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J. P. Berdahl, D. H. Johnson, R. R. Allingham; Cerebrospinal Fluid Pressure Is Lower in Primary Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1599.
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To compare cerebrospinal fluid (CSF) pressure in patients with primary open angle glaucoma (POAG) with non-glaucomatous patients.
Retrospective review of 2064 medical records revealed 28 patients with POAG and 49 patients without POAG that had CSF pressure measured between 1996-2007. Glaucoma status was defined as the presence of glaucomatous optic nerve damage and associated visual field loss. Demographics (age and gender), medical history, medication use, indication for lumbar puncture, visual field defects, cup-to-disk ratio, intraocular pressure (IOP), CSF pressure, and translaminar pressure difference (IOP - CSF pressure) were measured and analyzed by univariate and multivariate analysis.
CSF pressure was 13.0 +/- 4.2mmHg in non-glaucoma patients and 9.2 +/- 2.9mmHg in POAG patients (p < 0.00005). CSF pressure was lower in POAG patients regardless of indication for lumbar puncture or age. Linear regression analysis showed that cup to disc ratio correlated independently with IOP (p<0.0001), CSF pressure (p<0.0001), and the translaminar pressure difference (p<0.0001). Multivariate analysis demonstrated that larger cup to disc ratio (p<0.0001) was associated with lower CSF pressure.
CSF pressure is significantly lower in POAG patients compared to non-glaucomatous controls. These data support the notion that CSF pressure may play an important contributory role in the pathogenesis of POAG.
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