Intracranial pressure linked to changes in nasal visual field in patients with glaucoma
Researchers have identified significant associations between intracranial pressure, translaminar pressure difference and visual field parameters in patients with normal-tension glaucoma, according to a study published in Diagnostics.
“Recently, researchers have focused on intracranial pressure (ICP) and translaminar pressure difference as a component having a potential role in glaucomatous optic neuropathy,” Akvile Stoskuviene, of the Eye Clinic at Lithuanian University of Health Sciences, and colleagues wrote. “Although some small studies have reported that ICP is not reduced in glaucoma, the literature overall largely supports the influence of reduced ICP in the development and progression of glaucoma.”
Stoskuviene and colleagues sought to assess the relationship between ICP and visual field (VF) zones in patients with normal-tension glaucoma by conducting a prospective study of 80 patients (mean age, 59.5 years) with early-stage glaucoma, all of whom underwent complete ophthalmological and neurological examinations.
Researchers evaluated IOP, visual perimetry and noninvasive ICP — measured via a two-depth transcranial doppler — and calculated translaminar pressure difference (TPD) by subtracting ICP from IOP. They divided the VFs of participants into nasal, temporal, peripheral, central and paracentral zones and calculated the average pattern deviation scores in each zone.
According to results, participants had a mean ICP of 8.5 mm Hg. Lower ICP was associated with lower IOP (P < .001) and lower systolic blood pressure (P = .02), while higher TPD correlated with lower mean deviation (P = .01) and higher pattern standard deviation (P = .01).
Further, ICP and TPD were significantly linked with the most negative averaged pattern deviation scores in the nasal zone (P = .001). There were no significant associations between ICP or TPD and any other VF zones.
“Higher translaminar pressure difference was correlated with lower mean deviation and higher pattern standard deviation,” Stoskuviene and colleagues wrote. “Intracranial pressure was significantly associated with the lowest averaged pattern deviation values within the nasal visual field zone.
“These data support additional studies to reveal the mechanistic involvement of ICP in glaucoma pathophysiology, especially as a potential biomarker for normal-tension glaucoma.”
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