Cerebrospinal fluid, glymphatic pathways, and optic nerve health in glaucoma

Increasingly, evidence from neuroscience and ophthalmology highlights the importance of cerebrospinal fluid (CSF) dynamics and the glymphatic system, an astrocyte-driven perivascular network responsible for bulk fluid transport and metabolic waste clearance, in maintaining both central nervous system and optic nerve health. Traditional glaucoma research has focused on intraocular pressure and structural optic nerve changes; however, new experimental and clinical studies suggest that impaired CSF flow and glymphatic dysfunction may disrupt waste clearance, alter pressure gradients across the lamina cribrosa, and sensitize retinal ganglion cells (RGCs) to injury in both high- and normal-tension glaucoma. Advances in imaging technologies, computational models, and molecular techniques are beginning to unravel the underlying neurofluid interactions implicated in optic neuropathies. Despite these developments, significant gaps remain regarding the precise mechanisms, the interplay between fluid systems and ocular tissues, and the translation of these insights into clinical diagnostics or therapeutics for glaucoma.This Research Topic aims to deepen our understanding of how cerebrospinal fluid dynamics and glymphatic system function impact optic nerve physiology and contribute to glaucoma’s onset and progression. Specifically, the objective is to clarify the molecular, anatomical, and physiological mechanisms underlying neurofluid dysfunction and retinal ganglion cell vulnerability, leveraging a multidisciplinary approach that spans basic science, advanced imaging, modeling, and clinical studies. Ultimately, the goal is to pave the way for the identification of new biomarkers and potential therapeutic interventions, thereby moving beyond intraocular pressure-centric models toward a comprehensive neuro-ophthalmic paradigm in glaucoma management.This Research Topic welcomes investigations within, but not limited to, the following boundaries: studies focused on neurofluid interactions, glymphatic dysfunction, and CSF dynamics directly related to optic nerve and retinal health in glaucoma. Research not directly within the scope of glaucoma or without a connection to neurofluid systems will not be considered. To gather further insights, we invite submissions relating to:- The impact of CSF pressure and translaminar pressure gradients in various glaucoma subtypes, including normal-tension glaucoma- Anatomical and functional evidence for glymphatic pathways in the optic nerve and retina, and changes in glaucomatous eyes- Novel imaging modalities for assessing CSF flow and glymphatic function in peri-optic tissues- Molecular and cellular regulators of glymphatic transport, including astrocytes, aquaporin-4 channels, vascular pulsatility, and inflammation- Animal models and computational simulations of neurofluid dysfunction contributing to RGC loss- Interactions between intraocular pressure, CSF dynamics, and glymphatic clearance in disease progression- Development and application of CSF-related or glymphatic biomarkers for glaucoma phenotyping and risk assessment- Innovative or emerging therapeutic strategies for modulating CSF or glymphatic function in glaucoma careAll types of articles accepted by Frontiers in Ophthalmology are welcome. Topic editors: Jean-Claude Mwanza, David Fleischman, Benjamin J Frankfort Source: https://www.frontiersin.org/research-topics/79877/cerebrospinal-fluid-glymphatic-pathways-and-optic-nerve-health-in-glaucoma