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Neural control of choroidal blood flow.
Progress in Retinal and Eye Research ( IF 17.8 ) Pub Date : 2017-12-08 , DOI: 10.1016/j.preteyeres.2017.12.001
Anton Reiner 1 , Malinda E C Fitzgerald 2 , Nobel Del Mar 3 , Chunyan Li 3
Affiliation  

The choroid is richly innervated by parasympathetic, sympathetic and trigeminal sensory nerve fibers that regulate choroidal blood flow in birds and mammals, and presumably other vertebrate classes as well. The parasympathetic innervation has been shown to vasodilate and increase choroidal blood flow, the sympathetic input has been shown to vasoconstrict and decrease choroidal blood flow, and the sensory input has been shown to both convey pain and thermal information centrally and act locally to vasodilate and increase choroidal blood flow. As the choroid lies behind the retina and cannot respond readily to retinal metabolic signals, its innervation is important for adjustments in flow required by either retinal activity, by fluctuations in the systemic blood pressure driving choroidal perfusion, and possibly by retinal temperature. The former two appear to be mediated by the sympathetic and parasympathetic nervous systems, via central circuits responsive to retinal activity and systemic blood pressure, but adjustments for ocular perfusion pressure also appear to be influenced by local autoregulatory myogenic mechanisms. Adaptive choroidal responses to temperature may be mediated by trigeminal sensory fibers. Impairments in the neural control of choroidal blood flow occur with aging, and various ocular or systemic diseases such as glaucoma, age-related macular degeneration (AMD), hypertension, and diabetes, and may contribute to retinal pathology and dysfunction in these conditions, or in the case of AMD be a precondition. The present manuscript reviews findings in birds and mammals that contribute to the above-summarized understanding of the roles of the autonomic and sensory innervation of the choroid in controlling choroidal blood flow, and in the importance of such regulation for maintaining retinal health.



中文翻译:

脉络膜血流的神经控制。

脉络膜受到副交感神经、交感神经和三叉神经感觉神经纤维的丰富支配,这些神经纤维调节鸟类和哺乳动物以及其他脊椎动物的脉络膜血流。副交感神经支配已被证明可以使血管舒张并增加脉络膜血流量,交感神经输入已被证明可以使血管收缩并减少脉络膜血流量,感觉输入已被证明既可以集中传递疼痛和热信息,又可以局部作用以舒张和增加脉络膜血流量。脉络膜血流量。由于脉络膜位于视网膜后面,不能轻易对视网膜代谢信号做出反应,因此其神经支配对于视网膜活动、驱动脉络膜灌注的全身血压波动以及可能的视网膜温度所需的血流调节非常重要。前两者似乎是由交感神经和副交感神经系统通过对视网膜活动和全身血压作出反应的中枢回路介导的,但眼灌注压的调整似乎也受到局部自动调节生肌机制的影响。脉络膜对温度的适应性反应可能是由三叉神经感觉纤维介导的。脉络膜血流的神经控制会随着年龄的增长以及各种眼部或全身疾病(例如青光眼、年龄相关性黄斑变性(AMD)、高血压和糖尿病)而发生损害,并可能导致这些情况下的视网膜病理和功能障碍,或对于 AMD 来说是一个先决条件。本手稿回顾了鸟类和哺乳动物的研究结果,这些发现有助于理解脉络膜自主神经和感觉神经支配在控制脉络膜血流中的作用,以及这种调节对维持视网膜健康的重要性的上述概述。

更新日期:2017-12-08
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