@article{10.1167/iovs.17-21592,
    author = {Gampa, Amulya and Vangipuram, Gautam and Shirazi, Zainab and Moss, Heather E.},
    title = "{Quantitative Association Between Peripapillary Bruch's Membrane Shape and Intracranial Pressure}",
    journal = {Investigative Ophthalmology & Visual Science},
    volume = {58},
    number = {5},
    pages = {2739-2745},
    year = {2017},
    month = {05},
    abstract = "{   The purpose of this study was to determine if there is a quantitative relationship between chronic intracranial pressure (ICP) and peripapillary Bruch's membrane (pp-BM) shape and to determine whether change in pp-BM shape can be detected within 1 hour after ICP lowering by lumbar puncture (LP).    In this study, 30° nasal-temporal optical coherence tomography B-scans were obtained within 1 hour before and after LP in 39 eyes from 20 patients (age = 23–86 years, 75\\% female, ICP [opening pressure] = 10–55 cm H2O). A total of 16 semi-landmarks defined pp-BM on each image. Geometric morphometric analysis identified principal components of shape in the image set. Generalized estimating equation models, accounting for within-subject correlation, were used to identify principal components that were associated with chronic ICP (comparing pre-LP images between eyes) and/or acute ICP changes (comparing pre- and post-LP images within eyes). The pp-BM width and anterior pp-BM location were calculated directly from each image and were studied in the same manner.    Principal component 1 scalar variable on pre-LP images was associated with ICP (P \\< 0.0005). Principal component 4 magnitude changed within eyes after LP (P = 0.003). For both principal components 1 and 4, lower ICP corresponded with a more posterior position of pp-BM. Chronic ICP was associated with both pp-BM width (6.81 μm/cm H2O; P = 0.002) and more anterior location of temporal and nasal pp-BM margins (3.41, 3.49 μm/cm H2O; P \\< 0.0005, 0.002).    This study demonstrates a quantitative association between pp-BM shape and chronic ICP level. Changes in pp-BM shape are detectable within 1 hour of lowering ICP. pp-BM shape may be a useful marker for chronic ICP level and acute ICP changes. Further study is needed to determine how pp-BM shape changes relate to clinical markers of papilledema.  }",
    issn = {1552-5783},
    doi = {10.1167/iovs.17-21592},
    url = {https://doi.org/10.1167/iovs.17-21592},
    eprint = {https://arvojournals.org/arvo/content\_public/journal/iovs/936209/i1552-5783-58-5-2739.pdf},
}