Cerebrospinal Fluid Pressure Is Decreased in Primary Open-angle Glaucoma

Ophthalmology ◽  
2008 ◽  
Vol 115 (5) ◽  
pp. 763-768 ◽  
Author(s):  
John P. Berdahl ◽  
R. Rand Allingham ◽  
Douglas H. Johnson
2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Catherine G. Knier ◽  
David Fleischman ◽  
David O. Hodge ◽  
John P. Berdahl ◽  
Michael P. Fautsch

Elevated intraocular pressure (IOP) is the most prevalent risk factor for primary open-angle glaucoma. However, IOP alone does not fully describe a mechanical basis for disease in patients with normal tension glaucoma or primary open-angle glaucoma. The translaminar pressure difference (TLPD) theory proposes that the pressure gradient generated by the difference of IOP and cerebrospinal fluid pressure (CSFp) acting at the level of the optic nerve can lead to cupping and glaucoma when IOP is higher than normal and/or CSFp is lower than normal. The study results to date have generally supported the TLPD theory; however, varying methods, populations, and sample sizes make it difficult to compare results. To further assess whether there is an association between low CSFp and open-angle glaucoma, 30 years of clinical data that assess 96,543 lumbar punctures were analyzed. Patients with open-angle glaucoma showed a significantly lower CSFp than randomly selected normal control patients (9.9 ± 3 mm·Hg (n = 86) versus 12.1 ± 3.6 mm·Hg (n = 114), p < 0.001 ) following adjustment for age and sex. This retrospective study provides strong evidence for an association between open-angle glaucoma and low CSFp.


2014 ◽  
Vol 93 (3) ◽  
pp. e234-e236 ◽  
Author(s):  
David Fleischman ◽  
John Berdahl ◽  
Sandra S. Stinnett ◽  
Michael P. Fautsch ◽  
R. R. Allingham

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e86678 ◽  
Author(s):  
Jost B. Jonas ◽  
Ningli Wang ◽  
Ya Xing Wang ◽  
Qi Sheng You ◽  
Xiaobin Xie ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Laura Landi ◽  
Federica Casciaro ◽  
Serena Telani ◽  
Carlo E. Traverso ◽  
Alon Harris ◽  
...  

Purpose. To investigate potential associations between intraocular pressure (IOP) and cerebrospinal fluid pressure (CSFP) in patients with primary open-angle glaucoma (POAG) and healthy subjects. Methods. Forty-three subjects were recruited. Weight and height were measured to calculate body mass index (BMI), along with blood pressure, heart rate, visual acuity, and IOP. Biometrics exam, corneal pachymetry, peripapillary retinal nerve fiber layer (RNFL) thickness, and macular thickness were assessed. The visual field exam was performed on all patients, and both pattern standard deviation (PSD) and mean deviation (MD) were considered. CSFP was estimated indirectly by using the mathematical formula CSFP = 0.44 × BMI + 0.16 × diastolic pressure − 0.18 × age − 1.91, based on the previous scientific studies. The TLCPD was calculated as follows: IOP−CSFP. Results. A significant (p<0.05) difference was found between the two groups for several parameters. Specifically, the CSFP was lower in patients with POAG than in healthy subjects (8.14 ± 4.52 and 7.43 ± 2.06, p<0.001, respectively). Anamnestic TLCPD was found to be significantly (p<0.001) higher in patients with POAG compared to healthy subjects. A significant (p<0.05) correlation was found between anamnestic TLCPD and MD (r = −0.31), inferior RNFL thickness (r = −0.29), superior RNFL thickness (r = −0.27), IOP (r = 0.22), and CSFP (r = −0.46). Conclusion. The CSFP was lower in glaucomatous patients compared to healthy subjects, whereas the TLCPD was higher in glaucomatous patients compared to healthy subjects, even though this difference was not statistically significant. A higher TLCPD may damage the RNFL, resulting in functional visual field impairment.


PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0162862 ◽  
Author(s):  
Lan Li ◽  
Cairui Li ◽  
Hua Zhong ◽  
Yijin Tao ◽  
Yuansheng Yuan ◽  
...  

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