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Year : 2015  |  Volume : 10  |  Issue : 4  |  Page : 503-504

Author's reply

Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago College of Medicine, Chicago, IL, USA

Date of Submission30-Oct-2015
Date of Acceptance30-Dec-2015
Date of Web Publication18-Feb-2016

Correspondence Address:
Ahmad A Aref
Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois College of Medicine, 1855 W. Taylor Street, Unit 3.171 Chicago, IL 60612
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2008-322X.176895

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How to cite this article:
Aref AA, Jain S. Author's reply. J Ophthalmic Vis Res 2015;10:503-4

How to cite this URL:
Aref AA, Jain S. Author's reply. J Ophthalmic Vis Res [serial online] 2015 [cited 2020 Oct 23];10:503-4. Available from: https://www.jovr.org/text.asp?2015/10/4/503/176895

Dear Editor,

We appreciate Dr. Wostyn, et al's interest in our manuscript titled, “Senile Dementia and Glaucoma: Evidence for a Common Link”.[1] Dr. Wostynet al's work in this area is indeed intriguing. Dr. Wostynet al's hypothesis states that deficient exchange between cerebrospinal fluid and brain interstitial fluid compartments along the optic nerve may allow the accumulation of neurotoxins, including amyloid-β, and subsequently predispose to glaucomatous optic neuropathy.[2] Specifically, this deficiency in waste exchange could occur within a network of diseased paravenous drainage pathways. The glymphatic pathway, as described by Iliffet al, may become dysfunctional due to genetic insult to the Aqp4 gene, which regulates generation of the water channel aquaporin-4 in astrocytes.[3] Animals with deletion of the Aqp4 gene exhibit decreased clearance of amyloid-β via the glymphatic pathway.

Given the potential link between Alzheimer's disease and glaucomatous optic neuropathy, we agree that the aforementioned findings may have important implications regarding the pathophysiology and possible therapy for certain forms of glaucomatous optic neuropathy. It would be interesting to investigate the effects of suppression of the Aqp4 gene on optic nerve health. Possible subsequent glaucomatous optic neuropathy, presumably due to accumulation of amyloid-β via a dysfunctional glymphatic pathway, would strongly support the link between Alzheimer's disease and “normal tension” types of glaucoma. Furthermore, this would offer a potential therapeutic target for both diseases.

Financial Support and Sponsorship

The authors are supported by NIH Core Grant EY001792 and an Unrestricted Grant from Research to Prevent Blindness.

Conflicts of Interest

There are no conflicts of interest.

  References Top

Jain S, Aref AA. Senile dementia and glaucoma: Evidence for a common link. J Ophthalmic Vis Res 2015;10:178-183.  Back to cited text no. 1
Wostyn P, Van Dam D, Audenaert K, Killer HE, De Deyn PP, De Groot V, et al. A new glaucoma hypothesis: A role of glymphatic system dysfunction. Fluids Barriers CNS 2015;12:16.  Back to cited text no. 2
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.  Back to cited text no. 3


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