Abstract
Purpose :
Low cerebrospinal fluid pressure (CSF-P) has been associated with the pathogenesis of glaucomatous optic neuropathy, in particular in patients with low-tension glaucoma, and glaucoma has been associated with optic nerve head (ONH) and lamina cribrosa (LC) positional changes. The aim of this study was to determine the effect of acute CSF-P reduction on ONH and anterior LC displacement using swept-source optical coherence tomography (SS-OCT) in healthy subjects.
Methods :
In this interventional study, 16 eyes of 8 in-patient adults benefiting from diagnostic lumbar puncture (LP) for non-ocular diseases were recruited prospectively. All ONH and LC imaging were performed using a commercially available SS-OCT device (6mm, 164 overlap) before, 5, 60 and 360 minutes after LP. The internal limiting membrane (ILM), posterior surface of the Bruch’s membrane/retinal pigment epithelium complex (BM/RPE), neural canal opening (NCO), retinal vessels (RV), outer limit of the choroid (ELC) and anterior LC surface (ALCS) were manually delineated by 3 separate observers and compared.
Results :
Four males and four females were recruited with a mean age, 50.4 ± 11.5 years and a mean body mass index, 22.7 ± 4.6 kg/m2). Mean volume of CSF collected was 1,63 ± 0,53 mL.. At all times after LP, we did not observe any displacement of ILM, BM/RPE, NCO, RV, ELC or ALCS, even for two patients that experienced post LP headache.
Conclusions :
While acute and transient elevation of intra-ocular pressure has been associated with a condensation of neuroretinal rim, prelaminar tissue, and LC, without major changes in the optic disc size and position of the anterior LC surface, acute significant reduction of CSF-P was not associated with any morphological changing in neither ONH nor LC position.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.