THE FRY,GLENN,A. AWARD LECTURE 1992 - AQUEOUS-HUMOR PROTEINS - A KEY FOR UNLOCKING GLAUCOMA

In this report I summarize recently reported studies which establish t he existence of a previously undocumented diffusional pathway for plas ma-derived proteins from the ciliary body stroma to the anterior chamb er of the normal mammalian eye via the iris root. The data support the hypothesis that nearly all of the plasma-derived protein present in t he aqueous humor of the anterior chamber arrives via this pathway, thu s by-passing the posterior chamber. Additional studies suggest that so me of the protein transported via the pathway is shunted directly into the trabecular meshwork and aqueous outflow pathways. Perfusion studi es show how the perfused eyes were later immunohistochemically stained to reveal the distribution and qualitative amounts of serum albumin. These studies strongly suggest that the well-known ''wash-out'' effect , encountered in experimental studies of aqueous outflow, arises predo minantly from wash-out of the protein depot that serves as the anterio r diffusional pathway for proteins. Taken as a whole, these studies su pport the hypothesis that protein is a physiologically relevant and im portant element in the generation of normal aqueous outflow resistance , possibly more important than glycosaminoglycans (GAG's).