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Do normal-tension and high-tension glaucoma result from brain and ocular glymphatic system disturbances, respectively?

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Fig. 1: Macroscopic overview of the brain and ocular glymphatic systems, emphasizing the role played by pressure gradients, hydrostatic barriers and lymphatic drainage, shown in the context of known pathways for aqueous humour and cerebrospinal fluid (CSF) efflux.


  1. Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA, et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012;4:147ra111.

    Article  Google Scholar 

  2. Wang X, Lou N, Eberhardt A, Yang Y, Kusk P, Xu Q, et al. An ocular glymphatic clearance system removes β-amyloid from the rodent eye. Sci Transl Med. 2020;12:eaaw3210.

    CAS  Article  Google Scholar 

  3. Rangroo Thrane V, Hynnekleiv L, Wang X, Thrane AS, Krohn J, Nedergaard M. Twists and turns of ocular glymphatic clearance—new study reveals surprising findings in glaucoma. Acta Ophthalmol. 2020.

  4. Mathieu E, Gupta N, Ahari A, Zhou X, Hanna J, Yücel YH. Evidence for cerebrospinal fluid entry into the optic nerve via a glymphatic pathway. Investig Ophthalmol Vis Sci. 2017;58:4784–91.

    CAS  Article  Google Scholar 

  5. Pircher A, Montali M, Wostyn P, Pircher J, Berberat J, Remonda L, et al. Impaired cerebrospinal fluid dynamics along the entire optic nerve in normal-tension glaucoma. Acta Ophthalmol. 2018;96:e562–569.

    Article  Google Scholar 

  6. Wostyn P. The “ocular glymphatic clearance system”: a key missing piece of the Alzheimer’s disease-glaucoma puzzle found? Eye. 2020.

    Article  PubMed  Google Scholar 

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Correspondence to Peter Wostyn.

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Wostyn, P. Do normal-tension and high-tension glaucoma result from brain and ocular glymphatic system disturbances, respectively?. Eye 35, 2905–2906 (2021).

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