Silicone Wire Embolization-induced Acute Retinal Artery Ischemia and Reperfusion Model in Mouse: Gene Expression Provide Insight into Pathological Processes

Reviewer #1 (Public Review):

Summary:

Wang, Y. et al. used a silicone wire embolus to definitively and acutely clot the pterygopalatine ophthalmic artery in addition to carotid artery ligation to completely block the blood supply to the mouse inner retina, which mimics clinical acute retinal artery occlusion. A detailed characterization of this mouse model determined the time course of inner retina degeneration and associated functional deficits, which closely mimic human patients. Whole retina transcriptome profiling and comparison revealed distinct features associated with ischemia, reperfusion, and different model mechanisms. Interestingly and importantly, this team found a sequential event including reperfusion-induced leukocyte infiltration from blood vessels, residual microglial activation, and neuroinflammation that may lead to neuronal cell death.

Strengths:

Clear demonstration of the surgery procedure with informative illustrations, images, and superb surgical videos.

Two-time points of ischemia and reperfusion were studied with convincing histological and in vivo data to demonstrate the time course of various changes in retinal neuronal cell survivals, ERG functions, and inner/outer retina thickness.

The transcriptome comparison among different retinal artery occlusion models provides informative evidence to differentiate these models.

The potential applications of the in vivo retinal ischemia-reperfusion model and relevant readouts demonstrated by this study will certainly inspire further investigation of the dynamic morphological and functional changes of retinal neurons and glial cell responses during disease progression and before and after treatments.

Weaknesses:

It would be beneficial to the manuscript and the readers if the authors could improve the English of this manuscript by correcting obvious grammar errors, eliminating many of the acronyms that are not commonly used by the field, and providing a reason why this complicated but clever surgery procedure was designed and a summary table with the time course of all the morphological, functional, cellular, and transcriptome changes associated with this model.

Reviewer #2 (Public Review):

Summary:

The authors of this manuscript aim to develop a novel animal model to accurately simulate the retinal ischemic process in retinal artery occlusion (RAO). A unilateral pterygopalatine ophthalmic artery occlusion (UPOAO) mouse model was established using silicone wire embolization combined with carotid artery ligation. This manuscript provided data to show the changes in major classes of retinal neural cells and visual dysfunction following various durations of ischemia (30 minutes and 60 minutes) and reperfusion (3 days and 7 days) after UPOAO. Additionally, transcriptomics was utilized to investigate the transcriptional changes and elucidate changes in the pathophysiological process in the UPOAO model post-ischemia and reperfusion. Furthermore, the authors compared transcriptomic differences between the UPOAO model and other retinal ischemic-reperfusion models, including HIOP and UCCAO, and revealed unique pathological processes.

Strengths:

The UPOAO model represents a novel approach to studying retinal artery occlusion. The study is very comprehensive.

Weaknesses:

Some statements are incorrect and confusing. It would be helpful to review and clarify these to ensure accuracy and improve readability.

Author response:

eLife assessment:

The manuscript establishes a sophisticated mouse model for acute retinal artery occlusion (RAO) by combining unilateral pterygopalatine ophthalmic artery occlusion (UPOAO) with a silicone wire embolus and carotid artery ligation, generating ischemia-reperfusion injury upon removal of the embolus. This clinically relevant model is useful for studying the cellular and molecular mechanisms of RAO. The data overall are solid, presenting a novel tool for screening pathogenic genes and promoting further therapeutic research in RAO.

Thank you for recognizing the sophistication and clinical relevance of our mouse model for acute retinal artery occlusion. We are grateful for your supportive feedback.

Public Reviews:

Reviewer #1:

Summary:

Wang, Y. et al. used a silicone wire embolus to definitively and acutely clot the pterygopalatine ophthalmic artery in addition to carotid artery ligation to completely block the blood supply to the mouse inner retina, which mimics clinical acute retinal artery occlusion. A detailed characterization of this mouse model determined the time course of inner retina degeneration and associated functional deficits, which closely mimic human patients. Whole retina transcriptome profiling and comparison revealed distinct features associated with ischemia, reperfusion, and different model mechanisms. Interestingly and importantly, this team found a sequential event including reperfusion-induced leukocyte infiltration from blood vessels, residual microglial activation, and neuroinflammation that may lead to neuronal cell death.

Strengths:

Clear demonstration of the surgery procedure with informative illustrations, images, and superb surgical videos.

Two-time points of ischemia and reperfusion were studied with convincing histological and in vivo data to demonstrate the time course of various changes in retinal neuronal cell survivals, ERG functions, and inner/outer retina thickness.

The transcriptome comparison among different retinal artery occlusion models provides informative evidence to differentiate these models.

The potential applications of the in vivo retinal ischemia-reperfusion model and relevant readouts demonstrated by this study will certainly inspire further investigation of the dynamic morphological and functional changes of retinal neurons and glial cell responses during disease progression and before and after treatments.

We sincerely appreciate your detailed and positive feedback. These evaluations are invaluable in highlighting the significance and impact of our work. Thank you for your thoughtful and supportive review.

Weaknesses:

It would be beneficial to the manuscript and the readers if the authors could improve the English of this manuscript by correcting obvious grammar errors, eliminating many of the acronyms that are not commonly used by the field, and providing a reason why this complicated but clever surgery procedure was designed and a summary table with the time course of all the morphological, functional, cellular, and transcriptome changes associated with this model.

Thank you for your thorough review of the manuscript. We sincerely apologize for any grammatical errors resulting from our English language proficiency and have taken the necessary steps to polish the article. Additionally, we have heeded your advice and reduced the use of field-specific acronyms to enhance readability for both the manuscript and its readers.

Regarding the rationale behind the design of the UPOAO model, we have provided a description in Introduction section. Our group focuses on the research of pathogenesis and clinical treatment for RAO. The absence of an accurate mouse model simulating the retinal ischemic process has hampered progress in developing neuroprotective agents for RAO. To better simulate the retinal ischemic process and possible ischemia-reperfusion injury following RAO, we developed a novel vascular-associated mouse model called the unilateral pterygopalatine ophthalmic artery occlusion (UPOAO) model. We drew inspiration from the widely employed middle cerebral artery occlusion (MCAO) model, commonly used in cerebral ischemic injury research, which guided the development of the UPOAO model.

We appreciate your valuable suggestion regarding the inclusion of a summary table outlining the time course of morphological, functional, cellular, and transcriptome changes associated with this model. To address this, we intend to include a supplementary table at the end of the article, which will offer a comprehensive overview of the experimental results, thereby aiding in clarity and interpretation.

Once again, we thank you for your insightful comments and suggestions, which have greatly contributed to the improvement of our manuscript.

Reviewer #2:

Summary:

The authors of this manuscript aim to develop a novel animal model to accurately simulate the retinal ischemic process in retinal artery occlusion (RAO). A unilateral pterygopalatine ophthalmic artery occlusion (UPOAO) mouse model was established using silicone wire embolization combined with carotid artery ligation. This manuscript provided data to show the changes in major classes of retinal neural cells and visual dysfunction following various durations of ischemia (30 minutes and 60 minutes) and reperfusion (3 days and 7 days) after UPOAO. Additionally, transcriptomics was utilized to investigate the transcriptional changes and elucidate changes in the pathophysiological process in the UPOAO model post-ischemia and reperfusion. Furthermore, the authors compared transcriptomic differences between the UPOAO model and other retinal ischemic-reperfusion models, including HIOP and UCCAO, and revealed unique pathological processes.

Strengths:

The UPOAO model represents a novel approach to studying retinal artery occlusion. The study is very comprehensive.

We greatly appreciate your positive assessment of our work and are encouraged by your recognition of its significance.

Weaknesses:

Some statements are incorrect and confusing. It would be helpful to review and clarify these to ensure accuracy and improve readability.

We sincerely appreciate your meticulous review of the manuscript. Taking into account your valuable feedback, we will thoroughly address the inaccuracies identified in the revised version. Additionally, we will commit to polishing the article to ensure improved readability. We apologize for any confusion caused by these inaccuracies and genuinely thank you for bringing them to our attention.