135
EW GLAUCOMA
April 2016
Contact information
Francis: bfrancis@doheny.org
Huang: ahuang@doheny.org
what this technology provides:
a real-time method to visualize
aqueous humor outflow at normal
pressures because we introduced the
dye at not supraphysiologic pressure
levels."
His group also used the OCT
component to confirm that the
angiographic signal did indeed rep-
resent aqueous humor outflow. One
important aspect is that the imaging
happens "live," and is tested under
normal conditions.
"We're not trying to force fluid
through at a very high pressure or
do anything that's not naturally
occurring in the eye," Dr. Francis
said. "We're testing from a starting
point in the anterior chamber and
trabecular meshwork all the way to
an endpoint."
Dr. Francis is excited about the
possibility of optimizing surgery and
being able to understand the distal
outflow pathway better. "We don't
have a lot of information about the
distal outflow pathway, and this has
great potential to help us learn," Dr.
Francis said.
Building a better understanding
By adding to what specialists already
know about the outflow biology of
the eye, "this may help us do things
like develop new drugs to change
the angiographic patterns. We'll be
able to determine how our medical
and surgical interventions affect the
outflow," Dr. Huang said. "We might
be able to determine at a molecular
level what 'good' flow and 'bad' flow
represents." Dr. Francis thinks angi-
ography "will help us pharmacolog-
ically manage glaucoma. By under-
standing the outflow pathway, we
can devise better medications that
will enhance the outflow pathway
either on their own or after these
surgical procedures."
Intraoperatively, Dr. Francis
said in some of the pig eyes, what
looked like an aqueous vein was 2
clock hours away from where it was
expected to be—it wasn't radially
coming out of Schlemm's canal, but
"taking a big S-curve," he said. "If
you looked externally, distally, at the
aqueous vein, you'd miss where it
goes into the canal."
Dr. Huang plans on progressing
the study into humans once he's re-
ceived regulatory and legal approval
from UCLA. EW
Reference
1. Saraswathy S, et al. Aqueous angiogra-
phy: Real-time and physiologic aqueous
humor outflow imaging. PLoS One. 2016 Jan
25;11(1):e0147176.
Editors' note: Dr. Francis has no finan-
cial interests related to his comments.
Dr. Huang has financial interests with
Glaukos and Heidelberg Engineering.
