Orbital cerebrospinal fluid space in glaucoma: the Beijing intracranial and iIntraocular pressure (iCOP) study

Objective - Low cerebrospinal fluid pressure (CSF-P) may be involved in the pathogenesis of glaucoma. We measured the optic nerve subarachnoid space width (ONSASW) as a surrogate for orbital CSF-P in patients with primary open-angle glaucoma (POAG) with normal and high pressure and a control group....

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Hauptverfasser: Wang, Ningli (VerfasserIn) , Jonas, Jost B. (VerfasserIn) , Weinreb, Robert N. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 28 June 2012
In: Ophthalmology
Year: 2012, Jahrgang: 119, Heft: 10, Pages: 2065-2073
ISSN:1549-4713
DOI:10.1016/j.ophtha.2012.03.054
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.ophtha.2012.03.054
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0161642012003223
Volltext
Verfasserangaben:Ningli Wang, Xiaobin Xie, Diya Yang, Junfang Xian, Yong Li, Ruojin Ren, Xiaoxia Peng, Jost B. Jonas, Robert N. Weinreb

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520 |a Objective - Low cerebrospinal fluid pressure (CSF-P) may be involved in the pathogenesis of glaucoma. We measured the optic nerve subarachnoid space width (ONSASW) as a surrogate for orbital CSF-P in patients with primary open-angle glaucoma (POAG) with normal and high pressure and a control group. - Design - Prospective observational study. - Participants - The study included 39 patients with POAG; 21 patients had normal pressure (intraocular pressure [IOP] 21 mmHg), and 18 patients had high pressure (IOP >21 mmHg); 21 subjects formed the control group. - Methods - By using magnetic resonance imaging (MRI) with fat-suppressed fast recovery fast spin echo (FRFSE) T2-weighted sequence, we determined the ONSASW at 3, 9, and 15 mm posterior to the globe. - Main Outcome Measures - The ONSASW and optic nerve diameter. - Results - At all 3 measurement locations of 3, 9, and 15 mm, the ONSASW was significantly (P<0.001, P<0.001, and P = 0.003, respectively) narrower in the normal-pressure group (0.67±0.16, 0.55±0.09, and 0.51±0.12 mm, respectively) than in the high-pressure group (0.93±0.21, 0.70±0.12, and 0.62±0.11 mm, respectively) or the control group (0.87±0.15, 0.67±0.07, and 0.61±0.07 mm, respectively). The high-pressure and control groups did not vary significantly at 3, 9, and 15 mm (P = 0.31, P = 0.39, and P = 0.44, respectively). At all 3 measurement locations, ONSASW was narrower in the normal-pressure group compared with the high-pressure and control groups after adjustment for optic nerve diameter (P<0.01). Correspondingly, the width of the optic nerve subarachnoid space measured at 3, 9, and 15 mm behind the globe, respectively, was significantly (all P<0.05) associated with IOP after adjustment for optic nerve diameter and visual field defect. - Conclusions - The narrower orbital optic nerve subarachnoid space in patients with POAG with normal pressure compared with high pressure suggests a lower orbital CSF-P in patients with POAG with normal pressure. - Financial Disclosure(s) - The author(s) have no proprietary or commercial interest in any materials discussed in this article. 
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