Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
ISSN: 2155-9570
Janardan Kumar
Keynote: J Clin Exp Ophthalmol
For over half a century, glaucoma research has made little progress towards understanding the regulation of aqueous humor
outflow resistance and fluid dynamics. Nevertheless, an understanding of the fluid dynamics in the eye, being either
pulsatory or continuous as demonstrated in an ex vivo environment, would provide the key information as to the mechanisms
of glaucoma. Without this understanding, it is difficult to predict definitively the role of outflow pathway cells in aqueous
humor outflow resistance at the molecular level. Several designs of the perfusion systems have been proposed as measurements
of the aqueous humor outflow facility in enucleated eyes either at constant pressure or at constant flow. The major problem
of perfusion systems measurement is that the equipment is not available commercially, so the perfusion equipment is selfassembled
in laboratories after procuring the parts from different resources. Above all, the Grant perfusion system holds
unique features that measure the outflow facility at constant pressure while two pairs of enucleated whole eyes are evaluated,
simultaneously. Based on the same principle, the newly engineered real time perfusion system equipped with modern tools
and technology using Balance Talk XL program 5.1 (Labtronics Inc., Canada) measures the outflow facility at constant pressure
and was presented at ARVO 2006 by J Kumar. Clearly, the perfusion of H-7 in porcine eyes using the newly designed real time
perfusion system model demonstrated that the perfusion of Optimedia, the composition similar to aqueous humor is a far
superior physiological media than the traditionally used PBS plus glucose for the analysis of outflow facility. Our preliminary
data analysis of outflow suggested that the aqueous outflow is discontinuous and exhibits a pulsatory motion. We anticipate
that the newly designed real time perfusion system will be a valuable research tool for studies aimed at characterizing fluid
dynamics as well as being easy to assemble and commercially available. If so, this will raise awareness for glaucoma research
among basic scientists worldwide and contribute to a better understanding of aqueous flow and the mechanism of glaucoma
leading to new treatment options.
Janardan Kumar is the Professor and Former Chair of Natural Sciences. He has earned MS in biochemistry from University of Allahabad and received PhD in
chemistry at CDRI, Lucknow affiliated to Kanpur University in India. Being research Assistant Professor in the department of Cell Biology at Duke University in 1998,
he developed his research interest to the field of glaucoma and joined the internationally renowned laboratory of Prof. David L Epstein at Duke Eye Center, Duke
University, Durham, NC (USA). His work at Duke Eye Center provided opportunity to file two patents, one for glaucoma therapy and the other for vitrectomy. At TEI
biosciences in 2002, he gained a unique experience on stem cell research. His strategies made him capable of inducing differentiation of insulin producing cells
from adult human skin fibroblast stem cells using specific signaling complexes, and successful transplantation of these cells into three diabetic nude mice resulted
of maintaining the normal glucose level for approximately a month.