Molecular mechanisms of water transport in the eye.

The four major sites for ocular water transport, the corneal epithelium and endothelium, the ciliary epithelium, and the retinal pigment epithelium, are reviewed. The cornea has an inherent tendency to swell, which is counteracted by its two surface cell layers, the corneal epithelium and endothelium. The bilayered ciliary epithelium secretes the aqueous humor into the posterior chamber, and the retinal pigment epithelium transports water from the retinal to the choroidal site. For each epithelium, ion transport mechanisms are associated with fluid transport, but the exact molecular coupling sites between ion and water transport remain undefined. In the retinal pigment epithelium, a H+-lactate cotransporter transports water. This protein could be the site of coupling between salt and water in this epithelium. The distribution of aquaporins does not suggest a role for these proteins in a general model for water transport in ocular epithelia. Some water-transporting membranes contain aquaporins, others do not. The ultrastructure is also variable among the cell layers and cannot be fitted into a general model. On the other hand, the direction of cotransport in symporters complies with the direction of fluid transport in both the corneal epi- and endothelium, as well as the ciliary epithelium and retinal pigment epithelium.