Evaluation of cerebrospinal fluid pressure in patients with Alzheimer’s disease as a possible cause of glaucoma

Abstract

Purpose To investigate whether cerebrospinal fluid (CSF) pressure and trans‐lamina cribrosa pressure gradient play a role in the pathogenesis of glaucoma. Our hypothesis is that a low cerebrospinal fluid (CSF) pressure may be correlated with the presence of glaucoma. The first objective is to investigate whether the CSF pressure in Alzheimer’s disease (AD) patients with glaucoma is lower than in AD patients without glaucoma. The second goal is to evaluate an animal model with AD for the incidence and prevalence of glaucoma. If glaucoma is present histopathological analysis will be performed on retina and optic nerve, to search for Alzheimer‐type changes. Methods Newly diagnosed AD suspects will undergo a lumbar puncture with CSF manometry, during neurological work‐up. Ophthalmological evaluation consists of best corrected visual acuity, slit lamp biomicroscopy, gonioscopy, fundoscopy and pachymetry. Diagnosis of glaucoma or ocular hypertension will be made on the basis of visual field examination, optic disc evaluation and IOP measurement. Correlation between CSF pressure, trans lamina cribrosa pressure gradient and the presence of glaucoma will be calculated. The prevalence of low tension glaucoma will be compared to the prevalence of chronic open angle glaucoma with elevated IOP. In the second part of the project a genetically modified strain of mice with AD will be examined and screened for the development of glaucoma. Opthalmological examination will consist of IOP measurement, corneal pachymetry, optic disc evaluation and visual evoked potentials with flash. Histopathological analysis will be performed by the team of Prof De Deyn PP. Results will follow Conclusion will follow