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[Advances in imaging techniques of the distal aqueous outflow pathway in glaucoma]
1Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Fifth Clinical Institute of Shantou University Medical College, GuangDong Engineering Technology Research Center of Precision Treatment for Ocular Diseases, Guangdong Engineering Research Center of Intelligent Diagnosis and Treatment for Ocular Diseases, Shantou Key Laboratory of Ocular Disease Prevention,Treatment, and Research, Shantou 515041, China.
Abstract:
The distal aqueous humor outflow pathway is an essential component of aqueous humor drainage and is closely associated with intraocular pressure control after minimally invasive glaucoma surgery (MIGS). However, in vivo assessment of its structure and function remains a major clinical challenge. Optical coherence tomography enables continuous visualization of the distal outflow pathway beyond Schlemm's canal through improved micrometer-scale axial resolution, although its performance is limited by tissue overlap and similar optical signals. Aqueous angiography visualizes segmental aqueous humor outflow intraoperatively and assesses distal outflow patency. Hemoglobin video imaging exploits the differential optical absorption of hemoglobin and aqueous humor to enable dynamic, quantitative evaluation of aqueous humor outflow. This review summarizes recent advances in imaging of the distal aqueous humor outflow pathway and discusses their potential applications in evaluating MIGS outcomes and guiding individualized treatment.
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