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. Author manuscript; available in PMC: 2021 Jul 21.
Published in final edited form as: Prog Retin Eye Res. 2020 Nov 17;83:100917. doi: 10.1016/j.preteyeres.2020.100917

Fig. 3. Aqueous pulse wave distance and velocity profile vs. intraocular pressure.

Fig. 3.

Fig. 1 demonstrates the source of the oscillatory pulse waves found in the aqueous veins. Aqueous veins show oscillatory aqueous discharge into episcleral veins. Increased stroke volume increases aqueous outflow, (a, b, c, d) Stroke volume responses in a 59-year-old Caucasian male after an increase in intraocular pressure (IOP) following a water-drinking test. Outflow medications that reduce IOP have a similar initial increase in the pulsatile flow until IOP falls to a new lower setpoint, (a) Baseline IOP: velocity (V) is low. The aqueous pulse wave travels a short distance (D) with each stroke. Oscillation of a standing transverse wave results in a systolic discharge of aqueous fluid into a small venous tributary (ST), (b) Increased distance traveled by the oscillatory aqueous pulse wave, (c) A further increase in velocity and travel of the aqueous pulse wave. At each systole, a lamina of clear aqueous discharges into an episcleral vein, (d) Additional velocity increase and increased travel of the pulse wave. Continuous oscillating laminar flow now occurs in a more distal episcleral vein. Two hours after drinking water, IOP was again 10 mm Hg, and stroke volume returned to the appearance in (a). Illustrations from: Johnstone M, The Glaucoma Book. New York: Springer, 2010:65–78. Vessel Images from Johnstone M, Aqueous Veins, J Glaucoma 13, 421 438, 2004. Video – Stroke Volume Control of IOP 1-s2.0-S1350946220300896-mmc3.mp4.