April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
CSF Trends in Diseases Associated with Glaucoma
Author Affiliations & Notes
  • David Fleischman
    Ophthalmology, University of North Carolina, Chapel Hill, NC
  • John P Berdahl
    Vance Thompson Vision, Sioux Falls, SD
  • Sandra S Stinnett
    Duke University Eye Center, Durham, NC
  • Michael P Fautsch
    Ophthalmology, Mayo Clinic, Rochester, MN
  • R Rand Allingham
    Duke University Eye Center, Durham, NC
  • Footnotes
    Commercial Relationships David Fleischman, None; John Berdahl, Alcon (C); Sandra Stinnett, None; Michael Fautsch, None; R Allingham, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 907. doi:
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      David Fleischman, John P Berdahl, Sandra S Stinnett, Michael P Fautsch, R Rand Allingham; CSF Trends in Diseases Associated with Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):907.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: Measured cerebrospinal fluid pressure (CSFP) is reduced in patients with POAG compared to non-glaucomatous controls and may play a role in the pathogenesis of glaucoma. A variety of systemic, vascular and neurologic diseases are associated with glaucoma. In this study, we looked in the Mayo Clinic electronic medical records (EMR) for trends in CSFP in patients with disorders related to risk for POAG.

Methods: All patients having undergone a lumbar puncture (LP) with a CSFP recorded at the Mayo Clinic (Rochester, MN) between 1996-2009 were reviewed. Patients with diagnoses of the following diagnoses were identified: Alzheimer, diabetes, atherosclerosis, hypertension, cerebrovascular accidents, migraine, basal ganglia degeneration, cerebellar degeneration. CSF parameters were compared to the non-diseased groups. Diseases or surgical interventions known to affect CSFP were primary exclusion criteria.

Results: Of 33,932 patients who underwent LP, the Mayo Clinic EMR contained 13,715 patients who met all entry criteria. Significant relative increased CSFP by age was identified in patients with diabetes (20-39 years, +11.71%, p<0.01), Alzheimer (>70 years, +6.23%, p<0.01), atherosclerosis (20-39 years, +15.48%, p<0.01), and hypertension (40-69 years, +2.47%, p<0.05). Relative decreased CSFP by age was identified in Alzheimer (40-69 years, -10.56%, p<0.001) and cerebellar degeneration (40-69 years, -4.36%, p<0.01).

Conclusions: We have found preliminary evidence that CSFP may be altered in several disorders that have a known association with POAG. These include diabetes, systemic hypertension, Alzheimer disease and cerebellar degeneration. The role of CSFP alteration in these disorders, as either a contributing factor or as the result of disease pathology, has received little attention. Alterations of CSFP induced by non-glaucomatous disorders may influence risk for POAG.

Keywords: 577 lamina cribrosa • 461 clinical (human) or epidemiologic studies: natural history • 629 optic nerve  

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