Glaucoma and biomechanics

Purpose of review Biomechanics is an important aspect of the complex family of diseases known as the glaucomas. Here, we review recent studies of biomechanics in glaucoma. Recent findings Several tissues have direct and/or indirect biomechanical roles in various forms of glaucoma, including the trabecular meshwork, cornea, peripapillary sclera, optic nerve head/sheath, and iris. Multiple mechanosensory mechanisms and signaling pathways continue to be identified in both the trabecular meshwork and optic nerve head. Further, the recent literature describes a variety of approaches for investigating the role of tissue biomechanics as a risk factor for glaucoma, including pathological stiffening of the trabecular meshwork, peripapillary scleral structural changes, and remodeling of the optic nerve head. Finally, there have been advances in incorporating biomechanical information in glaucoma prognoses, including corneal biomechanical parameters and iridial mechanical properties in angle-closure glaucoma. Biomechanics remains an active aspect of glaucoma research, with activity in both basic science and clinical translation. However, the role of biomechanics in glaucoma remains incompletely understood. Therefore, further studies are indicated to identify novel therapeutic approaches that leverage biomechanics. Importantly, clinical translation of appropriate assays of tissue biomechanical properties in glaucoma is also needed.

Automated summary

This review summarizes recent studies on the role of biomechanics in glaucoma. It is found that various tissues, including the trabecular meshwork, cornea, peripapillary sclera, optic nerve head/sheath, and iris, have biomechanical involvement in different forms of glaucoma. Multiple mechanosensory mechanisms and signaling pathways are identified in the trabecular meshwork and optic nerve head. Biomechanical information has also been incorporated into glaucoma prognoses. However, the understanding of the role of biomechanics in glaucoma is still incomplete.