Cerebrospinal fluid dynamics between the intracranial and the subarachnoid space of the optic nerve. Is it always bidirectional?

Killer, Hanspeter E.; Jaggi, Gregor P.; Flammer, Josef; Miller, Neil R.; Huber, Andreas; Mironov, A

doi:10.1093/brain/awl324

Cited by 226 publications

(194 citation statements)

References 52 publications

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“…Moreover, we have tested our measurements at the same position in all the patients, while the MRI study searched for the wider ONSD section area. Data from both retrospective and prospective studies suggest that peripherally measured ICP is diminished in NTG patients when compared to other neurologic patients [18,19]. While there is a possibility for the underlying neurological condition to have an impact on the ICP, one would expect ONSD to be decreased in such patients.…”

Section: Discussionmentioning

confidence: 99%

Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma

Pinto

Vandewalle

Pronk

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Purpose 1. Identify differences in optic nerve sheath diameter (ONSD) as an indirect measure of intracranial pressure (ICP) in glaucoma patients and a healthy population. 2. Identify variables that may correlate with ONSD in primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) patients. Methods Patients with NTG (n046) and POAG (n061), and healthy controls (n042) underwent B-scan ultrasound measurement of ONSD by an observer masked to the patient diagnosis. Intraocular pressure (IOP) was measured in all groups, with additional central corneal thickness (CCT) and visual field defect measurements in glaucomatous patients. Only one eye per patient was selected. Kruskal-Wallis or Mann-Whitney were used to compare the different variables between the diagnostic groups. Spearman correlations were used to explore relationships among these variables. Results ONSD was not significantly different between healthy, NTG and POAG patients (6.09±0.78, 6.03±0.69, and 5.71±0.83 respectively; p00.08). Visual field damage and CCT were not correlated with ONSD in either of the glaucoma groups (POAG, p00.31 and 0.44; NTG, p00.48 and 0.90 respectively). However, ONSD did correlate with IOP in NTG patients (r00.53, p<0.001), while it did not in POAG patients and healthy controls (p00.86, p00.46 respectively). Patient's age did not relate to ONSD in any of the groups (p>0.25 in all groups). Conclusions Indirect measurements of ICP by ultrasound assessment of the ONSD may provide further insights into the retrolaminar pressure component in glaucoma. The correlation of ONSD with IOP solely in NTG patients suggests that the translaminar pressure gradient may be of particular importance in this type of glaucoma.

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Section: Discussionmentioning

confidence: 99%

Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma

Pinto

Vandewalle

Pronk

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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“…54 Authors performed MRI and CT-cisternography and compared albumin, IgG, x-trace protein, and brain-derived protein lipocalin-like prostaglandin D-synthase content. From differences in ratios of CSF proteins in optic nerve vs the lumbar region, and cisternography, they concluded that CSF flow compartmentalized in the optic nerve under these pathological conditions.…”

Section: Haemodilutionmentioning

confidence: 99%

Perioperative visual loss: what do we know, what can we do?

Roth¹

2009

British Journal of Anaesthesia

253

116

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Perioperative visual loss (POVL), a rare, but devastating complication, can follow non-ocular surgery. Highest rates of visual loss are with cardiac and spine surgery. The main causes of visual loss after non-ocular surgery are retinal vascular occlusion and ischaemic optic neuropathy. This review updates readers on the incidence, suspected risk factors, diagnosis, and treatment of POVL due to these conditions. Br J Anaesth 2009; 103 (Suppl. 1): i31-i40Keywords: complications, neurological; complications, neuropathy; eye, intraocular pressure; eye, pupil; surgery, spinal Visual loss after anaesthesia and surgery is a rare, unexpected, and devastating complication. Clinicians have suspected that incidence is increasing, particularly with spinal fusion surgery; however, recent data suggest that this may not be the case. This review will update readers on the incidence, suspected risk factors, diagnosis, and treatment of perioperative visual loss (POVL), in the setting of non-ocular surgery. The causes of POVL are primarily retinal vascular occlusion (RVO) and ischaemic optic neuropathy (ION). The relevant anatomy of the ocular circulation has been reviewed elsewhere and is summarized in Figure 1. 80 Other sources are glycine toxicity during transurethral resection of the prostate, acute angle closure glaucoma, cortical blindness, and expansion of an intraocular sulphur hexafluoride vitrectomy bubble by administration of nitrous oxide. As these are less common, the reader is referred for details to a recent more inclusive review. 80

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“…Histological examination of the meninges of the human optic nerve showed the perioptic SAS most narrow in the intracanalicular region. 7 In view of the anatomical features and our observation of notable SAS dilation at the intraorbital region, a check valve phenomenon at the intracanalicular region may have caused local CSF entrapment. 8,9 Another possible explanation is impaired CSF absorption.…”

Section: Discussionmentioning

confidence: 84%

“…Owing to the cul-de-sac structure, CSF dynamics between the intracranial SAS and the SAS of the optic nerve remain to be determined in detail. 7,9 Killer and colleagues reported that lymphatics present in the optic dura oŠers an out‰ow pathway of CSF at the optic nerve sheath. 10 In our case, MR imaging demonstrated enhancing dura mater along with the optic nerve sheath.…”

Section: Discussionmentioning

confidence: 99%

Reversible Distension of the Subarachnoid Space around the Optic Nerves in a Case of Idiopathic Hypertrophic Pachymeningitis

et al. 2012

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Idiopathic hypertrophic pachymeningitis (IHP) is a chronic in‰ammatory disease of unknown cause. We report a case of IHP with bilateral distended subarachnoid space (SAS) of the optic nerves and unilateral visual disturbance. We observed marked amelioration of magnetic resonance (MR) imagingˆndings after initiation of treatment with prednisolone. This radiologicalˆnding implicates optic nerve sheath involvement that aŠects cerebrospinal ‰uid (CSF) dynamics around the optic nerve.

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Cerebrospinal fluid dynamics between the intracranial and the subarachnoid space of the optic nerve. Is it always bidirectional?

Cited by 226 publications

References 52 publications

Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma

Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma

Perioperative visual loss: what do we know, what can we do?

Reversible Distension of the Subarachnoid Space around the Optic Nerves in a Case of Idiopathic Hypertrophic Pachymeningitis

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