Determinants of maximum cup depth in non-glaucoma and primary open-angle glaucoma subjects: a population-based study

Abstract

Background/objectives To study the associations of intraocular pressure (IOP) and retinal vessel diameters: central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) with the maximum cup depth (MCD) in subjects with and without POAG. Subjects/methods Eligible subjects from the Handan Eye Study. All participants underwent physical and comprehensive eye examinations. Univariable and multivariable linear regression models assessed the association between MCD and other parameters. Results Four thousand one hundred and ninety-four eligible nonglaucoma and 40 POAG subjects were analyzed. On univariable analysis, deeper MCD was significantly associated with younger age, male gender, lower systolic blood pressure (BP), higher IOP, higher estimated cerebro-spinal fluid pressure (ECSFP), lower estimated trans-laminal cribrosa pressure difference (ETLCPD), longer axial length, narrower CRAE, narrower CRVE, larger disc area (DA) and a lower prevalence of hypertension and diabetes. On multivariable analysis, significant independent determinants of MCD were larger DA (P < 0.001; beta: 0.042; B: 0.20; 95% CI: 0.19, 0.22), younger age (P < 0.001; beta: −0.09; B: −0.002; 95% CI: −0.003, −0.001), higher IOP (P < 0.01; beta: 0.040; B: 0.003; 95% CI: 0.001, 0.005), and narrower CRAE (P < 0.001; beta: −0.06; B: −0.001; 95% CI: −0.001, −0.0003). On adding ECSFP and ETLCPD to the model, MCD was associated with IOP but not with estimated CSFP and TLCPD. A 1 μm decrease in CRAE or 1 mmHg increase of IOP was associated with a 1 μm increase of MCD (P < 0.001) and 3 μm increase of MCD respectively (P = 0.009). Conclusions Narrow CRVE and higher IOP are associated with an increase in MCD.

“Dual‐pressure theory” in pathogenesis of glaucomatous optic neuropathy from the Beijing intracranial and intraocular pressure study

“…Handan Eye Study [60], and Central Indian Eye Disease Study [18]. The sensitivity and specificity of ONSASA value for ICP prediction could reach 1.00 and 0.92, respectively, when a 20 mmHg cutoff point for ICP grading was set.…”

“…The formula has been verified and used in several large‐scale natural population studies including the Beijing Eye Study [17], Handan Eye Study [60], and Central Indian Eye Disease Study [18]. The technique has been evaluated as “a simple and elegant solution to the challenge of clinically non‐invasive ICP measurement [61]”.…”

Three-Decade Evaluation of Cerebrospinal Fluid Pressure in Open-Angle Glaucoma at a Tertiary Care Center

“…In contrast, studies measuring the optic nerve sheath diameter as a surrogate for CSFp did not find a significant association with TLPD in OAG [12,14]. Studies using measured or estimated CSFp based on patient BMI, diastolic blood pressure, and age have shown both positive and negative associations between CSFp, OAG, and OHT [8,10,[15][16][17].…”