Structure, function and innervation of ciliary muscle
LYU Xiaoli1,2 TAO Jinhua1 MIAO Wanhong1
1.Department of Ophthalmology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200120, China;
2.Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Province, Hangzhou 310005, China
Abstract：The structure and function of ciliary muscle are related to the occurrence and development of many ophthalmic diseases, such as anterior rotation, hypertrophy of ciliary muscle are associated with glaucoma， vitreous body movement driven by ciliary muscle contraction is related to vitreoretinal interface diseases such as idiopathic macular membrane and idiopathic macular hole, the excessive and insufficient function of ciliary muscle can lead to the occurrence of visual fatigue. At the same time, the structure and function of ciliary muscle are also affected by local and systemic factors, such as local eye injury can lead to ciliary body edema, brain injury can lead to ciliary muscle spasm and psychological factors can also affect the function of ciliary muscle. These factors can directly affect the peripheral ciliary muscle to cause structural and functional abnormalities, and can also affect the functional state of the ciliary muscle through the central nerve innervation. Therefore, a deep understanding of the structure and innervation of ciliary muscle is of great significance for the diagnosis and treatment of clinical diseases and research in related fields. This paper aims to summarize ciliary muscle structure and function, focusing on ciliary muscle level, the midbrain Edinger-Westphal nuclear level and the supra nuclear level, describe the general situation of ciliary muscle nerve innervation.
[1] 葛坚，王宁利.眼科学[M].3版.北京：人民卫生出版社，2015：66-68.
[2] Khan A，Pope JM，Verkicharla PK，et al. Change in human lens dimensions，lens refractive index distribution and ciliary body ring diameter with accommodation [J]. Biomed Opt Express，2018，9（3）：1272-1282.
[3] Chang YC，Liu K，Cabot F，et al. Variability of manual ciliary muscle segmentation in optical coherence tomography images [J]. Biomed Opt Express，2018，9（2）：791-800.
[4] Wagner S，Schaeffel F，Zrenner E，et al. Prolonged nearwork affects the ciliary muscle morphology [J]. Exp Eye Res，2019，186：107741.
[5] Domínguez-Vicent A，Monsálvez-Romín D，Esteve-Taboada JJ，et al. Effect of age in the ciliary muscle during accommodation：Sectorial analysis [J]. J Optom，2019，12（1）：14-21.
[6] Mao Y，Bai HX，Li B，et al. Dimensions of the ciliary muscles of Brücke，Müller and Iwanoff and their associations with axial length and glaucoma [J]. Graefes Arch Clin Exp Ophthalmol，2018，256（11）：2165-2171.
[7] Park CY，Lee JK，Kahook MY，et al. Revisiting ciliary muscle tendons and their connections with the trabecular meshwork by two photon excitation microscopic imaging [J]. Invest Ophthalmol Vis Sci，2016，57（3）：1096-1105.
[8] May C. Morphologic characteristics of the human ciliary muscle [J]. New Front Ophthalmol，2017：3.
[9] Flügel-Koch CM，Croft MA，Kaufman PL，et al. Anteriorly located zonular fibres as a tool for fine regulation in accommodation [J]. Ophthalmic Physiol Opt，2016，36（1）：13-20.
[10] Flügel-Koch C，Neuhuber WL，Kaufman PL，et al. Morphologic indication for proprioception in the human ciliary muscle [J]. Invest Ophthalmol Vis Sci，2009，50（12）：5529-5536.
[11] Ruggeri M，de Freitas C，Williams S，et al. Quantification of the ciliary muscle and crystalline lens interaction during accommodation with synchronous OCT imaging [J].Biomed Opt Express，2016，7（4）：1351-1364.
[12] Croft MA，Lütjen-Drecoll E，Kaufman PL. Age-related posterior ciliary muscle restriction–A link between trabecular meshwork and optic nerve head pathophysiology [J]. Exp Eye Res，2017，158：187-189.
[13] Neuhuber W，Schr?觟dl F. Autonomic control of the eye and the iris [J]. Auton Neurosci，2011，165（1）：67-79.
[14] Ikeda N，Ikeda T，Kohno T. Traumatic myopia secondary to ciliary spasm after blunt eye trauma and reconsideration of its pathogenesis [J]. Graefes Arch Clin Exp Ophthalmol，2016，254（7）：1411-1417.
[15] Esteve-Taboada JJ，?譧guila-Carrasco D，Antonio J，et al. Effect of phenylephrine on the accommodative system [J]. J Ophthalmol，2016，2016：1-13.
[16] Zhang J，Ni Y，Li P，et al. Anterior Segment Biometry with Phenylephrine and Tropicamide during Accommodation Imaged with Ultralong Scan Depth Optical Coherence Tomography [J]. J Ophthalmol，2019：6827215.
[17] Randhawa P. Pharmacological and physiological manipulation of ocular accommodation [D]. Birmingham：Aston University，2017.
[18] Chen Y，Shi Z，Shen Y. Eye damage due to cosmetic ultrasound treatment：a case report [J]. BMC Ophthalmol，2018，18（1）：214.
[19] Gualdi L，Gualdi F，Rusciano D，et al. Ciliary muscle electrostimulation to restore accommodation in patients with early presbyopia：Preliminary results [J]. J Refract Surg，2017，33（9）：578-583.
[20] Heermann S. Neuroanatomy of the Oculomotor System [J]. Klin Monbl Augenheilkd，2017，234（11）：1327-1343.
[21] Richter HO，Lee JT，Pardo JV. Neuroanatomical correlates of the near response：Voluntary modulation of accommodation/vergence in the human visual system [J]. Eur J Neurosci，2000，12（1）：311-321.
[22] Agarwal M，Ulmer JL，Chandra T，et al. Imaging correlates of neural control of ocular movements [J]. Eur Radiol，2016，26（7）：2193-2205.
[23] May PJ，Billig I，Gamlin P，et al. Central mesencephalic reticular formation control of the near response：lens accommodation circuits [J]. J Neurophysiol，2019，121（5）：1692-1703.
[24] May PJ，Warren S，Bohlen MO，et al. A central mesencephalic reticular formation projection to the Edinger-Westphal nuclei [J]. Brain Struct Funct，2016，221（8）：4073-4089.
[25] Marin-Franch I，Del Aguila-Carrasco AJ，Bernal-Molina P，et al. There is more to accommodation of the eye than simply minimizing retinal blur [J]. Biomed Opt Express，2017，8（10）：4717-4728.
[26] May PJ，Reiner A，Gamlin PD. Autonomic Regulation of the Eye [M]. Oxford Research Encyclopedia of Neuroscience，2019.
[27] Sander BP. The influence of the autonomic nervous system on the human choroid [D]. Brisbane：Queensland University of Technology，2017：48.
[28] Ostrin LA，Glasser A. Autonomic drugs and the accommodative system in rhesus monkeys [J]. Exp Eye Res，2010，90（1）：104-112.
[29] Del águila-Carrasco AJ，Lara F，Bernal-Molina P，et al. Effect of phenylephrine on static and dynamic accommodation [J]. J Optom，2019，12（1）：30-37.
[30] Hughes FE，Treacy MP，Duignan ES，et al. Persistent pseudomyopia following a whiplash injury in a previously emmetropic woman [J]. Am J Ophthalmol Case Rep，2017， 8：28-30.
[31] Padula WV，Capo-Aponte JE，Padula WV，et al. The consequence of spatial visual processing dysfunction caused by traumatic brain injury （TBI） [J]. Brain Inj，2017， 31（5）：589-600.
[32] May PJ，Warren S，Gamlin PDR，et al. An Anatomic Characterization of the Midbrain Near Response Neurons in the Macaque Monkey [J]. Invest Ophthalmol Vis Sci，2018，59（3）：1486-1502.
[33] Cléry J，Guipponi O，Odouard S，et al. Cortical networks for encoding near and far space in the non-human primate [J]. Neuroimage，2018，176：164-178.
[34] Krauzlis RJ，Goffart L，Hafed ZM. Neuronal control of fixation and fixational eye movements [J]. Philos Trans R Soc Lond B Biol Sci，2017，372（1718）. pii：20160205.
[35] Richter HO，Forsman M，Elcadi GH，et al. Corrigendum：Prefrontal Cortex Oxygenation Evoked by Convergence Load Under Conflicting Stimulus-to-Accommodation and Stimulus-to-Vergence Eye-Movements Measured by NIRS [J]. Front Hum Neurosci，2018，12：298.
2020, Vol. 17 
京公网安备 11010502046598号