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Protrusions of the inner wall of Schlemm's canal

Insights

Trabecular meshwork hernias are not the primary aqueous humor drainage pathway. This study found similar drainage through hernias and other Schlemm

Area of Science:

  • Ophthalmology
  • Fluid Dynamics
  • Microscopy

Background:

  • Trabecular meshwork (TM) hernias into Schlemm's canal (SC) were hypothesized as major aqueous humor (AH) outflow routes.
  • This hypothesis was compared to arachnoid villi in cerebrospinal fluid drainage.

Purpose of the Study:

  • To investigate the role of TM hernias in AH drainage.
  • To quantitatively assess if hernias represent the primary outflow pathway.

Main Methods:

  • Scanning electron microscopy (SEM) was used to examine cynomolgus monkey eyes.
  • Pore number and size were analyzed in hernias and other SC inner wall regions.
  • Analysis was performed at varying intraocular pressure (IOP) levels.

Main Results:

  • Quantitative analysis did not support hernias as the main AH drainage route.
  • AH drainage through hernias was comparable to other SC inner wall areas.
  • Hernial surface area constituted a minor fraction of the total inner wall surface.

Conclusions:

  • TM hernias are unlikely to be the principal pathway for AH outflow.
  • Aqueous humor drainage occurs through multiple regions of the inner wall of Schlemm's canal.
  • The contribution of hernias to overall AH outflow is limited.

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