What we can learn about biology from monogenic diseases; KIF11 and the glymphatic and lymphatic-like system of the retina and choroid and its possible role in the pathogenesis of pachychoroid and central serous chorioretinopathy

BACKGROUND: A recent article by Farrell et al. describes changes in the retinal vasculature and choroidal vasculature in patients with pathogenic variants in KIF11. The concept of a glymphatic system in the retina and a lymphatic-like system in the choroid is still in discussion. METHODS: Discussion of how this KIF11 variant helps to understand the glymphatic system in the retina and the lymphatic-like system in the choroid with review of the literature about the lymphatic-like system of the choroid and the glymphatic system of the retina. RESULTS: Iowa single cell Spectacle shows that the VEGFR3/Flt4 is expressed in the choroid and that correlates with a few prior studies. Additionally, KIF11 is important in the expression of VEGFR3/Flt4. DISCUSSION: The recent study showed how KIF11 affects the retinal vasculature and the choroidal vasculature. As KIF11 is important in the formation of the lymphatics, it probably is related in part to the development of a lymphatic-like system in the choroid and potentially the glymphatic system of the retina.