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Method Article
This study presents a methodology for the delivery of therapeutics into the retina and optic nerves of the adult rat. Additionally, a unique tissue retrieval method is introduced for a top-down en bloc collection of the optic nerve and retina in an adult rat.
Therapeutic delivery to the posterior segment of the eye, including the retina and optic nerve, is complicated by the presence of blood-brain and blood-retinal barriers. Small animal models, such as rats, are utilized for studying various ocular pathologies. While therapeutic delivery to the posterior eye is challenging, achieving it is essential for treating ocular disorders, many of which require validation in small animal models for translational relevance. Therefore, two posterior therapeutic delivery techniques are presented: intravitreal injection (IVI) and retrobulbar injection (RBI) for use in adult rats. Additionally, a method for the en bloc removal of the eyes and optic nerves is introduced for various histological and molecular analysis techniques. The dissection protocol enables full observation of the neuro-visual system while minimizing post-mortem injury to retinal and optic nerve tissues. Successful delivery of the therapeutic cyclosporine to the retina and optic nerve was achieved, with detectable concentrations observed twenty-four hours after injection using both IVI and RBI. Furthermore, en bloc retina and nerve samples were successfully extracted for full eye histological tissue analysis, facilitating comprehensive observation of the retina and the wider neuro-visual system.
Delivering therapeutics to the retina and optic nerve is incredibly difficult due to the complex anatomy of the eye1,2, specifically the presence of the blood-retinal barrier (BRB)3,4,5. The BRB serves to protect the retina from systemic circulation invasion, but is a challenging opponent to therapeutic administration as systemic therapeutic circulation is often blocked by the BRB6,7. Small lipophilic molecules can readily diffuse through the BRB, but larger and hydrophilic molecules have a harder time gaining access to the retina6. Intravitreal (IVI) and retrobulbar (RBI) injections enable the delivery of drugs to the ocular tissues, overcoming the limitations imposed by the BRB. The IVI serves as a promising compromise by administering therapeutics into the internal environment of the eye8,9. This method requires the drug to cross through the vitreous, thus bypassing the BRB, and diffusing through the retina and choroid in order to reach the optic nerve7. The RBI is delivered behind the eye into the retrobulbar space10. Therapeutics can be delivered by diffusion through the tissues and glands in the retrobulbar space, affecting the optic nerve and surrounding structures without directly entering the retina, which maintains the integrity of the BRB. By delivering drugs directly or indirectly into the eye, both intravitreal and retrobulbar injections can achieve higher local concentrations of the therapeutic drug, which enhances its effectiveness compared to topical or systemic administration (oral or intravenous)2. This is particularly important for treatments that require rapid action or high potency, as seen in many ocular diseases. Targeted delivery also limits the exposure of the rest of the body to the drug, which reduces the risk of off-target effects and helps to minimize potential adverse effects that can occur when medications are administered topically, orally, or intravenously11.
Other periocular injections, such as subconjunctival, posterior subtenon, and subretinal, have their own benefits and limitations2,5. Posterior subtenon injections have been observed to deliver high drug concentrations to ocular tissues; however, the subtenon injection is closer to the scleral than the orbital vasscularture5,12. In contrast, the RBI places the therapeutic closer to the optic nerve than the posterior subtenon or subconjunctival13. This may mean that optic nerve pathologies favor RBI-delivered therapeutics over other periocular injection types. Posterior subtenon injections have associated risks, including strabismus, hyphema, and elevated intraocular pressure5. Elevated intraocular pressure is also a reported risk factor in IVI, subconjunctival, and subretinal injections2. These injection types often require repetitive dosing in order to achieve the desired therapeutic effect2. Other risk factors associated with subretinal injections, subconjunctival injections, and IVI include cataract formation, retinal hemorrhage, retinal detachment, and inflammation2. These IVI, subretinal injections, and subconjunctival injections are more invasive than the RBI injections, as these injections are intraocular2. The RBI may be considered less invasive as it places the therapeutic in the retrobulbar space, without directly entering the needle into the globe of the eye. Other less invasive therapeutic delivery strategies, such as topical administration, fall short of sufficient drug delivery, with less than 5% of the drug being retained on the ocular surface2,5.
IVI is a prominent technique in preclinical models that is used for its ability to deliver therapeutic agents directly into the posterior segment of the eye. IVI delivers the drug directly to the vitreous humor, making it a preferred delivery technique for localized treatment14. The IVI technique allows the therapeutic to bypass the blood-retinal barrier, which is a common hindrance to drug penetration into the retina14. IVI introduces the opportunity for inflammation and damage to ocular structures, so meticulous adherence to the procedure must be employed14. To minimize retinal detachment and cataract formation, Chiu et al. describe an IVI approach that emphasizes a 45-degree bevel insertion and injection at the level of the par plana, avoiding the lens, retina, ocular muscle, and vessels15. In this technique, a 30 G needle is inserted into the nasal sclera for therapeutic delivery15. IVI is still associated with risks due to its invasive nature. Potential risks include retinal detachment, cataract formation, endophthalmitis, or hemorrhage16. The invasive nature of IVI techniques also increases intraocular pressure, as shown in an experiment on porcine eyes performed by Ikjong Park et al.16. The study shows changes in intraocular pressure during different stages of needle insertion and fluid injection. They report substantial variation in intraocular pressure during the procedure16.
RBIs have been successfully utilized in previous studies as a means of therapeutic delivery to rodents. One such study compared the effects of various prostaglandin analogs given via RBI17. Albino rats were given an RBI with a 26 G needle of 0.1 mL injectate inserted through the lateral area of the inferior fornix at a 45-degree angle17. The protocol used in this study was adapted from a previously described method in which the rats were anesthetized via intraperitoneal (IP) injection of chloralhydrate18. Another study conducted on rats compared topical drops to retrobulbar injections19. The rats were anesthetized via an IP injection of ketamine/xylazine, and the RBI was given via a 30 G needle19. In contrast to the previously discussed sedation methods, one study observing the effects of RBI on orbital fat used inhalational isoflurane to sedate the rats prior to RBI20. While these studies provide insight into what anesthetics and needle specifications could be successful, the positioning and handling of the animals during the procedure are not discussed.
Various studies in mice also conduct RBIs for therapeutic delivery methods. One study compared RBI to lateral tail vein injection for successfully inducing nephrotic syndrome21. A second study also compared the same two injection techniques in the administration of contrast media for cardiac imaging22. The mice were anesthetized with inhalational isoflurane and injected in the medial side of the eye22. Both studies adapted their RBI method from a previously written protocol. It is important to note that this protocol named their injection as retro-orbital yet described the injection location as the retrobulbar space behind the eye. The authors of this protocol utilized inhalational isoflurane as a preferred sedation method, noting the quick activation and recovery time of the mice23. For an RBI, the eye was partially protruded from the socket by applying pressure to the skin around the eye23. Then, the needle was introduced at the medial canthus bevel side down at an angle of 30 degrees and was inserted until it reached the base of the eye23. Care must be taken when applying pressure to the animal, as accidental blood flow blockage or tracheal collapse may occur23. The injector is also blind to the needle tip upon insertion, and therefore, damaging the eye is an associated risk.23 Damaging the eye upon therapeutic administration is a critical risk in this experiment, as causing additional injury directly undermines the results of the study. It also must be noted that the positioning and handling technique previously described was conducted on mice and did not include comments on applicability to rats.
There are many manners in which optic nerve and retina removal have been attempted. One such method explored the removal of optic nerves and eyes en bloc, preserving an intact optic chiasm24. This method is the most comparable to the current study as the individual eyes and optic nerves are also preserved for en bloc removal; however, the optic chiasm is separated. Exercising caution in this procedure would be of the utmost importance due to the complexity of the procedure. In the current method, we begin the dissection via the caudal skull and work rostrally in order to provide access in a way that limits damage to the optic nerves and allows the entire nerve to remain intact. Furthermore, keeping the nerve intact and attached to the eye is crucial to the embedding process, as damage to each part of the nerve can correspond to a different pathological observation24. The orientation of the optic nerve is important to consider as how it is embedded allows for different cross sections, which may be important for histological analysis.
A custom-made device known as the small animal laboratory ophthalmic operating table (SALOOT, an ophthalmic surgery platform) is comprised of a series of 3D printed materials to provide anesthesia and hold the animal in a stable position for ocular therapeutic injections. The SALOOT design allows for stability of the head and ocular structures for ophthalmic procedures, which improves the speed and reproducibility of operations while allowing for gas anesthesia delivery and scavenging of exhalation particulates. The SALOOT is a three-dimensional printed block featuring a concave reduction to hold the rat body with a narrower region at the front to hold the head of the animal into a nose cone with an isoflurane inlet. Beneath the nose cone is a small reservoir and exhaust outlet. The following methods were developed for therapeutic ocular delivery and precise ocular tissue retrieval; they were designed for studying tissues after ocular trauma, so it is crucial to delineate the effects of the trauma, injection, treatment, and dissection to avoid confounded interpretation of findings.
This article presents two ocular therapeutic injection methods, the intravitreal and retrobulbar injections, for use in adult rats. In addition, a tissue retrieval method is presented for the en bloc removal of the intact optic nerve and retina from an adult rat. These techniques enable the investigation of ocular and peri-ocular effects of induced pathology and treatment.
All experiments were conducted in accordance with the ARVO Statement for the Use of Animals in Ophthalmic and Visual Research and approved by the institutional animal care and use committee at Ohio State University. Male Sprague Dawley rats weighing ~200 g and around 2 months of age were used for this study25. Details of the reagents and the equipment used are listed in the Table of Materials.
1. Intravitreal injection (IVI)
2. Retrobulbar injection (RBI)
3. Ocular tissue isolation dissection
Preliminary pilot experiments were performed on cadaver animals using injection dye (Evans Blue dye) and tattoo ink (Figure 2B) to optimize the placement and size of the needle for both RBI and IVI. Tattoo ink was non-dilute, and then Evans Blue powder was mixed in PBS until the fluid became opaque. We concluded the ideal RBI featured a 28 G needle inserted at an angle halfway between 6 and 7 o'clock along the lower orbital rim until the back of the ocular socket was felt. This delivered...
The intricate challenges associated with delivering therapeutics to the retina and optic nerve, primarily due to the impermeable barrier posed by the BRB, underscore the significance of this study3,4. The exploration of IVI and RBI techniques not only highlights innovative approaches for overcoming these obstacles but also emphasizes the broader implications for ocular care and therapeutic development. These findings demonstrate that both IVI and RBI can facilita...
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
This work was partially funded by US Department of Defense Vision Research Program Awards W81XWH-15-1-0074 and W81XWH-22-1-0989. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. This research grant was supported in part by the Ohio Affiliate of Prevent Blindness Young Investigator Student Fellowship Award for Females Scholars in Vision Research. We gratefully acknowledge support from the Ross Foundation. Services were performed at the OSU Vision Sciences Research Core Program under P30EY032857. We would like to thank The Ohio State University Laboratory and Animal Resources (ULAR). In addition, we would like to thank Reilly undergraduate lab members Michelle Mosko, Emma Lally, Sam Duckworth, and Eve Howard. We would also like to thank Bongsu Kim for contributing to the SALOOT design, as well as Elizabeth Urbanski and Ryan Webb. Figure 1, Figure 2A, and Figure 3 were created with BioRender.com.
Name | Company | Catalog Number | Comments |
Anakinra 100 mg/0.67 mL | Sobi | NDC: 66658-0234-07 | |
Antipamezole hydrochloride (Antisedan) 5.0 mg/mL | Zoetis | NADA #141-033 | 107204-8 | |
Bacteriostatic sodium chloride (0.9%) | Hospira Inc. | NDC: 0409-1966-02 | |
Cryotube | VWR | 76417-258 | https://us.vwr.com/store/product?keyword=76417-258 |
Curved forceps | Fischer Scientific | 08-953F | |
cyclosporine injection 250 mg/mL | Perrigo | NDC: 00574-0866-10 | |
cyclosporine topical, 0.05% (Restasis) | AbbVie (Vizient) | NDC: 00023-9163-30 | |
Cyotube Cap | Thermo Scientific | 3471BLK | https://www.fishersci.com/shop/products/screw-cap-microcentrifuge-tube-caps/14755237?searchHijack=true&searchTerm= screw-cap-microcentrifuge-tube-caps&searchType=Rapid& matchedCatNo=14755237 |
Evans Blue | Sigma-Aldrich | E2129-10G | |
Eye Spears | Fischer Scientific | NC0972725 | https://www.fishersci.com/shop/products/ultracell-pva-eye-spears-100-p/NC0972725 |
Fine forceps | Fischer Scientific | 08-953E | https://www.fishersci.com/shop/products/fisherbrand-dissecting-jewelers-microforceps-2/08953E?gclid=Cj0KCQiAkJO8BhCGARIsAM kswyiER9Kanmi3ZMgoXTr82Zg3 g44m1Q6WLftkYfb36hC7pbkwR hVAy3MaAqkLEALw_wcB&ef_id =Cj0KCQiAkJO8BhCGARIsAMks wyiER9Kanmi3ZMgoXTr82Zg3g4 4m1Q6WLftkYfb36hC7pbkwRhV Ay3MaAqkLEALw_wcB:G:s&ppc _id=PLA_goog_2086145680_81 843405274_08953E__38624700 1354_6556597232892883360& ev_chn=shop&s_kwcid=AL!4428 !3!386247001354!!!g!827721591 040!&gad_source=1 |
Fine ophthalmic forceps with teeth | Fisher Scientific | 50-253-8287 | https://www.fishersci.com/shop/products/bonn-suturing-forceps-7-5-cm/502538287 |
Flat spatula | Fischer Scientific | 14-375-100 | https://www.fishersci.com/shop/products/fisherbrand-spoonula-lab-spoon/1437510#?keyword= |
Hot bead Sterilizer | Fine Science Tools | 18000-45 | https://www.finescience.com/en-US/Products/Instrument-Care-Accessories/Sterilization/Hot-Bead-Sterilizers |
Hypromellose 0.3% (GenTeal Tears Severe Dry Eye Gel) | Alcon Laboratories Inc. | https://www.amazon.com/GenTeal-Tears-Lubricant-Ointment-Night-Time/dp/B01IN5G1L0/ref=sr_1_4?dib=eyJ2IjoiMSJ9.DxYpqjIIBNO TVuPo7jln5xeGazA_YFg0cbt3 kCyC-0ouZARw5qIHYvCM7vB R_vO30OWUEXDZhQmQfLQ9 ySld4mujpzrWjxbsEXLBs5JPhjZ eUPgPY0sHoJA46f9EYULdxiTu BQy5fVA2OB20RV09mbdW8hX 6j8-bXIYTZljPGMo5_GMq9jnJo8 3iR35c1THxEiEH2FsvSx7VXup- QK9uCkWwAYrw2v3tyLUCq2JT APPF34nsYqGnSASMgOARU_ 2lVz-kIy-QUEYHGOoIimIWwBY htz33RkFrq7YjtnC2uDbImNiudG zWJv-uUhmJngYjbBGbeWE0VX 7CGPkEokUZrCQ8AI2HeXjSMph gPhMbK88RcHJ63AyH0TiBtS2k1 Xceh-CD26_prJSNxF6Mv5-jgGf9 iLmXvVtKkkSwc-5uYLk7gZHaFC Yj73F_imbmeHYr.4vfu7h4m4Jlfy- qiqmgeAnDHlJTGYV22HJ2w_xD ir0k&dib_tag=se&keywords=Gent eal+gel&qid=1736793609&sr=8-4 | |
ibudilast | Millipore Sigma | I0157-10MG | |
insulin syringe 0.5 mL with a 28 gauge Micro-Fine IV Needle | Becton, Dickinson and Company (BD) | 14-826-79 | |
Isoflurane | Covetrus | NDC: 11695-6777-2 | |
Ketamine | Covetrus | NDC: 11695-0703-1 | |
Long Evans Rat | Charles River Laboratories International, Inc. | https://www.criver.com/products-services/find-model/long-evans-rat?region=3611 | |
Mayo Scissors | Electron Microscopy Sciences | 72968-03 | |
Medium microscissors | Amazon | https://www.sigmaaldrich.com/US/en/product/aldrich/z168866#product-documentation | |
Medium straight hemostats or needle drivers | Sigma-Aldrich | Z168866-1EA | https://www.sigmaaldrich.com/US/en/product/aldrich/z168866#product-documentation |
Needle 33 G with a style 4 tip at a length of 10 mm and angle of 15 degrees | Hamilton | 7803-05 | |
paraformaldehyde 4 in phosphate-buffered saline (PBS) (4% PFA) | Thermo Fischer | J61899.AK | |
Petri dish | Millipore Sigma | P5606-400EA | https://www.sigmaaldrich.com/US/en/product/sigma/p5606?utm_source=google&utm_medium= cpc&utm_campaign=8674694095 &utm_content=105162454052& gad_source=1&gclid=Cj0KCQiA kJO8BhCGARIsAMkswygXXfgY ABr7EfLtf4tvuLS0E8A4SxX4XM NJQDaI80Yi4FO-iahCsPcaAp9E EALw_wcB |
phosphate-buffered saline (PBS) | Sigma-Aldrich | P3813-10PAK | https://www.sigmaaldrich.com/US/en/product/sigma/p3813 |
Povidone-Iodine (Betadine) 5% | Alcon Laboratories Inc. | NDC: 0065-0411-30 | |
Shaker Model 3500 | VWR | 89032-092 | |
Small iris scissors | Sigma-Aldrich | Z265977-1EA | https://www.sigmaaldrich.com/US/en/product/aldrich/z265977& |
small microscissors | Fisher Scientific | 17-456-004 | https://www.fishersci.com/shop/products/self-opening-scissors-2/17456004?keyword=true |
Sprague Dawley Rat | Charles River Laboratories International, Inc. | SAS 400 | https://emodels.criver.com/product/400 |
Sucrose | Millipore Sigma | 57-50-1 | https://www.sigmaaldrich.com/US/en/substance/sucrose3423057501 |
syringe 10 µL (Model 701 RN) | Hamilton | 80330 | |
Tattoo Ink (Intenze Tattoo Ink True Black 1 oz) | Amazon | https://www.amazon.com/Intenze-Tattoo-Ink-True-Black/dp/B01GW747L2 | |
tauroursodeoxycholic acid (TUDCA) | Milipore Sigma | 580549-1GM | |
Tetracaine Hydrochloride Ophthalmic Solution 0.5% | Bausch & Lomb Inc. | NDC: 68682-920-64 | |
Xylazine (Rompun) 100 mg/mL | Dechra | NADA #047-956 | |
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