Theory of macular diseases in terms of glymphatic fluid circulation

Abstract

This article is an analysis of theoretical aspects of etiopathogenesis of the macular zone of the eye in terms of glymphatic circulation of tissue fluid. To date, a lot of data has been accumulated on functional and structural changes of the macular zone in normal and in various pathologies. The genesis of macular oedema along with subretinal and choroidal neovascularisation could be highlighted and understood from a different point of view if assuming the presence of the glymphatic para- and perivascular fluid flow within the retina, channels in the vitreous body and the choroid. Clinical features of the various eye diseases including hereditary, highlight the paravascular glymphatic outflow routes. The totality of data on various eye diseases, as well as the revealed clinical features of their course based on the latest scientific data and glymphatic flow in the nervous tissue allowed us to make assumptions about the presence of new physiological patterns of fluid flow in the posterior segment of the eye and formulate a new concept of pathogenesis of macular diseases.