Lymphatic drainage a newly discovered route of aqueous outflow

Research is providing new insight into the outflow patterns aqueous in eyes with glaucoma that may in turn allow greater individualisation of treatment, said Stefano Gandolfi MD at the 13^th European Glaucoma Society Congress in Florence Italy. “The interest in monitoring the outflow of the aqueous humour from the eye actually has recently become extremely compelling both in terms of research and new medications that are expected to work directly on the physiological outflow mechanisms of the eye,” said Dr Gandolfi, University of Bologna, Italy. Dr Gandolfi noted that in addition to the conventional trabecular-canalicular outflow and uveoscleral outflow,  new research from Neeru Gupta’s  group in Canada suggests that lymphatic vessels in the eye may also provide a means of aqueous drainage from the anterior chamber that may also be modulated pharmacologically. Recent research also suggests that eye drops consisting of a combination of indocyanine green and liposomes can allow visualisation of Schlemm’s canal and the collector channels, as well as the lymphatic outflow patterns of the aqueous in the individual eye. “That may allow us to make better patient selection. On top of that having it will help to measure the lymphatic areas that are being shown to be relevant in determining the total capability of the eye to drain the aqueous humour from the anterior chamber straight into the conventional pathways,” Dr Gandolfi said.