Relationship between the optic nerve sheath diameter and lumbar cerebrospinal fluid pressure in patients with normal tension glaucoma
Relationship between the optic nerve sheath diameter and lumbar cerebrospinal fluid pressure in patients with normal tension glaucoma
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DOI：
10.1038/eye.2017.70
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发表时间：
2017-09-01
期刊：
影响因子：
3.9
通讯作者：
Killer, H. E.
中科院分区：
文献类型：
--
作者：
Pircher, A.;Montali, M.;Killer, H. E.
目的 探讨白种人正常眼压性青光眼（NTG）患者视神经鞘直径（ONSD）与腰椎脑脊液压力（CSF-p）的关系。 患者与方法 对瑞士阿劳州立医院眼科 2005 年至 2015 年开角型青光眼患者的病历进行回顾性分析。共有 38 名患者（平均年龄 68.6 +/- 11.3 岁，21 名女性和 17 名男性）符合 NTG 的诊断标准，并接受了眼眶计算机断层扫描 (CT) 和腰椎穿刺 (LP)。总共 38 名年龄和性别匹配、没有已知 ON 疾病的白人受试者（平均年龄：68.9 +/- 10.9 岁）作为 ONSD 测量的对照。 ONSD 在距离后眼球 3 mm 处测量，腰椎 CSF-p 与测量结果相关。通过使用独立双尾 t 检验和非参数 Spearman 相关检验进行统计分析。 结果 NTG 中的平均 ONSD 测量为 6.4 +/- 0.9 mm，对照组为 5.4 +/- 0.6 mm。 NTG 和对照之间的差异显示出统计学显着性（t 检验：P < 0.000）。 NTG 中的平均 CSF-p 为 11.6 +/- 3.7 mm Hg。 ONSD 和 CSF-p 之间不存在统计学上的显着相关性（Spearman 相关系数 rho = 0.06，P = 0.72）。 结论 这项研究表明 38 名白种人 NTG 患者的 ONSD 增大且腰椎 CSF-p 正常。由于增大的 ONSD 通常与颅内 CSF-p 增加相关，因此这些结果可以通过颅内和眶内蛛网膜下腔之间 CSF-p 的通讯受到干扰来解释。
Purpose To investigate on the relationship between the optic nerve sheath diameter (ONSD) and the lumbar cerebrospinal fluid pressure (CSF-p) in Caucasian patients with normal tension glaucoma (NTG).Patients and methods Retrospective analysis of medical records of patients with open-angle glaucoma in the period from 2005 to 2015 from the Ophthalmology Department, Cantonal Hospital Aarau, Switzerland was performed. A total of 38 patients (mean age 68.6 +/- 11.3 years, 21 females and 17 males) fulfilled the diagnostic criteria of NTG and underwent computed tomography (CT) of the orbit and lumbar puncture (LP). In total, 38 age-and gender-matched Caucasian subjects (mean age: 68.9 +/- 10.9 years) without known ON diseases served as controls for ONSD measurements. ONSDs were measured at a distance of 3 mm from the posterior globe and lumbar CSF-p was related to the measurements. Statistical analysis was performed by using the independent two-tailed t-test and the non-parametric Spearman's correlation test.Results The mean ONSD in NTGs measured 6.4 +/- 0.9 mm and in controls 5.4 +/- 0.6 mm. The difference between NTGs and controls showed statistical significance (t-test: P < 0.000). The mean CSF-p in NTG was 11.6 +/- 3.7 mm Hg. There was no statistical significant correlation between ONSD and CSF-p (Spearman's correlation coefficient rho = 0.06, P = 0.72).Conclusions This study demonstrates enlarged ONSDs and normal lumbar CSF-p in 38 Caucasian NTG patients. As enlarged ONSDs generally are associated with increased intracranial CSF-p, these results can be explained by a disturbed communication of CSF-p between the intracranial and intraorbital subarachnoid spaces.