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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

New Insights Into Pathophysiological Mechanisms Regulating Conventional Aqueous Humor Outflow

Department of Eye Diseases, Medical Academy, Lithuanian University of Health Sciences, Lithuania
Author to whom correspondence should be addressed.
Medicina 2013, 49(4), 26;
Received: 2 January 2013 / Accepted: 30 April 2013 / Published: 5 May 2013
The aim of the article was to overview the pathophysiology of the conventional outflow pathway, trabecular meshwork, and intraocular pressure and to discuss the options of future glaucoma treatment directed to improvement in aqueous outflow. The literature search in the Medline, Embase, and Cochrane databases from April to May 2012 was performed; a total of 47 articles analyzed. The diminished conventional pathway may be altered by several pathophysiological mechanisms like TM obstruction caused by transforming growth factor-β2, clastic nondeformable cells, macrophages leaking from hypermature cataract, iris pigment, lens capsular fragments after YAG-laser posterior capsulotomy, proteins and their subfragments. It is known that trabecular meshwork contraction reduces outflow, and the actomyosin system is directly linked to this mechanism. New glaucoma drugs are still under investigation, but it is already proven that agents such as latranculin-B are effective in improving aqueous drainage. Selective Rho-associated coiled coilforming protein kinase inhibitors have been shown to cause a significant improvement in outflow facility and may become a new option for glaucoma treatment. Caldesmon negatively regulates actin-myosin interactions and thus increases outflow. Stem cells may replace missing or nonfunctional trabecular meshwork cells and hopefully will bring a new treatment solution. Pathophysiological mechanisms regulating conventional aqueous humor outflow are still not fully understood and require further investigations. Future treatment decisions should be directed to a specific mechanism regulating an elevation in intraocular pressure.
Keywords: intraocular pressure; trabecular meshwork; conventional aqueous humor pathway intraocular pressure; trabecular meshwork; conventional aqueous humor pathway
MDPI and ACS Style

Paulavičiūtė-Baikštienė, D.; Baršauskaitė, R.; Janulevičienė, I. New Insights Into Pathophysiological Mechanisms Regulating Conventional Aqueous Humor Outflow. Medicina 2013, 49, 26.

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