A pulsatile pump in the TM, a new concept in trabecular outflow research
Reviewed by Zhihang Cheng

This is a research article where the authors propose a new model in conceptualising the mechanisms involved in the aqueous outflow at the trabecular meshwork (TM). The authors demonstrated evidence of a pump within the Schlemm’s canal. A pulse generated from the natural systole and diastole of the cardiac muscles drives the trabecular meshwork compression and the pump. The authors propose an elastic energy equilibrium governs elastance and shear stress to maintain homeostasis. The authors showed in some cases of glaucoma this pulsatile flow stops and Phased-based OCT (PhS-OCT) may quantify pulsatile flow. The authors believe the pump mechanism model offers a target for new diagnostic and therapeutic alternatives in glaucoma.

Aqueous outflow regulation – 21st century concepts.
Johnstone M, Xin C, Tan J, et al.
PROGRESS IN RETINAL AND EYE RESEARCH
2021;83:100917.