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The orbit is a paired, transversely oval, and cone-shaped osseous cavity bounded and formed by the anterior and middle cranial base as well as the viscerocranium. Its main contents are the anterior part of the visual system, globe and optic nerve, and the associated neural, vascular, muscular, glandular, and ligamentous structures required for oculomotion, lacrimation, accommodation, and sensation. A complex stream of afferent and efferent information passes through the orbit, which necessitates a direct communication with the anterior and middle cranial fossae, the pterygopalatine and infratemporal fossae, as well as the aerated adjacent frontal, sphenoidal, and maxillary sinuses and the nasal cavity. This article provides a detailed illustration and description of the microsurgical anatomy of the orbit, with a focus on the intrinsically complex spatial relationships around the annular tendon and the superior orbital fissure, the transition from cavernous sinus to the orbital apex. Sparse reference will be made to surgical approaches, their indications or limitations, since they are addressed elsewhere in this special issue. Instead, an attempt has been made to highlight anatomical structures and elucidate concepts most relevant to safe and effective transcranial, transfacial, transorbital, or transnasal surgery of orbital, periorbital, and skull base pathologies. [ABSTRACT FROM AUTHOR]

Background: Ciliary ganglion (CG) can be easily injured without notice in many intraorbital procedures. Surgical procedures approaching the lateral side of the orbit are at risk of CG injury which results in transient mydriasis and tonic pupil. This study aims to focus on the morphometric study of the CG which is pertinent to intraoperative procedure.Materials and Methods: Forty embalmed cadaveric globes were dissected to observe the location, shape and size of CG, characteristics and number of roots reaching CG, number of short ciliary nerve in the orbit. Distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were measured.Results: Ciliary ganglion was located between optic nerve and lateral rectus in every case. Its shape could be oval, round and irregular. Mean width of CG was 2.24 mm and mean length was 3.50 mm. Concerning the roots, all 3 roots were present in 29 (72.5%) cases. Absence of motor root was found in 7 (17.5%) cases. Absence of sympathetic root was found in 4 (5%) cases. The number of motor root could be 1, 2 and also 3 roots. Three motor roots were found in 1 case which originated from nerve to inferior oblique muscle. Only one sensory root was found in every specimen. One sympathetic root could be observed in most of the specimens and 6-14 short ciliary nerves were found. Mean distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were 16.04 mm, 1.47 mm, 2.88 mm, and 31.53 mm, respectively.Conclusions: This study described the characteristic of CG, number of its nerve root and some measurements relevant to intraorbital procedures in Asian population. Moreover, a new parameter was the distance between CG and scleral insertion of the lateral rectus muscle. This parameter should be considered when performing operation involved the lateral rectus muscle and BTX-A injection to lateral rectus muscle to reduce CG injury. [ABSTRACT FROM AUTHOR]

Herpes simplex virus type I (HSV-1) infection causes inflammation in the cornea known as herpes simplex virus keratitis (HSK), a common but serious corneal disease. It is not entirely clear whether the virus during recurring infection comes from the trigeminal ganglia or the eye tissue, including the retina and ciliary ganglion. Because the tree shrew is closely related to primates and tree shrew eye anatomic structures are similar to humans, we studied HSV-1 corneal infection in the tree shrew. We found that HSK symptoms closely mimic those found in human HSK showing typical punctiform and dendritic viral keratitis during the acute infection period. Following the HSV-specific lesions, complications such as stromal scarring, corneal thickening (primary infection), opacity, and neovascularization were observed. In the tree shrew model, following ocular inoculation, the cornea becomes infected, and viral protein can be detected using anti-HSV-1 antibodies in the epithelial layer and retina neuronal ganglion cells. The HSV-1 transcripts, ICP0, ICP4, and LAT can be detected at 3 days post-infection (dpi), peaking at 5 dpi. After 2 weeks, ICP4 and ICP0 transcripts are reduced to a basal level, but the Latency Associated Transcripts (LATs) continue to accumulate. Interestingly, after the acute infection, we still detected abundant active HSV-1 in tree shrew eyes. Further, we found HSV-1 persistent in the ciliary ganglion and cornea. These findings are discussed in support of the tree shrew as a non-human primate HSK model, which could be useful for mechanistic studies of HSK. [ABSTRACT FROM AUTHOR]

The ciliary ganglion is of outmost physiological importance, due to its involvement in pupillary light reflex circuits. The ciliary ganglion may be damaged during surgical procedures. Therefore, the aim of the study was to examine the anatomical variations of the ganglion with an emphasis in location in the orbit. Anatomical variations of the parasympathetic root of the ganglion were also examined and classified. 40 orbits were dissected. The orbital content was removed en bloc. The lateral rectus muscle was detached from its insertion and reflected. After the removal of the orbital fat, the ciliary ganglion was visualized. Then, the morphology, roots and location of the ganglion were assessed. The location of the ciliary ganglion varied from 17 to 83.7% (mean = 51.4%, median = 53%, SD 14.8%) of the distance between the point of the optic nerve emerging from the eyeball and the common tendinous ring (counting from the front). In most cases (55%) it was found between 50.1 and 75% of the distance between the back of the eye and the common tendinous ring, while in 37.5% of cases it was found between 25 and 50% of this distance. The parasympathetic root of the ciliary ganglion was variable. Its origin was from the nerve to the inferior oblique muscle in most of cases. In four cases (10%), the parasympathetic root of the ciliary ganglion was duplicated. The ciliary ganglion occupies a variable position with regards to the optic nerve. The parasympathetic root of the ganglion may be unusually short or doubled. [ABSTRACT FROM AUTHOR]

In chicks, axial length and choroidal thickness undergo circadian oscillations. The choroid is innervated by both branches of the autonomic nervous system, but their contribution(s) to these rhythms is unknown. We used two combination lesions to test this. For parasympathectomy, nerve VII was sectioned presynaptic to the pterygopalatine ganglia, and the ciliary post-ganglionics were cut (double lesion; n = 8). Triple lesions excised the sympathetic superior cervical ganglion as well (n = 8). Sham surgery was done in controls (n = 7). 8-14 days later, axial dimensions were measured with ultrasonography at 4-h intervals over 24 h. Rhythm parameters were assessed using a "best fit" function, and growth rates measured. Both types of lesions resulted in ultradian (> 1 cycle/24 h) rhythms in choroidal thickness and axial length, and increased vitreous chamber growth (Exp-fellow: double: 69 µm; triple: 104 µm; p < 0.05). For double lesions, the frequency was 1.5 cycles/day for both rhythms; for triples the choroidal rhythm was 1.5 cycles/day, and the axial was 3 cycles/day. For double lesions, the amplitudes of both rhythms were larger than those of sham surgery controls (axial: 107 vs 54 µm; choroid: 124 vs 29 µm, p < 0.05). These findings provide evidence for the involvement of abnormal ocular rhythms in the growth stimulation underlying myopia development. [ABSTRACT FROM AUTHOR]

The ganglion cardiacum or juxtaductal body is situated along the left recurrent laryngeal nerve in the aortic window and is an extremely large component of the cardiac nerve plexus. This study was performed to describe the morphologies of the ganglion cardiacum or juxtaductal body in human fetuses and to compare characteristics with intracardiac ganglion. Ganglia were immunostained in specimens from five fetuses of gestational age 12-16 weeks and seven fetuses of gestational age 28-34 weeks. Many ganglion cells in the ganglia were positive for tyrosine hydroxylase (TH; sympathetic nerve marker) and chromogranin A, while a few neurons were positive for neuronal nitric oxide synthase (NOS; parasympathetic nerve marker) or calretinin. Another ganglion at the base of the ascending aorta carried almost the same neuronal populations, whereas a ganglion along the left common cardinal vein contained neurons positive for chromogranin A and NOS but no or few TH-positive neurons, suggesting a site-dependent difference in composite neurons. Mixtures of sympathetic and parasympathetic neurons within a single ganglion are consistent with the morphology of the cranial base and pelvic ganglia. Most of the intracardiac neurons are likely to have a non-adrenergic non-cholinergic phenotype, whereas fewer neurons have a dual cholinergic/noradrenergic phenotype. However, there was no evidence showing that chromogranin A- and/or calretininpositive cardiac neurons corresponded to these specific phenotypes. The present study suggested that the ganglion cardiacum was composed of a mixture of sympathetic and parasympathetic neurons, which were characterized the site-dependent differences in and near the heart. [ABSTRACT FROM AUTHOR]

Alternative splicing results in production of four agrin proteins (agrin0, agrin8, agrin11, and agrin19) with different AChR aggregating activities. However, the cellular origin of mRNAs encoding each agrin isoform remains unknown. Using single-cell PCR, we demonstrate that in the chick ciliary ganglion, nonneuronal cells express only mRNA encoding agrin0, whereas neurons express one or any combination of agrin mRNAs. Moreover, significant differences were observed between the agrin mRNA profiles of ciliary and choroid neurons in the ganglion. The abundance of each agrin mRNA, the fraction of neurons expressing each transcript, and the combinations of transcripts expressed by neurons also change during development. Our results demonstrate that transcripts encoding agrin proteins with high AChR aggregating activity are expressed exclusively by neurons in the ciliary ganglion and that alternative splicing of agrin mRNA is regulated during development and in a cell-specific manner.

In Malpolon monspessulana, the nervus oculomotorius arises from the ventral side of the pars peduncularis mesencephali of the midbrain by a single root. It runs closely applied to both the nervus abducens and the ramus nasalis of the nervus trigeminus. These nerves together with the nervus trochlearis leave the cranial cavity through the foramen orbitale magnum. Within this foramen the nervus oculomotorius divides into two rami: superior and inferior. The two rami innervate the rectus superior, rectus inferior, rectus medialis and the obliquus inferior muscles. The nervus trochlearis arises from the lateral side of the mesencephalon by a single root and passes to innervate the obliquus superior muscle. The nervus abducens arises from the ventral side of the medulla oblongata by a single root and passes for a distance through the vidian canal excavated in the parachordal cartilage. It innervates the rectus lateralis muscle. The eye muscle nerves carry special somatic motor fibres. The ciliary ganglion receives the preganglionic parasympathetic fibres from the ramus inferior of the nervus oculomotorius via the radix ciliaris brevis. Both the radix ciliaris longa and sympathetic root are absent. The ciliary ganglion is a well defined mass located in the postorbital region, irregular in shape formed of one type of neuron and gives off only one ciliary nerve.

Myo/Nog cells, named for their expression of MyoD and noggin, enter the eye during early stages of embryonic development. Their release of noggin is critical for normal morphogenesis of the lens and retina. Myo/Nog cells are also present in adult eyes. Single nucleated skeletal muscle cells designated as myofibroblasts arise from Myo/Nog cells in cultures of lens tissue. In this report we document the presence of Myo/Nog cells in the lens, ciliary body and on the zonule of Zinn in mice, rabbits and humans. Myo/Nog cells were rare in all three structures. Their prevalence increased in the lens and ciliary body of rabbits 24 h following cataract surgery. Rabbits developed posterior capsule opacification (PCO) within one month of surgery. The number of Myo/Nog cells continued to be elevated in the lens and ciliary body. Myo/Nog cells containing alpha smooth muscle actin and striated muscle myosin were present on the posterior capsule and overlaid deformations in the capsule. Myo/Nog cells also were present on the zonule fibers and external surface of the posterior capsule. These findings suggest that Myo/Nog contribute to PCO and may use the zonule fibers to migrate between the ciliary processes and lens. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract: Importance: Consideration of age‐related changes in macular ganglion cell‐inner plexiform layer (mGCIPL) thickness are important for glaucoma progression analysis. Background: To report age‐related changes in and the determinants of high‐definition optical coherence tomography (HD‐OCT) measurements of mGCIPL thickness. Design: Cross‐sectional study. Participants: 326 healthy adults. Methods: All subjects underwent Cirrus HD‐OCT measurements of mGCIPL. One‐way analysis of variance (ANOVA) was used to compare mGCIPL thickness between 7 decades based age groups and macular sectors. Multiple regression analysis determined the association between mGCIPL thickness and age, gender, intraocular pressure (IOP), peripapillary retinal nerve fibre layer thickness (pRNFL) and spherical equivalent. Main Outcome Measures: Change in mGCIPL thickness and determinants of thickness. Results: Mean mGCIPL thickness in 295 subjects was 80.80 ± 6.42 μm. Mean mGCIPL decreased by 0.12 μm (95% CI [confidence interval], 0.09–0.16) with every year of age; 1.61 μm (95% CI, 0.08–2.41) per decade. It showed two steep declines with age, first in the fifth and next in the seventh decade with relative stability between them. mGCIPL thickness was associated with pRNFL thickness (β = 0.30, P < 0.001) and IOP (β = −0.19, P = 0.03) but not with gender (β = −1.09, P = 0.116) or spherical equivalent (β = −0. 24, P = 0.145). Conclusions and Relevance: Mean mGCIPL thickness showed a small age‐related linear decrease with two steep drops in the fifth and seventh decades. Thinner mGCIPL was independently associated with age, thinner pRNFL and higher IOP. These factors should be considered if using mGCIPL to detect progression of glaucoma and other optic neuropathies characterized by the loss of retinal ganglion cells. [ABSTRACT FROM AUTHOR]

Introduction: Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is characterized by bladder distension without urinary tract obstruction, decreased or absent intestinal peristalsis and microcolon. Although the definitive cause remains unknown, changes in the ACTG2 gene are thought to be responsible for the intestinal and bladder hypoperistalsis. Case report: This female newborn with MMIHS had a c.532C>A /p.Arg178Ser heterozygous de novo mutation detected in the ACTG2 gene. Normal immature ganglion cells, normal calretinin punctate positivity, maintence of smooth muscle actin immunoreactivity, and decreased numbers of interstitial cells of Cajal(ICCs) were detected. Conclusion: This previously unreported c.532C>A /p.Arg178Ser heterozygous de novo mutation in the ACTG2 gene may lead to a severe form of MMIHS. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the usefulness of 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (SHINKEI) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).Methods: This institutional review board-approved retrospective study included 14 CIDP patients and nine normal subjects. The signal-to-noise ratio (SNR), contrast ratio (CR), and the size of the cervical ganglions and roots were measured by two raters.Results: The SNRs of the ganglions and roots were larger in patients with CIDP (9.55 ± 3.87 and 9.81 ± 3.64) than in normal subjects (7.21 ± 2.42 and 5.70 ± 2.14, P < 0.0001, respectively). The CRs of the ganglions and roots were larger in patients with CIDP (0.77 ± 0.08 and 0.68 ± 0.12) than in normal subjects (0.72 ± 0.07 and 0.53 ± 0.11, P < 0.0001, respectively). The sizes of the ganglions and the roots were larger in patients with CIDP (6.44 ± 1.61 mm and 4.89 ± 1.94 mm) than in normal subjects (5.24 ± 1.02 mm and 3.39 ± 0.80 mm, P < 0.0001, respectively).Conclusions: Patients with CIDP could be distinguished from controls on 3D SHINKEI.Key Points: • 3D SHINKEI could visualize brachial plexus with high spatial resolution. • CIDP patients showed increased SNR, CR, and the size of brachial plexus. • 3D SHINKEI could discriminate CIDP patients from normal subjects. [ABSTRACT FROM AUTHOR]

Background Photophobia is defined as a painful psychosomatic discomfort triggered by intense light flow through the pupils to the brain, but the exact mechanism through which photophobia is induced by subarachnoid hemorrhage (SAH) is not well understood. In this study, we aimed to investigate whether there was any relationship between the mydriasis induced by the degeneration of the ciliary ganglion (CG) and photophobia in instances of SAH. Materials and methods Five of a total of 25 rabbits were used as the intact control group; five were used in the sham-operated control group; and the remaining 15 were used as the SAH group, which was created by injecting autologous blood into their cisterna magna. All animals were examined daily for 20 days to evaluate their level of photophobia, after which their brains, CGs and superior cervical ganglia (SCGs) were extracted bilaterally. The densities of normal and degenerated neurons in these ganglia were examined by stereological methods. Results In SAH animals with a high photophobia score, the mean pupil diameter and density of degenerated neurons density in the CG were greater than in cases with a low photophobia score ( p < 0.05). Further analysis revealed that the increase in the density of degenerated neurons in the CG following SAH resulted in the paralysis of the parasympathetic pathway of the pupillary muscles and mydriasis, which facilitates the excessive transfer of light to the brain and photophobia. Conclusion Our findings indicate that SAH results in a high density of degenerated neurons in the CG, which induces mydriasis and is an important factor in the onset of photophobia. This phenomenon is likely due to more light energy being transferred through mydriatic pupils to the brain, resulting in vasospasm of the supplying arteries. [ABSTRACT FROM AUTHOR]

We reveal the neuroanatomy of the optic ganglia and central brain in the water flea Daphnia magna by use of classical neuroanatomical techniques such as semi-thin sectioning and neuronal backfilling, as well as immunohistochemical markers for synapsins, various neuropeptides and the neurotransmitter histamine. We provide structural details of distinct neuropiles, tracts and commissures, many of which were previously undescribed. We analyse morphological details of most neuron types, which allow for unravelling the connectivities between various substructural parts of the optic ganglia and the central brain and of ascending and descending connections with the ventral nerve cord. We identify 5 allatostatin-A-like, 13 FMRFamide-like and 5 tachykinin-like neuropeptidergic neuron types and 6 histamine-immunoreactive neuron types. In addition, novel aspects of several known pigment-dispersing hormone-immunoreactive neurons are re-examined. We analyse primary and putative secondary olfactory pathways and neuronal elements of the water flea central complex, which displays both insect- and decapod crustacean-like features, such as the protocerebral bridge, central body and lateral accessory lobes. Phylogenetic aspects based upon structural comparisons are discussed as well as functional implications envisaging more specific future analyses of ecotoxicological and endocrine disrupting environmental chemicals. [ABSTRACT FROM AUTHOR]

Adie’s pupil is characterised by pupil dilatation, segmental iris palsy, light-near dissociation, and slow re-dilatation. Most commonly, tonic pupils are unilateral and idiopathic, but can be caused by orbital disorders and autonomic neuropathies. There are only a few case reports of tonic pupils in patients with Sjögren’s syndrome, caused by an autoimmune ciliary ganglionitis. The authors report on two cases with bilateral tonic pupils as the initial manifestation of primary Sjögren’s syndrome. Both patients presented with blurred vision, bilateral tonic pupils, and sicca symptoms. The findings suggest that Sjögren’s syndrome should be considered in patients presenting with bilateral Adie’s tonic pupils. [ABSTRACT FROM PUBLISHER]

Motile cilia of the lungs respond to environmental challenges by increasing their ciliary beat frequency in order to enhance mucociliary clearance as a fundamental tenant of innate defense. One important second messenger in transducing the regulable nature of motile cilia is cyclic guanosine 3',5'-monophosphate (cGMP). In this review, the history of cGMP action is presented and a survey of the existing data addressing cGMP action in ciliary motility is presented. Nitric oxide (NO)-mediated regulation of cGMP in ciliated cells is presented in the context of alcohol-induced cilia function and dysfunction. [ABSTRACT FROM AUTHOR]

Conservation of a patient's residual hearing and prevention of fibrous tissue/new bone formation around an electrode array are some of the major challenges in cochlear implant (CI) surgery. Although it is well-known that fibrotic tissue formation around the electrode array can interfere with hearing performance in implanted patients, and that associated intracochlear inflammation can initiate loss of residual hearing, little is known about the molecular and cellular mechanisms that promote this response in the cochlea. In vitro studies in neonatal rats and in vivo studies in adult mice were performed to gain insight into the pro-inflammatory, proliferative, and remodeling phases of pathological wound healing that occur in the cochlea following an electrode analog insertion. Resident Schwann cells (SC), macrophages, and fibroblasts had a prominent role in the inflammatory process in the cochlea. Leukocytes were recruited to the cochlea following insertion of a nylon filament in adult mice, where contributed to the inflammatory response. The reparative stages in wound healing are characterized by persistent neuro-inflammation of spiral ganglion neurons (SGN) and expression of regenerative monocytes/macrophages in the cochlea. Accordingly, genes involved in extracellular matrix (ECM) deposition and remodeling were up-regulated in implanted cochleae. Maturation of scar tissue occurs in the remodeling phase of wound healing in the cochlea. Similar to other damaged peripheral nerves, M2 macrophages and de-differentiated SC were observed in damaged cochleae and may play a role in cell survival and axonal regeneration. In conclusion, the insertion of an electrode analog into the cochlea is associated with robust early and chronic inflammatory responses characterized by recruitment of leukocytes and expression of pro-inflammatory cytokines that promote intracochlear fibrosis and loss of the auditory hair cells (HC) and SGN important for hearing after CI surgery. [ABSTRACT FROM AUTHOR]

Granular cell tumour (GCT) is mostly benign lesion first described by Abrikossoff and named after him. Most cases are reported in the head and neck area, where the tongue is the most common site. Here we review previous cases in the literature for GCT in the orbit and present a new case. A 49-year-old male presented with apparent exophthalmos. Examination of the patient revealed the presence of a mass in the bottom side of the orbit. A substantial progress was noted after two months from the initial examination using computed tomography (CT) scan. An orbital mass was extracted and histological analysis showed signs typical for GCT. Immunohistochemistry was positive for S-100; the biopsy showed no mitotic or necrotic areas. Proptosis was resolved after surgery and a six-year follow-up CT scan was performed. We conclude that rapid progress of the tumour does not necessarily suggest malignancy. [ABSTRACT FROM AUTHOR]

In Malpolon monspessulana , the nervus oculomotorius arises from the ventral side of the pars peduncularis mesencephali of the midbrain by a single root. It runs closely applied to both the nervus abducens and the ramus nasalis of the nervus trigeminus. These nerves together with the nervus trochlearis leave the cranial cavity through the foramen orbitale magnum. Within this foramen the nervus oculomotorius divides into two rami: superior and inferior. The two rami innervate the rectus superior, rectus inferior, rectus medialis and the obliquus inferior muscles. The nervus trochlearis arises from the lateral side of the mesencephalon by a single root and passes to innervate the obliquus superior muscle. The nervus abducens arises from the ventral side of the medulla oblongata by a single root and passes for a distance through the vidian canal excavated in the parachordal cartilage. It innervates the rectus lateralis muscle. The eye muscle nerves carry special somatic motor fibres. The ciliary ganglion receives the preganglionic parasympathetic fibres from the ramus inferior of the nervus oculomotorius via the radix ciliaris brevis. Both the radix ciliaris longa and sympathetic root are absent. The ciliary ganglion is a well defined mass located in the postorbital region, irregular in shape formed of one type of neuron and gives off only one ciliary nerve. [ABSTRACT FROM AUTHOR]