眼科 ›› 2022, Vol. 31 ›› Issue (6): 405-412.doi: 10.13281/j.cnki.issn.1004-4469.2022.06.001

• 专家讲座 •    下一篇

小梁网泵调控理论及其对青光眼诊疗的启示

辛晨   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室 100730
  • 收稿日期:2022-10-23 出版日期:2022-11-25 发布日期:2022-11-25
  • 通讯作者: 辛晨,Email: xinchen1981@sina.com
  • 基金资助:
    北京经济开发区新创工程领军人才培养项目

Theory of trabecular meshwork pump regulation and its implications for glaucoma diagnosis and treatment

Xin Chen   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
  • Received:2022-10-23 Online:2022-11-25 Published:2022-11-25
  • Contact: Xin Chen, Email: xinchen1981@sina.com
  • Supported by:
    Talent Project of Innovation Projects in Beijing Economic Development Zone

摘要:  小梁网房水引流功能异常导致眼压升高,是原发性开角型青光眼发生发展的最主要危险因素。房水具有搏动外流的特征,说明小梁网是弹性组织,其弹性状态与Schlemm管腔开放程度、管类瓣膜结构联动和深层巩膜静脉丛的开放与闭合密切相关,表明小梁网对房水的引流具有泵调控机制。本文对小梁网泵调控机制的理论基础、相关检查的临床应用及对青光眼微创手术的启示进行了系统介绍。希望小梁网泵调控理论为了解原发性开角型青光眼发病机制、选择治疗策略、优化和创新手术设计提供新的视角。(眼科,2022,31: 405-412)

关键词: 小梁网, Schlemm管, 集液管, 原发性开角型青光眼

Abstract:  Abnormality in trabecular meshwork pathway leads to high intraocular pressure (IOP), which is the most significant risk factor for primary open angle glaucoma (POAG). Pulsatile characterize the aqueous outflow and originates the development of pumping theory. Trabecular meshwork is prestressed elastic tissue sensitive to IOP variation. Trabecular meshwork is the mobile wall of the compressible chamber, Schlemm canal (SC). It links the IOP induced motion to valve-like structure in SC, which cooperates with opening/close of deep scleral plexus of channels. All above factors involve in regulation of IOP. This article introduces the concept of aqueous pumping system and its potentials in clinic. It could provide new perspective for glaucoma specialist to better understand the mechanism of POAG, optimize the treatment and develop new strategies. (Ophthalmol CHN, 2022, 31: 405-412)

Key words:  trabecular meshwork, Schlemm canal, collector channel, primary open angle glaucoma