Abstract
Elevated intraocular pressure (IOP) is the primary risk factor for blindness in glaucoma. IOP is determined by many factors including aqueous humour production and aqueous humour outflow (AHO), where AHO disturbance represents the primary cause of increased IOP. With the recent development of new IOP lowering drugs and Minimally Invasive Glaucoma Surgeries (MIGS), renewed interest has arisen in shedding light on not only how but where AHO is occurring for the trabecular/conventional, uveoscleral/unconventional, and subconjunctival outflow pathways. Historical studies critical to understanding outflow anatomy will be presented, leading to the development of modern imaging methods. New biological behaviours uncovered by modern imaging methods will be discussed with relevance to glaucoma therapies emphasized.
摘要
升高的眼内压 (intraocular pressure, IOP)是青光眼致盲的首要危险因素。IOP取决于房水产生及房水流出 (aqueous humour outflow, AHO) 等诸多因素, 其中AHO障碍为导致IOP升高的首要原因。随着近年来新的降眼压药及青光眼微创手术 (Minimally Invasive Glaucoma Surgeries, MIGS) 的发展, 人们不仅对对阐明小梁/传统、葡萄膜巩膜/非传统和结膜下流出道的AHO方式也对其部位产生了新的兴趣。历史研究的关键是阐明流出通道解剖, 为现代影像技术发展奠定基础。本文将讨论青光眼治疗与现代影像学方法所揭示的新的生物学行为的相关性。
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Acknowledgements
This work was supported by China Scholarship Council Grant (#201808110001), Capital Characteristic Clinic Project of Beijing (Z18110000171808) [XX]; NIH NEI R01EY030501 [ASH], R21EY026260 [YH]; Qindao Benefit People Demonstration Guide Special Project 20-3-4-39-nsh [XP]; Glaucoma Research Foundation Shaffer Grant [ASH]; Research to Prevent Blindness Career Development Award 2016 [ASH]; an unrestricted grant from Research to Prevent Blindness [UCLA]; Japan Society for the Promotion of Science (JP18K16972) [GA]. The sponsors or funding organizations had no role in this manuscript. ASH is a consultant for (Allergan, Santen, Gore, and Aerie), he has received research support from (Heidelberg Engineering, Glaukos, and Diagnosys), he has received speaker fees from (Heidelberg Engineering, Glaukos, and Santen). The remaining authors have no financial disclosures.
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Lee, J.Y., Akiyama, G., Saraswathy, S. et al. Aqueous humour outflow imaging: seeing is believing. Eye 35, 202–215 (2021). https://doi.org/10.1038/s41433-020-01215-0
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