Journal
CURRENT OPINION IN OPHTHALMOLOGY
Volume 23, Issue 2, Pages 135-143Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICU.0b013e32834ff23e
Keywords
intraocular pressure; outflow facility; Schlemm's canal; trabecular meshwork
Categories
Funding
- Allergan, Inc.
- National Eye Institute [EY017007, EY019696, EY003279, EY008247, EY010572]
- Research to Prevent Blindness Foundation
Ask authors/readers for more resources
Purpose of review Regulation of intraocular pressure by the conventional (trabecular) outflow pathway is complicated, involving a myriad of mechanical and chemical signals. In most, intraocular pressure is maintained within a tight range over a lifetime. Unfortunately in some, dysfunction results in ocular hypertension and open-angle glaucoma. In the context of established knowledge, this review summarizes recent investigations of conventional outflow function, with the goal of identifying areas for future inquiry and therapeutic targeting. Recent findings Mechanical stimulation of conventional outflow cells due to intraocular pressure fluctuations impacts contractility, gene expression, pore formation, enzyme activity, and signaling. Numerous local signaling mediators in the conventional pathway such as bioactive lipids, cytokines, nitric oxide, and nucleotides participate in the regulation of outflow. Interestingly outflow through the conventional pathway is not uniform, but segmental, with passageways constantly changing due to focal protease activity of trabecular cells clearing extracellular matrix materials. The relationship between extracellular matrix expression and trabecular meshwork contractility appears to coordinately impact outflow resistance and is the target of a new class of drugs, the Rho kinase inhibitors. Summary The conventional outflow pathway is a dynamic, pressure-sensitive tissue that is vulnerable to pathology on many fronts, each representing a therapeutic opportunity.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available