The Role of Cerebrospinal Fluid Pressure in Glaucoma Pathophysiology: The Dark Side of the Optic Disc

Morgan, William H.; Yu, Dao‐Yi; Balaratnasingam, Chandrakumar

doi:10.1097/ijg.0b013e31815c5f7c

Cited by 132 publications

(108 citation statements)

References 49 publications

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“…In animal models, one variable that has been shown to be related to structural changes in the ONH similar to the glaucomatous damage is intracranial pressure (ICP) [1]. The literature suggests that pressure gradients between intra-and extra-ocular compartments may be involved in the damage to the retinal ganglion cell's axons that cross the lamina cribosa [2,3]. However, the need for painful and invasive techniques to study ICP, such as lumbar puncture, has deterred most authors from evaluating this variable in the overall glaucoma research field.…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…5 In addition the effect of the translaminar pressure gradient on the lamina cribrosa may be important. 6,7 Additional research in this area has focused on humoral abnormalities in patients with OAG. A number of molecules are currently under investigation, such as endothelin-1, 8 vascular endothelial growth factor, 9 tumor necrosis factor-alpha, 10 matrix metalloproteinases, and their inhibitors.…”

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confidence: 99%

Lipocalin-like Prostaglandin D Synthase (L-PGDS) Concentration in Aqueous Humour in Patients With Open-angle Glaucoma

Bauer

Killer

Forrer

et al. 2014

Journal of Glaucoma

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PURPOSE:: To report on the concentration of lipocalin-like prostaglandin D synthase (L-PGDS) in the aqueous humour (AH) in patients with open-angle glaucoma (OAG). PATIENTS AND METHODS:: Prospective assessment in 20 patients (13 female, 7 male, mean age 74±10.6 y) who underwent surgery for OAG. AH was sampled and analyzed for L-PGDS concentration. AH from 26 patients (11 female, 15 male, 72.4±14.4 y) without glaucoma who underwent cataract surgery, served as control subjects. RESULTS:: The L-PGDS concentration in the AH sampled from the anterior chamber in the OAG group (5.9±2.4 mg/L) was significantly (P<0.001) higher than in the control group (3.3±1.3 mg/L). There were no significant differences between the concentrations of L-PGDS between the left and the right eye or between genders. CONCLUSIONS:: L-PGDS concentration in the AH of patients with OAG was significantly elevated compared with its concentration in the AH of nonglaucomatous eyes. As L-PGDS is a biologically pluripotent protein, its possible role in glaucoma warrants further examination. Patients and Methods: Prospective assessment in 20 patients (13 female, 7 male, mean age 74 ± 10.6 y) who underwent surgery for OAG. AH was sampled and analyzed for L-PGDS concentration. AH from 26 patients (11 female, 15 male, 72.4 ± 14.4 y) without glaucoma who underwent cataract surgery, served as control subjects.Results: The L-PGDS concentration in the AH sampled from the anterior chamber in the OAG group (5.9 ± 2.4 mg/L) was significantly (P < 0.001) higher than in the control group (3.3 ± 1.3 mg/L). There were no significant differences between the concentrations of L-PGDS between the left and the right eye or between genders.Conclusions: L-PGDS concentration in the AH of patients with OAG was significantly elevated compared with its concentration in the AH of nonglaucomatous eyes. As L-PGDS is a biologically pluripotent protein, its possible role in glaucoma warrants further examination.

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“…15,20 It has been shown that mechanical stress and possible deformation of the LC can have a deleterious effect on axonal functioning. 21,22 Furthermore, anterior displacement of prelaminar tissue following trabeculectomy for OAG has been described in a number of studies with variable results. Patients in these studies were followed up for periods varying from several weeks to 2 years, [1][2][3][4][5] and different patient populations and imaging platforms were used.…”

Section: Discussionmentioning

confidence: 99%

Topographic Optic Disc Changes After Successful Trabeculectomy Evaluated Using Spectral Domain Optical Coherence Tomography

Russo

Katsanos

Riva

et al. 2013

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To investigate topographic optic disc changes after surgical intraocular pressure (IOP) reduction in adults with open angle glaucoma (OAG). Methods: Optic discs of patients with advanced primary open angle or exfoliation glaucoma were imaged using optical coherence tomography within 1 week before trabeculectomy. Patients were rescanned 1 week, 1 month, and 1 year after surgery. Maximum cup depth (MCD), and average cup depth (ACD) were calculated. Results: Twenty-two eyes from 20 patients (age, 70.5 -10.6 years; average mean defect of visual field, -15.0 -9.8 dB) were followed up for 1 year. The IOP decreased from 22.1 -2.8 mmHg at baseline to 11.5 -2.6 mmHg 1 year following surgery (P < 0.001). One-week and 1-month postoperative IOPs were 11.2 -2.8 and 11.2 -3.5 mmHg, respectively (P < 0.001). Compared to the baseline values (356 -172 mm), postoperative ACD showed a significant decrease at 1 week (312 -164 mm; P < 0.001) and 1 month (338 -175 mm; P = 0.007) after surgery, but not at 1 year (339 -176 mm; P = 0.354). Similarly, MCD significantly decreased from baseline (477 -190 mm) 1 week (431 -203 mm; P = 0.029) and 1 month (448 -198 mm; P = 0.047) after the surgery, but not after 1 year (479 -188 mm; P = 1.0). Conclusions: Trabeculectomy reduces IOP in eyes with advanced OAG, which induces topographic optic disc changes. Such optic disc changes became less pronounced over time and were no longer detectable 1 year after surgery.

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The Role of Cerebrospinal Fluid Pressure in Glaucoma Pathophysiology: The Dark Side of the Optic Disc

Cited by 132 publications

References 49 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

Lipocalin-like Prostaglandin D Synthase (L-PGDS) Concentration in Aqueous Humour in Patients With Open-angle Glaucoma

Topographic Optic Disc Changes After Successful Trabeculectomy Evaluated Using Spectral Domain Optical Coherence Tomography

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