Determination of the Trans-Lamina Cribrosa Pressure Difference in a Community-Based Population and its Association with Open-Angle Glaucoma.

Autor: Tailor PD; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota., Aul BJ; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota., Sit AJ; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota., Fautsch MP; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota., Chen JJ; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota; Department of Neurology, Mayo Clinic, Rochester, Minnesota. Electronic address: Chen.John@mayo.edu.
Jazyk: angličtina
Zdroj: Ophthalmology. Glaucoma [Ophthalmol Glaucoma] 2024 Mar-Apr; Vol. 7 (2), pp. 168-176. Date of Electronic Publication: 2023 Oct 01.
DOI: 10.1016/j.ogla.2023.09.002
Abstrakt: Purpose: To determine the trans-lamina cribrosa pressure difference (TLCPD) in a cohort of normal community-based patients and the relationship to primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG).
Design: Retrospective cohort study of the Mayo Clinic Study of Aging.
Participants: The Mayo Clinic Study of Aging is a prospective study evaluating the normal aging population.
Methods: Mayo Clinic Study of Aging patients who underwent routine lumbar puncture (LP) studies with eye examinations were reviewed. The trans-lamina cribrosa pressure difference was calculated in 2 contexts of intraocular pressure (IOP): (1) maximum IOP at eye visit closest in time to the LP (closest-in-time TLCPD); and (2) IOP before IOP-lowering treatment (pretreatment IOP and pretreatment TLCPD) in POAG and NTG patients. Glaucoma patients without POAG or NTG were excluded. Regression analyses were performed to determine the relationship with glaucoma.
Main Outcome Measures: IOP, intracranial pressure, TLCPD, POAG, normal-tension glaucoma (NTG) diagnosis, glaucoma parameters.
Results: Five hundred forty-eight patients were analyzed. Of these, there were 38 treated glaucoma patients (14 POAG and 24 NTG) and 510 nonglaucomatous patients. Cerebral spinal fluid (CSF) opening pressure was 155.0 ± 42.2 mmH 2 O in nonglaucomatous patients, 144.0 ± 34.0 mmH 2 O in POAG (P = 0.15 vs. nonglaucomatous patients), and 136.6 ± 29.3 mmH 2 O in NTG (P = 0.017 vs. nonglaucomatous patients). Intraocular pressure was 15.47 ± 2.9 mmHg in nonglaucomatous patients, 26.6 ± 3.7 mmHg in POAG, and 17.4 ± 3.4 mmHg in NTG. The closest-in-time TLCPD in the nonglaucomatous cohort was 4.07 ± 4.22 mmHg, which was lower than both the POAG cohort (7.19 ± 3.6 mmHg) and the NTG cohort (5.79 ± 4.5 mmHg, P = 0.04). Pretreatment TLCPD for the overall glaucoma cohort was 10.57 ± 6.1 mmHg. The POAG cohort had a higher pretreatment TLCPD (16.05 ± 5.2 mmHg) than the NTG cohort (7.37 ± 4.1 mmHg; P < 0.0001). Closest-in-time TLCPD for the nonglaucoma cohort (4.07± 4.2 mmHg) was significantly lower than pretreatment TLCPDs for both POAG (16.05 ± 5.2 mmHg; P < 0.0001) and NTG (7.37 ± 4.1 mmHg; P < 0.0001) cohorts.
Conclusions: This study establishes the baseline TLCPD in a large cohort of normal, community-based patients. The differences in regression analysis between TLCPD and IOP suggests NTG pathophysiology is partially driven by TLCPD, but is also likely multifactorial.
Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
(Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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