PURPOSE: To assess whether a low cerebrospinal fluid pressure (CSF-P) is associated with open-angle glaucoma in eyes with normal intraocular pressure (IOP). DESIGN: Prospective, interventional study. PARTICIPANTS: The study included 43 patients with open-angle glaucoma (14 with a normal IOP, and 29 with an elevated IOP) and 71 subjects without glaucoma. INTERVENTIONS: All patients underwent standardized ophthalmologic and neurologic examinations and measurement of lumbar CSF-P. MAIN OUTCOME MEASURES: Cerebrospinal fluid pressure and IOP. RESULTS: Lumbar CSF-P was significantly (P<0.001) lower in the normal IOP glaucoma group (9.5+/-2.2 mmHg) than in the high IOP glaucoma group (11.7+/-2.7 mmHg) or the control group (12.9+/-1.9 mmHg). The trans-lamina cribrosa pressure difference (IOP minus CSF-P) was significantly (P<0.001) higher in the normal IOP glaucoma group (6.6+/-3.6 mmHg) and the high-IOP glaucoma group (12.5+/-4.1 mmHg) than in the control group (1.4+/-1.7 mmHg). The extent of glaucomatous visual field loss was negatively correlated with the height of the CSF-P and positively correlated with the trans-lamina cribrosa pressure difference. In the control group, CSF-P was significantly correlated with both systolic blood pressure (P = 0.04) and IOP (P<0.001). The trans-lamina cribrosa pressure difference was not significantly associated with blood pressure (P = 0.97). CONCLUSIONS: In open-angle glaucoma with normal IOP, CSF-P is abnormally low, leading to an abnormally high trans-lamina cribrosa pressure difference. Pathogenetically, a low CSF-P in normal-IOP glaucoma may be similar to a high IOP in high-IOP glaucoma. Consequently, the glaucomatous visual field defect is positively correlated with the trans-lamina cribrosa pressure difference and inversely correlated with the CSF-P. In nonglaucomatous subjects, CSF-P, blood pressure, and IOP are significantly associated with each other. Copyright (c) 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
PURPOSE: To assess whether a low cerebrospinal fluid pressure (CSF-P) is associated with open-angle glaucoma in eyes with normal intraocular pressure (IOP). DESIGN: Prospective, interventional study. PARTICIPANTS: The study included 43 patients with open-angle glaucoma (14 with a normal IOP, and 29 with an elevated IOP) and 71 subjects without glaucoma. INTERVENTIONS: All patients underwent standardized ophthalmologic and neurologic examinations and measurement of lumbar CSF-P. MAIN OUTCOME MEASURES: Cerebrospinal fluid pressure and IOP. RESULTS: Lumbar CSF-P was significantly (P<0.001) lower in the normal IOP glaucoma group (9.5+/-2.2 mmHg) than in the high IOP glaucoma group (11.7+/-2.7 mmHg) or the control group (12.9+/-1.9 mmHg). The trans-lamina cribrosa pressure difference (IOP minus CSF-P) was significantly (P<0.001) higher in the normal IOP glaucoma group (6.6+/-3.6 mmHg) and the high-IOP glaucoma group (12.5+/-4.1 mmHg) than in the control group (1.4+/-1.7 mmHg). The extent of glaucomatous visual field loss was negatively correlated with the height of the CSF-P and positively correlated with the trans-lamina cribrosa pressure difference. In the control group, CSF-P was significantly correlated with both systolic blood pressure (P = 0.04) and IOP (P<0.001). The trans-lamina cribrosa pressure difference was not significantly associated with blood pressure (P = 0.97). CONCLUSIONS: In open-angle glaucoma with normal IOP, CSF-P is abnormally low, leading to an abnormally high trans-lamina cribrosa pressure difference. Pathogenetically, a low CSF-P in normal-IOP glaucoma may be similar to a high IOP in high-IOP glaucoma. Consequently, the glaucomatous visual field defect is positively correlated with the trans-lamina cribrosa pressure difference and inversely correlated with the CSF-P. In nonglaucomatous subjects, CSF-P, blood pressure, and IOP are significantly associated with each other. Copyright (c) 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Authors: Ian A Sigal; Richard A Bilonick; Larry Kagemann; Gadi Wollstein; Hiroshi Ishikawa; Joel S Schuman; Jonathan L Grimm Journal: Invest Ophthalmol Vis Sci Date: 2012-05-04 Impact factor: 4.799
Authors: Ian A Sigal; Hongli Yang; Michael D Roberts; Jonathan L Grimm; Claude F Burgoyne; Shaban Demirel; J Crawford Downs Journal: Invest Ophthalmol Vis Sci Date: 2011-11-21 Impact factor: 4.799
Authors: Hongli Yang; Hilary Thompson; Michael D Roberts; Ian A Sigal; J Crawford Downs; Claude F Burgoyne Journal: Invest Ophthalmol Vis Sci Date: 2011-01-21 Impact factor: 4.799
Authors: Ian A Sigal; Hongli Yang; Michael D Roberts; Claude F Burgoyne; J Crawford Downs Journal: Invest Ophthalmol Vis Sci Date: 2011-03-30 Impact factor: 4.799
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