Aqueous Humor Outflow Structure and Function Imaging At the Bench and Bedside: A Review

Anterior segment glaucoma clinical care and research has recently gained new focus because of novel imaging modalities and the advent of angle-based surgical treatments. Traditional investigation drawn to the trabecular mesh work now emphasizes the entire conventional aqueous humor outflow (AHO) pathway from the anterior chamber to the episcleral vein. AHO investigation can be divided into structural and functional assessments using different methods. 

The historical basis for studying the anterior segment of the eye and AHO in glaucoma is discussed. Structural studies of AHO are reviewed and include traditional pathological approaches to modern tools such as multi-model two-photon microscopy and optical coherence tomography. Functional assessment focuses on visualizing AHO itself through a variety of non-real-time and real-time techniques such as aqueous angiography. Implications of distal outflow resistance and segmental AHO are discussed with an emphasis on melding bench-side research to viable clinical applications. 

These are the proteins in humans that are associated with Cross-Linked Actin Networks in Trabecular Meshwork Cells

The majority of the aqueous humor, which is produced by the ciliary body, is drained through the conventional outflow pathway. In this pathway, the aqueous humor flows from the posterior chamber to anterior chamber and exits the eye through the trabecular mesh work(TM), a multilayered tissue in the iridocorneal angle of the eye.

In primary open angle glaucoma (POAG), glucocorticoid-induced ocular hypertension (GC-OHT), and glucocorticoid induced glaucoma (GIG), the outflow resistance at the TM is increased, which causes intraocular pressure (IOP) elevation. Elevated IOP is the major risk factor for the development and progression of glaucoma that leads to irreversible visual loss that can cause blindness. 

Aqueous Humor Outflow Structure and Function Imaging At the Bench and Bedside: A Review

Anterior segment glaucoma clinical care and research has recently gained new focus because of novel imaging modalities and the advent of angle-based surgical treatments. Traditional investigation drawn to the trabecular mesh work now emphasizes the entire conventional aqueous humor outflow (AHO) pathway from the anterior chamber to the episcleral vein. AHO investigation can be divided into structural and functional assessments using different methods. 

The historical basis for studying the anterior segment of the eye and AHO in glaucoma is discussed. Structural studies of AHO are reviewed and include traditional pathological approaches to modern tools such as multi-model two-photon microscopy and optical coherence tomography. Functional assessment focuses on visualizing AHO itself through a variety of non-real-time and real-time techniques such as aqueous angiography. Implications of distal outflow resistance and segmental AHO are discussed with an emphasis on melding bench-side research to viable clinical applications.