AQUEOUS HUMOR OUTFLOW DYNAMICS
Aqueous humor outflow occurs through the conventional and unconventional pathways.
With aging, the latter becomes less active so that the conventional pathway remains the primary mechanism of aqueous humor outflow.
An abnormality of this pathway contributes significantly to disordered aqueous humor dynamics and consequent rise in intraocular pressure seen in primary open angle glaucoma and ocular hypertension. Recently, the ocular lymphatics have been implicated in aqueous humor outflow.
The trabecular meshwork is now understood to be a complex organization of structures, which are controlled by various biomechanical and biochemical mechanisms. Among others, these include the actinomyosin cytoskeletal system, extracellular matrix, intracellular signaling responses mediated by protein kinase C, Rho/Rho kinase, and other biologic factors.
The following review describes the various pathophysiologic mechanisms involved in aqueous humor dynamics.