Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China.
Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100005, China.
Sci China Life Sci. 2018 May;61(5):534-540. doi: 10.1007/s11427-017-9140-8. Epub 2017 Dec 22.
Glaucoma is the leading cause of irreversible blindness worldwide. The reconstruction of aqueous outflow drainage (RAOD) has recently been proposed to aid in restoring aqueous outflow drainage in primary open-angle glaucoma. However, the mechanism of RAOD remains to be fully understood. Based on literature review and research studies, the potential mechanisms of RAOD are the following: (i) Circumferential dilation of the Schlemm's canal (SC) and surrounding collector channels. (ii) Instant formation of microcracks through RAOD procedures. (iii) Formation of more pores, and local detachment between the SC endothelium (SCE) and basement membrane. (iv) Activation of stem cells by constant mechanical stress caused by the tensional suture placed at the anterior part of the SC. (v) Reversal of trabecular meshwork (TM) herniation. (vi) Mobilization of the reserve of the aqueous drainage. (vii) Change of SCE phenotype. (viii) Mechanosensing and mechanotransducing of TM.
青光眼是全球范围内导致不可逆性失明的主要原因。最近提出了房水流出重建（RAOD），以帮助恢复原发性开角型青光眼的房水流出。然而，RAOD 的机制仍有待充分理解。基于文献回顾和研究，RAOD 的潜在机制如下：（i）Schlemm 管（SC）及其周围收集管的环周扩张。（ii）RAOD 手术过程中即时形成微裂缝。（iii）形成更多的孔，以及 SC 内皮（SCE）和基底膜之间的局部分离。（iv）SC 前区张力缝线引起的持续机械应力激活干细胞。（v）小梁网（TM）疝出的逆转。（vi）房水引流储备的动员。（vii）SCE 表型的改变。（viii）TM 的机械感应和机械转导。
