Computed tomography of aqueous humour outflow pathways

The anterior chamber of adult Rhesus monkeys (Macaca mulatta) was perfused with a radio-opaque contrast medium (Amipaque; mol. wt 789 daltons) at controlled intraocular pressure (IOP), and its subsequent distribution examined by computed tomography. In the living monkey no contrast medium was detectable outside the anterior chamber, even after prolonged (8 hr) perfusion. However, if the animal was then killed, and the IOP maintained artificially at its previous level, opacity appeared immediately throughout the anterior segment. Subsequent scans showed the contrast medium to diffuse into the anterior orbital tissues, and to move posteriorward through the globe wall and extraocular muscles. None entered the vitreous body and very little progressed behind the point at which the extraocular muscles exited from Tenon's capsule. Elevation of IOP did not appear to accelerate this posterior diffusion. It is inferred that in vivo contrast medium passing into the posterior, non-conventional aqueous drainage pathway is cleared immediately by the circulating blood in the uvea and possibly also the extraocular muscle. Tenon's capsule may provide a barrier to further intra-orbital diffusion.