Die Bedeutung des lymphatischen und des glymphatischen Systems für das Glaukom

Zusammenfassung

Das Normaldruckglaukom ist eine Variante des Offenwinkelglaukoms, das durch einen normalen Augendruck charakterisiert ist. Obwohl verschiedene pathophysiologische Erklärungen existieren (vaskuläre Dysregulation, Rolle der Lamina cribrosa) kann keine Theorie die Pathophysiologie schlüssig erklären. Der Sehnerv ist ein weißer Hirnfaszikel. Er ist auf seiner ganzen Länge von Liquor cerebrospinalis umspült. Auf der Basis von neuroradiologischen Untersuchungen vermutet man, dass ein Normaldruckglaukom aufgrund eines neurodegenerativen Prozesses entstehen kann. Eine ungenügende Liquordynamik kann dabei eine Rolle spielen, indem toxische Substanzen wie Aβ-Lipoprotein insuffizient aus dem Liquor entfernt werden. Dabei kommt dem lymphatischen und glymphatischen System eine wesentliche Rolle zu.

Abstract

Normal tension glaucoma is a variant of primary open angle glaucoma. It is characterized by normal intraocular pressure. Although there are several pathophysiological explanations (e. g. vascular dysregulation, the role of the lamina cribrosa), none of these explanations can fully explain its pathophysiology. The optic nerve is a white matter tract of the brain. It is surrounded by cerebrospinal fluid on its whole length. Neuroradiological examinations hint at a neurodegenerative origin of normal tension glaucoma. Impaired cerebrospinal fluid dynamics and reduced clearance of Aβ amyloid might play a role in this process. The lymphatic and the glymphatic system are thought to be essentially involved.

Schlüsselwörter

Normaldruckglaukom - Neurodegeneration - lymphatisches System - glymphatisches System

Key words

normal tension glaucoma - neurodegeneration - lymphatic system - glymphatic system

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