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John P. Berdahl, David Fleischman, Sandra S. Stinnett, R R. Allingham, Michael P. Fautsch; Increased Body Mass Index is Associated with Elevated Cerebrospinal Fluid Pressure. Invest. Ophthalmol. Vis. Sci. 2011;52(14):244.
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Decreased body mass index (BMI) is a possible risk factor for primary open angle glaucoma (POAG). Low cerebrospinal fluid pressure (CSFP) is also a possible risk factor for POAG, while elevated CSFP may be protective. The aim of this study is to investigate if BMI and CSFP are related.
Retrospectively extracted records of 4,800 patients who underwent diagnostic lumbar puncture at the Mayo Clinic (Rochester, MN) from 1996 to 2009 were examined. Exclusion criteria included diagnoses, surgical procedures or medications known to affect CSFP. The remaining patients’ CSFP results were recorded and categorized by unit of BMI. Mean CSFP for each unit BMI was calculated.
At BMI of 18, the mean CSFP is 112.9 mm H2O ± 48.7. By BMI of 21, there is a sustained and statistically significant increase in mean CSFP (124.4 mm H2O ± 42.5; p<0.05) that continues to a BMI of 35 (165.89 mm H2O ± 54.43; p<0.0001). Percent increase in CSFP from BMI of 18 to BMI of 35 was 32.4%.
Our findings suggest that as BMI increases, CSFP increases. Under the premise that low CSFP may be a risk factor for developing glaucoma, and elevated CSFP may be protective, this study indirectly suggests that an elevated BMI may protect against POAG due to a corresponding increase in CSFP and is consistent with recent studies.
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