青光眼发病机制-治疗方式

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1、AqueousproductionAqueoushumourisproducedfromplasmabytheciliaryepitheliumoftheciliarybodyparsplicata,usingacombinationofactiveandpassivesecretion（既有主动分泌也有被动运输）.Ahigh-proteinfiltratepassesoutoffenestratedcapillaries（ultrafiltration）intothestromaoftheciliaryp

2、rocesses,fromwhichactivetransportofsolutes（[容质）occursacrossthedual-layeredciliaryepithelium.Theosmoticgradienttherebyestablishedfacilitatesthepassiveflowofwaterintotheposteriorchamber.Secretionissubjecttotheinfluenceofthesympatheticnervoussystem,withopposi

3、ngactionsmediatedbybeta-2receptors（increasedsecretion）andalpha-2receptors（decreasedsecretion）（互相扌吉抗调节）.Enzymaticactionisalsocritical一carbonicanhydrase（碳酸酶）isamongthoseplayingakeyrole.[l]Thetrabecularmeshwork（小梁网）（trabeculum）isasieve-like（筛状）structureatthea

4、ngleoftheanteriorchamber（AC）throughwhich90%ofaqueoushumourleavestheeye.Ithasthreecomponents.Theuvealmeshwork（葡萄网）istheinnermostportion,consistingofcord-like（索状）endothelialcell-coveredstrandsarisingfromtheiris（虹月莫）andciliarybodystroma.Theintertrabecular（小梁）

5、spacesarerelativelylargeandofferlittleresistancetothepassageofaqueous.Thecorneoscleralmeshworkliesexternaltotheuvealmeshworktoformthethickestportionofthetrabeculum.Itiscomposedoflayersofconnectivetissuestrandswithoverlyingendothelial-likecells.Theintertrab

6、ecularspacesaresmallerthanthoseoftheuvealmeshwork,conferringgreaterresistancetoflow.Thejuxtacanalicular（cribriform）meshworkistheouterpartofthetrabeculum,andlinksthecorneoscleralmeshworkwiththeendotheliumoftheinnerwallofthecanalofSehlemm.Itconsistsofcellsem

7、beddedinadenseextracellularmatrixwithnarrowintercellularspaces,andoffersthemajorproportionofnormalresistancetoaqueousoutflow・TheSchlemmcanalisacircumferentialchannelwithintheperilimbalsclera.Theinnerwallislinedbyirregularspindle-shapedendothelialcellsconta

8、ininginfoldings（giantvacuoles）thatarethoughttoconveyaqueousviatheformationoftranscellularpores-Theouterwallislinedbysmoothflatcellsandcontainstheopeningsofcollectorchannels,whichleavethecanalatobliqueanglesan