Does chronic topical corticosteroid use affect the aqueous outflow of the Corneoscleral or Uveoscleral pathway primarily?

Chronic topical corticosteroid use is known to primarily influence the aqueous outflow through the corneoscleral pathway. Corticosteroids can lead to increased resistance to aqueous humor outflow, which can result in elevated intraocular pressure. This effect is largely due to the changes that the corticosteroids induce within the trabecular meshwork, the primary site involved in the corneoscleral outflow pathway.

In the presence of corticosteroids, there can be alterations in the extracellular matrix and its components, causing changes in cell morphology and reducing the ability of the aqueous humor to flow through the trabecular meshwork effectively. As a result, the aqueous drainage through the corneoscleral pathway becomes less efficient, contributing to the risk of developing steroid-induced glaucoma.

Conversely, while the uveoscleral pathway does allow for some aqueous humor drainage, the evidence suggests that corticosteroids do not have as significant an impact on this route compared to the corneoscleral pathway. Instead, the influences on the uveoscleral outflow are not as pronounced and do not lead to the same increased outflow resistance caused by corticosteroids.

Thus, the correct answer highlights the specific pathway affected by prolonged corticosteroid use in the ocular context