Abstract
Purpose :
Previous studies on Mayo Clinic patients undergoing lumbar puncture between 1987 and 2007 suggest that low cerebrospinal fluid pressure (CSFP) is associated with primary open angle glaucoma (POAG) and normotensive glaucoma (NTG). We performed a retrospective case controlled correlative study with Mayo Clinic patients from 2010 to 2019 to further examine the relationship between POAG, NTG, ocular hypertension (OHT) and CSFP.
Methods :
CSFP from adult patients (≥20 years old) undergoing lumbar puncture at Mayo Clinic Rochester, MN between 2010-2019 were abstracted from the medical record using natural language processing. Demographic factors and intraocular pressure measurements were obtained from the institutional data repository. Patients with multiple lumbar punctures, diagnoses or medications known to affect CSFP, or CSFP outside of the normal range (<4.4 and >18.4 mmHg) were excluded from analysis. Age matched control subjects were drawn from lumbar puncture patients with a diagnosis of cataract, myopia, presbyopia, or hyperopia. Patients >55 years of age at the time of lumbar puncture were used for comparisons to POAG and NTG (n=263) and patients 30-70 years of age were used for comparisons to the OHT cohort (n=283). Subjects were excluded from the control group if they had a history of ocular surgery or retinal disease. CSFP measurements were compared between groups using the Kruskal-Wallis test or Wilcoxon rank sum test with a type I error rate of 5%.
Results :
Of the 26563 unique patients that received a lumbar puncture from 2010-2019, 8750 (33%) patients met all entry criteria. Within this group, 22 patients had POAG; 7 NTG; and 34 OHT. CSFP (mean ± standard deviation) was found to be 10.4 ± 2.7 mmHg in POAG, 11.1 ± 2.9 mmHg in NTG, and 11.2 ± 2.9 mmHg in age matched controls (p=0.37). CSFP was 12.2 ± 3.2 mmHg in OHT and 11.9 ± 2.8 mmHg in age matched controls (p=0.59).
Conclusions :
Lower CSFP was observed in POAG and higher CSFP in OHT when compared to controls. However, these changes were not significant, presumably due to a small sample size.
This is a 2020 ARVO Annual Meeting abstract.