机构:[1]Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA.[2]Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing 100730, China.研究所眼科研究所首都医科大学附属北京同仁医院首都医科大学附属同仁医院[3]Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.首都医科大学附属北京同仁医院首都医科大学附属同仁医院[4]Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.[5]Department of Bioengineering, University of Washington, Seattle, WA 98195, USA.
Herein, we provide evidence that human regulation of aqueous outflow is by a pump-conduit system similar to that of the lymphatics. Direct observation documents pulsatile aqueous flow into Schlemm's canal and from the canal into collector channels, intrascleral channels, aqueous veins, and episcleral veins. Pulsatile flow in vessels requires a driving force, a chamber with mobile walls and valves. We demonstrate that the trabecular meshwork acts as a deformable, mobile wall of a chamber: Schlemm's canal. A tight linkage between the driving force of intraocular pressure and meshwork deformation causes tissue responses in milliseconds. The link provides a sensory-motor baroreceptor-like function, providing maintenance of a homeostatic setpoint. The ocular pulse causes meshwork motion oscillations around the setpoint. We document valves entering and exiting the canal using real-time direct observation with a microscope and multiple additional modalities. Our laboratory-based high-resolution SD-OCT platform quantifies valve lumen opening and closing within milliseconds synchronously with meshwork motion; meshwork tissue stiffens, and movement slows in glaucoma tissue. Our novel PhS-OCT system measures nanometer-level motion synchronous with the ocular pulse in human subjects. Movement decreases in glaucoma patients. Our model is robust because it anchors laboratory studies to direct observation of physical reality in humans with glaucoma.
基金:
This work was supported in part by research grants from the Public Health Service Center
Grant PO1-EY000292, Training Grant TO1-EY-00018, and research grant RO1EY00002, R01EY0190601
from the National Eye Institute, the W. H. Coulter Foundation Translational Research Partnership
Program, an Unrestricted Grant from Research to Prevent Blindness, and the Office of Research
Infrastructure Programs of the National Institutes of Health through Grant No. P51OD010425 at the
Washington National Primate Research Center and Carl Zeiss Meditec Inc.
第一作者机构:[1]Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA.
通讯作者:
推荐引用方式(GB/T 7714):
Johnstone Murray,Xin Chen,Martin Elizabeth,et al.Trabecular Meshwork Movement Controls Distal Valves and Chambers: New Glaucoma Medical and Surgical Targets[J].JOURNAL OF CLINICAL MEDICINE.2023,12(20):doi:10.3390/jcm12206599.
APA:
Johnstone Murray,Xin Chen,Martin Elizabeth&Wang Ruikang.(2023).Trabecular Meshwork Movement Controls Distal Valves and Chambers: New Glaucoma Medical and Surgical Targets.JOURNAL OF CLINICAL MEDICINE,12,(20)
MLA:
Johnstone Murray,et al."Trabecular Meshwork Movement Controls Distal Valves and Chambers: New Glaucoma Medical and Surgical Targets".JOURNAL OF CLINICAL MEDICINE 12..20(2023)