Estimated cerebrospinal fluid pressure and trans‐lamina cribrosa pressure difference in open angle glaucoma. The Korea National Health and Nutrition Examination Survey 2009‐2012

Abstract

PurposeTo investigate associations of estimated cerebrospinal fluid pressure (CSFP) and trans‐lamina cribrosa pressure difference (TLCPD) with glaucomatous optic neuropathy in a population‐based setting.MethodsA total of 6656 adults (≥40 years) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2009 to 2012 were included. Subjects were divided into non‐glaucomatous and glaucomatous group, and glaucomatous subjects were further divided into normal tension glaucoma (NTG) group and high tension glaucoma (HTG) group. Based on a previous study with lumbar CSFP measurements, CSFP was estimated as CSFP (mmHg) = 0.55 Body Mass Index(kg/m2) + 0.16 Diastolic Blood Pressure(mmHg)‐0.18 × Age(years)−1.91. TLCPD was calculated as intraocular pressure (IOP)‐CSFP. Differences in estimated CSFP and TLCPD were assessed between the non‐glaucomatous and glaucomatous groups.ResultsIn the non‐glaucomatous population (n = 6016), mean estimated CSFP was 11.38 ± 3.11 mmHg and mean TLCPD was 2.54 ± 3.83 mmHg. When compared to the glaucoma group (n = 640), lower IOP (p < 0.001), higher CSFP (p < 0.001), and lower TLCPD (p < 0.001) were observed in the non‐glaucomatous group. Differences between glaucomatous subjects and non‐glaucomatous subjects in estimated CSFP, TLCPD, and IOP were greater for the HTG subjects than for the NTG subjects.ConclusionsEstimated CSFP and TLCPD may play a significant role in pathogenesis of NTG and HTG.