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Intracranial pressure (ICP) and optic nerve subarachnoid space pressure (ONSP) correlation in the optic nerve chamber: the Beijing Intracranial and Intraocular Pressure (iCOP) study

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机构: [a]Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China [b]Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and VisualSciences Key Laboratory, Beijing, China [c]Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China [d]Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China [e]Department of Ophthalmology, Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China [f]Eye center, New York Eye and Ear Infirmary, NY, USA [g]Department of Endoscopic and Microinvasive Neurosugery, Beijing Neurosurgery Institute, Beijing Tiantian Hospital,Capital Medical University, Beijing, China [h]Institute of Medical Psychology, Medical Faculty, Otto-v.-Guericke University of Magdeburg, Magdeburg, Germany
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关键词: Optic nerve subarachnoid space pressure (ONSP) Cerebrospinal fluid dynamics Trans-optic canal pressure gradient (TCPG) Optic nerve chamber Optic neuropathy Glaucoma

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Purpose: Because a lowered intracranial pressure (ICP) is a possible mechanism of optic neuropathy, we wished to study the CSF dynamics in the optic nerve chamber by recording possible changes in the optic nerve subarachnoid space pressure (ONSP) and the impact on it when acutely lowering ICP. Methods: In eight normal dogs pressure probes were implanted in the left brain ventricle, lumbar cistern, optic nerve subarachnoid space and in the anterior eye chamber. Following CSF shunting from the brain ventricle we monitored changes of ICP, lumbar cistern pressure (LCP), ONSP and intraocular pressure (IOP). Results: At baseline, the pressures were different with ICP > LCP > ONSP but correlated with each other (P < 0.001). The "trans-lamina cribrosa pressure gradient" (TLPG) was highest for IOP-ONSP, lower for IOP-LCP, and lowest for IOP-ICP (P < 0.001). During CSF shunting the ICP gradually decreased in a linear fashion together with the ONSP ("ICP-depended zone"). But when the ICP fell below a critical breakpoint, ICP and ONSP became uncoupled and ONSP remained constant despite further ICP decline ("ICP-independent zone"). Conclusions: Because the parallel decline of ICP and ONSP breaks down when ICP decreases below a critical breakpoint, we interpret this as a sign of CSF communication arrest between the intracranial and optic nerve SAS. This may be caused by obstructions of either CSF inflow through the optic canal or outflow into the intra-orbital cavity. This CSF exchange arrest may be a contributing factor to optic nerve damage and the optic nerve chamber syndrome which may influence the loss of vision or its restoration. (C) 2016 Elsevier B.V. All rights reserved.

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出版当年[2015]版:
大类 | 3 区 医学
小类 | 4 区 神经科学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 神经科学
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出版当年[2014]版:
Q2 NEUROSCIENCES
最新[2023]版:
Q3 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [a]Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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通讯机构: [b]Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and VisualSciences Key Laboratory, Beijing, China [c]Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China [g]Department of Endoscopic and Microinvasive Neurosugery, Beijing Neurosurgery Institute, Beijing Tiantian Hospital,Capital Medical University, Beijing, China [*1]Department of Endoscopic and Microinvasive Neurosugery, Beijing Neurosurgery Institute, Beijing Tiantian Hospital,Capital Medical University, No.6 Tiantanxili Street, Dongcheng District,Beijing,China.100050. [*2]Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, No.1 Dongjiaominxiang Street, Dongcheng District,Beijing 100730,China.
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