Intracranial Pressure in Primary Open Angle Glaucoma, Normal Tension Glaucoma, and Ocular Hypertension: A Case-Control Study

• Published in: Investigative ophthalmology & visual science Vol. 49; no. 12; pp. 5412 - 5418
• Main Authors: Berdahl, John P, Fautsch, Michael P, Stinnett, Sandra S, Allingham, R. Rand
• Format: Journal Article
• Language: English
• Published: Rockville, MD ARVO 01.12.2008; Association for Research in Vision and Ophtalmology
• Subjects: Adult; Aged; Biological and medical sciences; Case-Control Studies; Eye and associated structures. Visual pathways and centers. Vision; Female; Fundamental and applied biological sciences. Psychology; Glaucoma and intraocular pressure; Glaucoma, Open-Angle - physiopathology; Humans; Intracranial Pressure - physiology; Intraocular Pressure - physiology; Male; Medical sciences; Middle Aged; Ocular Hypertension - physiopathology; Ophthalmology; Retrospective Studies; Spinal Puncture; Vertebrates: nervous system and sense organs; Eye disease; Open angle glaucoma; Ocular hypertension; Primary; Case control study; Ophthalmology; Intracranial pressure; Low tension glaucoma
• DOI: 10.1167/iovs.08-2228
• ISSN: 0146-0404; 1552-5783

To compare intracranial pressure (ICP) in subjects with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG; subset of POAG), and ocular hypertension (OHT) with that in subjects with no glaucoma. The study was a retrospective review of medical records of 62,468 subjects who had lumbar puncture between 1985 and 2007 at the Mayo Clinic. Of these, 57 POAG subjects, 11 NTG subjects (subset of POAG), 27 OHT subjects, and 105 control subjects met the criteria and were analyzed. A masked comparison of the relationship between ICP and other ocular and nonocular variables was performed by using univariate and multivariate analyses. ICP was significantly lower in POAG compared with age-matched control subjects with no glaucoma (9.1 +/- 0.77 mm Hg vs. 11.8 +/- 0.71 mm Hg; P < 0.0001). Subjects with NTG also had reduced ICP compared with the control subjects (8.7 +/- 1.16 mm Hg vs. 11.8 +/- 0.71 mm Hg; P < 0.01). ICP was higher in OHT than in age-matched control subjects (12.6 +/- 0.85 mm Hg vs. 10.6 +/- 0.81 mm Hg; P < 0.05). ICP is lower in POAG and NTG and elevated in OHT. ICP may play an important role in the development of POAG and NTG and in preventing the progression of OHT to POAG. Further prospective and experimental studies are warranted to determine whether ICP has a fundamental role in the pathogenesis of glaucoma.