Huang Alex S, Mohindroo Chirayu, Weinreb Robert N
Doheny Eye Institute, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Doheny Eye Institute, Los Angeles, CA, USA.
J Clin Exp Ophthalmol. 2016 Aug;7(4). doi: 10.4172/2155-9570.1000578. Epub 2016 Jul 24.
Anterior segment glaucoma clinical care and research has recently gained new focus because of novel imaging modalities and the advent of angle-based surgical treatments. Traditional investigation drawn to the trabecular meshwork now emphasizes the entire conventional aqueous humor outflow (AHO) pathway from the anterior chamber to the episcleral vein. AHO investigation can be divided into structural and functional assessments using different methods. The historical basis for studying the anterior segment of the eye and AHO in glaucoma is discussed. Structural studies of AHO are reviewed and include traditional pathological approaches to modern tools such as multi-model two-photon microscopy and optical coherence tomography. Functional assessment focuses on visualizing AHO itself through a variety of non-real-time and real-time techniques such as aqueous angiography. Implications of distal outflow resistance and segmental AHO are discussed with an emphasis on melding bench-side research to viable clinical applications. Through the development of an improved structure: function relationship for AHO in the anterior segment of the normal and diseased eye, a better understanding of the eye with improved therapeutics may be developed.
前段青光眼的临床护理与研究近来因新型成像技术以及基于房角的手术治疗方法的出现而有了新的重点。以往针对小梁网的研究如今强调从前房到巩膜表层静脉的整个传统房水流出（AHO）途径。AHO的研究可通过不同方法分为结构和功能评估。文中讨论了青光眼研究眼前段和AHO的历史基础。回顾了AHO的结构研究，包括从传统病理学方法到诸如多模态双光子显微镜和光学相干断层扫描等现代工具。功能评估侧重于通过多种非实时和实时技术（如水相血管造影）来观察AHO本身。讨论了远端流出阻力和节段性AHO的意义，重点是将实验室研究与可行的临床应用相结合。通过建立正常和患病眼前段AHO的结构与功能关系，有望更好地理解眼睛并改进治疗方法。
