Aqueous outflow channels and its lymphatic association: A review |
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| Institution: | 1. Singapore National Eye Centre, Singapore;2. Singapore Eye Research Institute, Singapore;3. Nanyang Technological University, Singapore;4. Duke-NUS Medical School, Singapore;5. SERI-NTU Advanced Ocular Engineering (STANCE) Program, Singapore;6. Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria;7. Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria;8. Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland;9. Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;10. Doheny Eye Centers, Doheny and Stein Eye Institutes, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA;1. Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy;2. Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland;3. Medical University of Warsaw, Warsaw, Poland;4. Department of Pathophysiology, Medical University of Lublin, Lublin, Poland;5. Department of Ophthalmology, University of Zurich, Zurich;6. Department of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland |
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| Abstract: | The human eye has a unique immune architecture and behavior. While the conjunctiva is known to have a well-defined lymphatic drainage system, the cornea, sclera, and uveal tissues were historically considered “alymphatic” and thought to be immune privileged. The very fact that the aqueous outflow channels carry a clear fluid (aqueous humor) along the outflow pathway makes it hard to ignore its lymphatic-like characteristics. The development of novel lymphatic lineage markers and expression of these markers in aqueous outflow channels and improved imaging capabilities has sparked a renewed interest in the study of ocular lymphatics. Ophthalmic lymphatic research has had a directional shift over the last decade, offering an exciting new physiological platform that needs further in-depth understanding. The evidence of a presence of distinct lymphatic channels in the human ciliary body is gaining significant traction. The uveolymphatic pathway is an alternative new route for aqueous outflow and adds a new dimension to pathophysiology and management of glaucoma. Developing novel animal models, markers, and non-invasive imaging tools to delineate the core anatomical structure and physiological functions may help pave some crucial pathways to understand disease pathophysiology and help develop novel targeted therapeutic approaches for glaucoma. |
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