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. 2008 Dec;49(12):5412-8.
doi: 10.1167/iovs.08-2228. Epub 2008 Aug 21.

Intracranial pressure in primary open angle glaucoma, normal tension glaucoma, and ocular hypertension: a case-control study

John P Berdahl  1 , Michael P Fautsch, Sandra S Stinnett, R Rand Allingham
Affiliations

Intracranial pressure in primary open angle glaucoma, normal tension glaucoma, and ocular hypertension: a case-control study

John P Berdahl et al. Invest Ophthalmol Vis Sci. 2008 Dec.

Abstract

Purpose: To compare intracranial pressure (ICP) in subjects with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG; subset of POAG), and ocular hypertension (OHT) with that in subjects with no glaucoma.

Methods: The study was a retrospective review of medical records of 62,468 subjects who had lumbar puncture between 1985 and 2007 at the Mayo Clinic. Of these, 57 POAG subjects, 11 NTG subjects (subset of POAG), 27 OHT subjects, and 105 control subjects met the criteria and were analyzed. A masked comparison of the relationship between ICP and other ocular and nonocular variables was performed by using univariate and multivariate analyses.

Results: ICP was significantly lower in POAG compared with age-matched control subjects with no glaucoma (9.1 +/- 0.77 mm Hg vs. 11.8 +/- 0.71 mm Hg; P < 0.0001). Subjects with NTG also had reduced ICP compared with the control subjects (8.7 +/- 1.16 mm Hg vs. 11.8 +/- 0.71 mm Hg; P < 0.01). ICP was higher in OHT than in age-matched control subjects (12.6 +/- 0.85 mm Hg vs. 10.6 +/- 0.81 mm Hg; P < 0.05).

Conclusions: ICP is lower in POAG and NTG and elevated in OHT. ICP may play an important role in the development of POAG and NTG and in preventing the progression of OHT to POAG. Further prospective and experimental studies are warranted to determine whether ICP has a fundamental role in the pathogenesis of glaucoma.

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Figures

FIGURE 1
FIGURE 1
(A) Uncorrected intracranial pressure in all groups. (B) After correction of the mean ICP of each group for variables predictive of ICP, the significant difference between POAG, the NTG subset and controls persisted and a significant difference between OHT and the control became apparent.
FIGURE 2
FIGURE 2
The translaminar pressure difference (TLPD) was higher in POAG, the NTG subset, and OHT. TLPD was calculated by subtracting ICP from maximum IOP (A) and by subtracting ICP from IOP (B) near the time of LP.
FIGURE 3
FIGURE 3
(A) ICP comparison in the current dataset. (B) ICPs in the current dataset (1985–1996) compared with those in the previous dataset (1996–2007).
See this image and copyright information in PMC

References

    1. Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–713. discussion 829–730. - PubMed
    1. Goetz C, editor. Textbook of Clinical Neurology. Philadelphia: Saunders; 2003. pp. 511–529.
    1. Morgan WH, Yu DY, Alder VA, et al. The correlation between cerebrospinal fluid pressure and retrolaminar tissue pressure. Invest Ophthalmol Vis Sci. 1998;39:1419–1428. - PubMed
    1. Berdahl JP, Allingham RR, Johnson DH. Cerebrospinal fluid pressure is decreased in primary open angle glaucoma. Ophthalmology. 2008;115(5):763–768. - PubMed
    1. Lenfeldt N, Koskinen LO, Bergenheim AT, Malm J, Eklund A. CSF pressure assessed by lumbar puncture agrees with intracranial pressure. Neurology. 2007;68:155–158. - PubMed

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