ArticleOphthalmology science2021
Structural Confirmation of Lymphatic Outflow from Subconjunctival Blebs of Live Human Subjects.
Article in Ophthalmology science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 12 citations in OpenAlex.
- Rescue of conjunctival lymphatics after mitomycin C induced inhibition in rat eyes: An experimental study.Indian journal of ophthalmology · 2026Article
- Ocular Lymphatics in Health and Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Drainage of subconjunctival hemorrhage through conjunctival lymphatic pathways.American journal of ophthalmology case reports · 2025Article
- VEGF-C and 5-Fluorouracil Improve Bleb Survival in a Rabbit Glaucoma Surgery Trabeculectomy Model.Investigative ophthalmology & visual science · 2024Article
- Article
- Detection of TTR Amyloid in the Conjunctiva Using a Novel Fluorescent Ocular Tracer.Translational vision science & technology · 2024Article
- Segmental Unconventional Outflow in Mouse Eyes.Investigative ophthalmology & visual science · 2023Article
- Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics.Vision (Basel, Switzerland) · 2023Article
- Subconjunctival Lymphatics Respond to VEGFC and Anti-Metabolites in Rabbit and Mouse Eyes.Investigative ophthalmology & visual science · 2022Article
- Article
- Bleb-related Porcine Lymphatic Outflow is Greater from Subconjunctival compared to Subtenon Blebs.Journal of current glaucoma practiceArticle
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
Abstract
purposeTo uncover the mechanism of subconjunctival outflow in human patients.
designCross-sectional study. SUBJECTS/PARTICIPANTS AND/OR CONTROLS: Fifteen subjects receiving subconjunctival anesthesia prior to intravitreal injection for routine clinical care.
methodsAnterior segment OCT (AS-OCT) was performed in patients with various instances of conjunctival edema or subconjunctival fluid. Other subjects received a subconjunctival mixture of 0.005% indocyanine green and 2% lidocaine. After subconjunctival injection of the tracer/anesthetic mixture, blebs and associated outflow pathways were angiographically imaged and the time for appearance recorded. The pattern and structure of outflow pathways were studied using AS-OCT. Angiographic and AS-OCT results were compared to trabecular/conventional outflow imaging which demonstrates veins.
main outcome measuresOcular surface lymphangiography and AS-OCT images.
resultsAS-OCT of the conjunctiva in a normal eye demonstrated thin non-edematous conjunctiva with absent intraconjunctival lumens or subconjunctival fluid. Subjects with a history of trabeculectomy, subconjunctival drug injection, or chemosis demonstrated thickened conjunctiva and intraconjunctival luminal pathways that contained valve-like structures. Tracer-based studies in patients demonstrated blebs with irregular subconjunctival bleb-related outflow patterns that arose in a time-dependent fashion. These angiographic pathways were luminal on OCT, sausage-shaped, and contained intraluminal valve-like structures. This was in contrast to trabecular/conventional outflow imaging where pathways were classically Y-shaped, of even-caliber, and lacked valve-like structures. DISCUSSION: Outflow pathways were seen in cases of conjunctival edema and after subconjunctival tracer injection. These pathways were lymphatic based upon pattern and structural study. Better understanding of bleb-related lymphatic outflow may lead to improved bleb-requiring glaucoma surgeries and subconjunctival drug delivery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.