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Glymphatic transport and ocular diseases
Xiaowei Wang1, Christine Delle2, Maiken Nedergaard3
1Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
Progress in Retinal and Eye Research
|December 25, 2025
Summary
The ocular glymphatic system clears waste and fluid in the eye. Dysfunction in this system contributes to various blinding eye diseases, including glaucoma and age-related macular degeneration.
Area of Science:
- Ophthalmology
- Neuroscience
- Cellular Biology
Background:
- Retinal neurons have high metabolic demands requiring efficient waste and fluid clearance.
- A glymphatic-like system in the eye facilitates fluid exchange and waste removal.
- This ocular glymphatic system involves bidirectional flow along the optic nerve.
Purpose of the Study:
- To review key contributors to glymphatic system dysfunction in ocular diseases.
- To explore the role of glymphatic impairment in various blinding conditions.
- To provide a framework for future research on the glymphatic system in eye health.
Main Methods:
- Integration of findings from preclinical models.
- Analysis of clinically grounded hypotheses.
- Review of existing literature on glymphatic function and ocular disease.
Main Results:
- Key contributors to glymphatic dysfunction include impaired barriers, perivascular space issues, aquaporin-4 abnormalities, immature vasculature, and immune activation.
- Glymphatic impairment is implicated in glaucoma, diabetic retinopathy, and Alzheimer's disease models.
- Disrupted glymphatic flow is suspected in papilledema, spaceflight neuro-ocular syndrome, and Terson syndrome.
Conclusions:
- Glymphatic dysfunction is a significant factor in numerous ocular diseases.
- Understanding these mechanistic links is crucial for developing new therapeutic strategies.
- This review highlights the need for further research into the glymphatic system's role in preventing vision loss.
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