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Normal-Tension Glaucoma Has Normal Intracranial Pressure: A Prospective Study of Intracranial Pressure and Intraocular Pressure in Different Body Positions
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
Umeå University, Faculty of Medicine, Department of Radiation Sciences.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
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2018 (English)In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 125, no 3, p. 361-368Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To test the hypothesis that normal-tension glaucoma (NTG) is caused by an increased pressure difference across the lamina cribrosa (LC) related to a low intracranial pressure (ICP).

DESIGN: Prospective case-control study.

PARTICIPANTS: Thirteen NTG patients (9 women; median 71 [range: 56-83] years) were recruited for investigation with the same protocol as 11 healthy volunteers (8 women; 47 [30-59] years). A larger control group (n = 51; 30 women; 68 [30-81] years) was used only for ICP comparison in supine position.

METHODS: ICP and intraocular pressure (IOP) were simultaneously measured in supine, sitting, and 9° head-down tilt (HDT) positions. Trans-lamina cribrosa pressure difference (TLCPD) was calculated using ICP and IOP together with geometric distances estimated from magnetic resonance imaging to adjust for hydrostatic effects.

MAIN OUTCOME MEASURES: ICP, IOP, and TLCPD in different body positions.

RESULTS: Between NTG patients and healthy volunteers, there were no differences in ICP, IOP, or TLCPD in supine, sitting, or HDT (P ≥ 0.11), except for IOP in HDT (P = 0.04). There was no correlation between visual field defect and TLCPD, IOP, or ICP and in any body position (P ≥ 0.39). Mean ICP in supine was 10.3 mmHg (SD = 2.7) in the NTG group (n = 13) and 11.3 (2.2) mmHg in the larger control group (n = 51) (P = 0.24).

CONCLUSIONS: There was no evidence of reduced ICP in NTG patients as compared with healthy controls, either in supine or in upright position. Consequently, the hypothesis that NTG is caused by an elevated TLCPD from low ICP was not supported.

Place, publisher, year, edition, pages
2018. Vol. 125, no 3, p. 361-368
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:umu:diva-142423DOI: 10.1016/j.ophtha.2017.09.022ISI: 000425377300015PubMedID: 29096996OAI: oai:DiVA.org:umu-142423DiVA, id: diva2:1161403
Funder
Swedish Research Council, 2015-05616
Available from: 2017-11-30 Created: 2017-11-30 Last updated: 2018-04-18Bibliographically approved

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Lindén, ChristinaQvarlander, SaraJóhannesson, GautiJohansson, EliasÖstlund, FannyMalm, JanEklund, Anders
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OphthalmologyDepartment of Radiation SciencesClinical NeuroscienceUmeå Centre for Functional Brain Imaging (UFBI)
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