Unconventional aqueous humor outflow: A review
File(s)Unconventional Aqueous Humor Outflow FINAL.docx (7.78 MB)
Accepted version
Author(s)
Johnson, M
McLaren, JW
Overby, DR
Type
Journal Article
Abstract
Aqueous humor flows out of the eye primarily through the conventional outflow pathway that includes the trabecular meshwork and Schlemm's canal. However, a fraction of aqueous humor passes through an alternative or ‘unconventional’ route that includes the ciliary muscle, supraciliary and suprachoroidal spaces. From there, unconventional outflow may drain through two pathways: a uveoscleral pathway where aqueous drains across the sclera to be resorbed by orbital vessels, and a uveovortex pathway where aqueous humor enters the choroid to drain through the vortex veins. We review the anatomy, physiology and pharmacology of these pathways. We also discuss methods to determine unconventional outflow rate, including direct techniques that use radioactive or fluorescent tracers recovered from tissues in the unconventional pathway and indirect methods that estimate unconventional outflow based on total outflow over a range of pressures. Indirect methods are subject to a number of assumptions and generally give poor agreement with tracer measurements. We review the variety of animal models that have been used to study conventional and unconventional outflow. The mouse appears to be a promising model because it captures several aspects of conventional and unconventional outflow dynamics common to humans, although questions remain regarding the magnitude of unconventional outflow in mice. Finally, we review future directions. There is a clear need to develop improved methods for measuring unconventional outflow in both animals and humans.
Date Issued
2016-02-02
Date Acceptance
2016-01-26
Citation
EXPERIMENTAL EYE RESEARCH, 2016, 158 (May 2017), pp.94-111
ISSN
0014-4835
Publisher
ELSEVIER
Start Page
94
End Page
111
Journal / Book Title
EXPERIMENTAL EYE RESEARCH
Volume
158
Issue
May 2017
Copyright Statement
© 2016 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000401784400012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Ophthalmology
Aqueous humor dynamics
Trabecular
Uveoscleral
Uveovortex
Mouse
Primate
Tracers
Indirect
UVEAL EFFUSION SYNDROME
INCREASES UVEOSCLERAL OUTFLOW
MONKEY CERCOPITHECUS ETHIOPS
EPISCLERAL VENOUS-PRESSURE
NORMAL HUMAN-EYE
INTRAOCULAR-PRESSURE
CYNOMOLGUS MONKEY
TRABECULAR MESHWORK
MACACA-IRUS
CILIARY MUSCLE
Animals
Aqueous Humor
Humans
Intraocular Pressure
Limbus Corneae
Models, Animal
Sclera
Secretory Pathway
Trabecular Meshwork
Uvea
Ophthalmology & Optometry
1101 Medical Biochemistry And Metabolomics
1109 Neurosciences
1113 Ophthalmology And Optometry
Publication Status
Published