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Variations in active outflow along the trabecular outflow pathway.

Elliott D K Cha1, Jia Xu1, Lihua Gong2

  • 1Boston University School of Medicine, Department of Ophthalmology Boston, MA, USA.

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|January 18, 2016
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Summary

The study reveals that the segmented pattern of aqueous humor outflow is maintained in distal pathways, including the trabecular meshwork (TM), inner wall (IW) of Schlemm

Keywords:
Collector channelsConfocal microscopyEpiscleral veinsImagingSchlemm's canalSegmental outflowTrabecular meshwork

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Area of Science:

  • Ophthalmology
  • Fluid Dynamics
  • Anatomy

Background:

  • Previous studies identified segmental outflow in the trabecular meshwork (TM) and inner wall (IW) of Schlemm's canal (SC).
  • The conservation of this segmented outflow pattern in more distal pathways remained uninvestigated.

Purpose of the Study:

  • To investigate if the segmented outflow pattern persists in distal outflow pathways using a novel global imaging technique.
  • To evaluate variations in active aqueous humor outflow across three distinct regions of the trabecular outflow pathway.

Main Methods:

  • Six human eyes were perfused to establish baseline outflow facility.
  • Fluorescent microspheres were used to label areas of active outflow.
  • Global en face imaging of the TM and episcleral veins (EPVs), followed by detailed analysis of effective filtration area (EFA) and tracer distribution.

Main Results:

  • A segmental outflow pattern was observed in all three locations: TM, IW, and EPVs.
  • The TM exhibited a significantly higher mean EFA (86.3%) compared to IW (34.7%) and EPVs (41.1%).
  • Active outflow was preferentially located in the nasal and inferior quadrants, correlating with increased TM thickness and a higher number of collector channels (CCs).

Conclusions:

  • The segmented nature of aqueous humor outflow is conserved throughout the trabecular outflow pathway, including distal locations.
  • Preferential outflow in nasal and inferior quadrants is associated with anatomical variations in the TM and CCs.
  • These findings establish a baseline for understanding outflow pathway alterations in conditions like glaucoma.