Ocular Glymphatic System: Its Modulation and Role in Intraocular Tumors

The glymphatic system is a glial-based perivascular network that clears metabolic waste from the central nervous system (CNS), and its dysfunction is related to neurodegenerative disease. This review describes a correlate ocular glymphatic system in the eye and describes how this might relate to ophthalmic diseases. This review article summarizes the published literature on the CNS and ophthalmic glymphatic system and how its dysfunction relates to disease. There are associations in the pathogenesis among neurodegeneration, glaucoma, and age-related macular degeneration (AMD), which could be explained through glymphatic dysfunction in the CNS and eye, respectively. The protective effects of exercise and sleep further demonstrate associations among neurodegeneration, glaucoma, and AMD. We provide new insights on the role of the glymphatic system and intraocular tumors, proposing that tumors may hijack the glymphatic system as a bidirectional pathway of communication between the eye and the brain. New therapies for enhancing CNS glymphatic flow are discussed. Dysfunction of the glymphatic system may be a unifying pathogenesis among neurodegeneration, glaucoma, and AMD. Future research should analyze whether CNS-focused therapeutics may improve ocular disease. The role of the glymphatic system in the pathogenesis of intraocular tumors warrants further investigation.