmica  aa. ciliares posteriores breves  choroidea aa. ciliares longae (24)  corpus ciliare + iris aa. musculares  aa. ciliares ant., a. epiclerales, aa. conjuctivales lat. a. centralis retinae  retina a. lacrimalis  aa. palpebrales lat. aa. palpebrales med.  aa. conjuctivales med.

  44. Vasa sanguinea retinae– fundus oculi a. centralis retinae arteriolae a. temporalis sup.+inf. a. nasalis sup.+inf. a. macularis sup.+inf. (+ media) veins correspond to arteries, they often cross

  45. A. cilioretinalis (cilioretinal a.) present in 10-33% of eyes branches from the a. ciliaris posterior brevis exits the discus n.II separately from a. centralis retinae additional supply to macula lutea from choroidal circulation provide a small amount of blood supply to the retina when a. centralis retinae is occluded 90% located temporally, 10% nasally occlusion of a. cilioretinalis → central visual loss occlusion of a. centralis retinae → spare central vision and macula lutea

  46. A. cilioretinalis (cilioretinal a.)

  47. Venous drainage of eye – 3 directions vv. episclerales vv. ciliares ant.  vv. sclerales  sinus venosus sclerae Schlemmi s. Lauthi vv. vorticosae (4 in quadrants of eyeball) v. centralis retinae v. ophthalmica sup.  sinus cavernosus v. ophthalmica inf.  plexus pterygoideus v. angularis  v. facialis  v. jugularis int. ! danger of inflammation spreading !

  48. Nervous supply of eye n. opticus – special sensory pars intraocularis, canalis, itracranialis vagina interna, externa n. ophthalmicus nn. ciliares longi – somatosensory n. lacrimalis, n. frontalis, n. nasociliaris – for surrounding structures nn. ciliares breves  ganglion ciliare – autonomic (visceromotor) (sympathetic fibres non-interpolated, parasympathetic interpolated) n.III., n. IV., n.VI – somatomotor

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