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Low cerebrospinal fluid pressure linked to open-angle glaucoma cases with low IOP
Ophthalmology. 2010;117(2);259-266.
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A prospective study found that lumbar cerebrospinal fluid pressure was significantly lower in normal IOP glaucoma patients, at 9.5 mm Hg, compared with glaucoma patients with high IOP, at 11.7 mm Hg, and a control group without glaucoma, at 12.9 mm Hg.
"In open-angle glaucoma with normal IOP, [cerebrospinal fluid pressure] is abnormally low, leading to an abnormally high trans-lamina cribrosa pressure difference. Pathogenetically, a low [cerebrospinal fluid pressure] in normal-IOP glaucoma may be similar to a high IOP in high-IOP glaucoma," the study authors said. "Consequently, the glaucomatous visual field defect is positively correlated with the trans-lamina cribrosa pressure difference and inversely correlated with the [cerebrospinal fluid pressure]."
The interventional study looked at 43 open-angle glaucoma subjects and 71 subjects without glaucoma. Of the 43 glaucoma patients, 14 had normal IOP and 29 had elevated IOP.
All study subjects had standardized ophthalmologic and neurologic examinations and measurement of lumbar cerebrospinal fluid pressure. The study's main outcome measures were IOP and cerebrospinal fluid pressure.
For patients without glaucoma, cerebrospinal fluid pressure, blood pressure and IOP were "significantly associated with each other," the authors said.
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