Noninvasive evaluation of cerebrospinal fluid pressure in ocular hypertension: a preliminary study

Xie, Xiaobin; Chen, Weiwei; Li, Zhen; Thomas, Ravi; Li, Yong; Xian, Junfang; Yang, Diya; Wang, Huaizhou; Zhang, Shoukang; Kang, Zefeng; Wang, Ningli; Intraocular, Beijing

doi:10.1111/aos.13724

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…Studies have found that for every 1 mmHg increase in IOP, the risk of glaucoma will increase by 12%, and that for every 1 mmHg interocular difference in IOP the risk of OH transforming into glaucoma increases by 21% ( 2 ). Although not all people with OH will develop glaucoma ( 3 ), Elevated IOP has always been considered the main risk factor for the progression of glaucoma ( 4 ), and it is also the only known modifiable risk factor in the disease ( 5 ), about 9.5% will develop glaucomatous optic nerve damage in their lifetime ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of the Fractional Amplitude of Low-Frequency Fluctuation in Ocular Hypertension Patients: A Resting-State fMRI Study

et al. 2022

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BackgroundThe fractional amplitude of low-frequency fluctuation (fALFF) method has been underutilized in research on the pathogenesis and clinical manifestations of ocular hypertension (OH).PurposeThis study uses resting state functional magnetic resonance imaging (rs-fMRI) and fALFF to investigate the nature of spontaneous brain activity in OH patients and the relationship, if any, between changes in activity and clinical features.Materials and MethodsA total of 18 subjects (9 females and 9 males) with ocular hypertension (OH) and 18 healthy controls (HCs) matched for gender, age, and educational level were recruited to this study. All participants underwent an rs-fMRI scan, and spontaneous brain activity was assessed using the fALFF method. Receiver operating characteristic curves were plotted to investigate differences between OH and HC groups.ResultsThe fALFF values of OH patients were significantly higher in the left precuneus lobe (LP), compared with the same region in controls (P < 0.05). Conversely, values in the left anterior cingulate lobe (LAC), were significantly lower (P < 0.05) in OH than in controls. However, no significant association was found between the mean fALFF values and clinical characteristics in either brain area.ConclusionHigh spontaneous activity in two brain areas may reflect neuropathological mechanisms underpinning visual impairment in OH patients.

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Section: Introductionmentioning

confidence: 99%

Characteristics of the Fractional Amplitude of Low-Frequency Fluctuation in Ocular Hypertension Patients: A Resting-State fMRI Study

et al. 2022

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“…Third, errors in both displacement and strain could occur. The errors observed here could arise from various sources such as OCT registration errors (intrinsic to the OCT machine), rotation of subjects’ head during OCT acquisition, OCT speckle noise and IOP fluctuations from ocular pulsations, 73 all of which were difficult to control. However, displacement error magnitudes were still lower than the OCT voxel resolution; 20 thus, these errors should not have significantly affected our observed trends.…”

Section: Discussionmentioning

confidence: 99%

How Myopia and Glaucoma Influence the Biomechanical Susceptibility of the Optic Nerve Head

Chuangsuwanich

Tun

Braeu

et al. 2022

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Purpose: We aimed to assess optic nerve head (ONH) deformations following acute intraocular pressure (IOP) elevations and horizontal eye movements (adduction and abduction) in control eyes, highly myopic (HM) eyes, HM eyes with glaucoma (HMG), and eyes with pathologic myopia alone (PM) or PM with staphyloma (PM+S). Methods: We studied 282 eyes, comprising of 99 controls, 51 HM, 35 HMG, 21 PM and 75 PM+S eyes. For each eye, we imaged the ONH using spectral-domain optical coherence tomography (OCT) under the following conditions: (1) primary gaze, (2) 20 degree adduction, (3) 20 degree abduction and (4) primary gaze with acute IOP elevation (to ~35 mmHg) achieved through ophthalmodynamometry. For each OCT volume, we automatically segmented the ONH tissues using deep learning. We performed digital volume correlation (DVC) analysis to compute IOP- and gaze-induced ONH displacements and effective strains (i.e. local deformations). All biomechanical quantities were compared across groups. Results: Under IOP elevation, we found that HM eyes exhibited significantly lower strains (3.9 +- 2.4 %) than PM eyes (6.9 +- 5.0%, p < 0.001), HMG eyes (4.7 +- 1.8%, p = 0.04) and PM+S eyes (7.0 +- 5.2%, p < 0.001). Under adduction, we found that HM eyes exhibited significantly lower strains (4.8% +- 2.7%) than PM+S eyes (6.0 +- 3.1%, p = 0.02). We also found significant associations between axial length (or refractive error) and strains - eyes with higher axial length and greater myopia were associated with higher strains. IOP-induced strains were also positively correlated with adduction-induced strains. Conclusion: We found that HMG eyes experienced significantly higher strains under IOP elevations as compared to HM eyes. Additionally, PM+S eyes experienced highest ONH strains as compared to other groups under all biomechanical loads. Our preliminary findings suggest the possibility of using a simple biomechanical test to tease out the susceptibility of HM eyes to further develop glaucoma and/or staphyloma.

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“…Fifth, errors in both displacement and strain could occasionally occur. The errors observed here could arise from various sources such as OCT registration errors (intrinsic to the OCT machine), rotation of subjects’ head during OCT acquisition, OCT speckle noise and IOP fluctuations from ocular pulsations, 62 all of which were difficult to control. However, displacement error magnitudes were still lower than the OCT voxel resolution (Appendix C); thus, these errors should not have significantly affected the observed trends.…”

Section: Discussionmentioning

confidence: 99%

Differing Associations between Optic Nerve Head Strains and Visual Field Loss in Normal- and High-Tension Glaucoma Subjects

Chuangsuwanich

Tun

Wang

et al. 2021

Preprint

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PurposeTo study the associations between optic nerve head (ONH) strains under intraocular pressure (IOP) elevation with retinal sensitivity in glaucoma subjects.DesignClinic based cross-sectional study.Participants229 subjects with primary open angle glaucoma (subdivided into 115 high tension glaucoma (HTG) subjects and 114 normal tension glaucoma (NTG) subjects).MethodsFor one eye of each subject, we imaged the ONH using spectral-domain optical coherence tomography (OCT) under the following conditions: (1) primary gaze and (2) primary gaze with acute IOP elevation (to approximately 33 mmHg) achieved through ophthalmodynamometry. A 3-dimensional (3D) strain-mapping algorithm was applied to quantify IOP-induced ONH tissue strain (i.e. deformation) in each ONH. Strains in the pre-lamina tissue (PLT) and the retina, the choroid, the sclera and the lamina cribrosa (LC) were associated (using linear regression) with measures of retinal sensitivity from the 24-2 Humphrey visual field test (Carl Zeiss Meditec, Dublin, CA, USA). This was done globally, then locally according to the regionalization scheme of Garway-Heath et al.Main Outcome MeasuresAssociations between ONH strains and values of retinal sensitivity from visual field testing.ResultsFor HTG subjects, we found that (1) there were significant negative linear associations between ONH strains and retinal sensitivity (p<0.001) (on average, a 1% increase in ONH strains corresponded to a decrease in retinal sensitivity of 1.1 dB), (2) high strain regions co-localized with anatomically-mapped regions of high visual field loss, (3) the strongest negative associations were observed in the superior region and in the PLT. In contrast, for NTG subjects, no significant associations between strains and retinal sensitivity were observed except in the supero-temporal region of the LC.ConclusionWe found significant negative associations between IOP-induced ONH strains and retinal sensitivity in a relatively large glaucoma cohort. Specifically, HTG subjects who experienced higher ONH strains were more likely to exhibit lower retinal sensitivities. Interestingly, this trend was in general less pronounced in NTG subjects, which could suggest a distinct pathophysiology between the two glaucoma subtypes.

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Noninvasive evaluation of cerebrospinal fluid pressure in ocular hypertension: a preliminary study

Abstract: The wider OSASW and higher estimated CSFP in OH subjects suggest a higher orbital CSFP. Despite a higher orbital CSFP that could be protective, the higher TLCPD in OH may play a significant role in the risk of developing glaucoma.

Cited by 11 publications

References 33 publications

Characteristics of the Fractional Amplitude of Low-Frequency Fluctuation in Ocular Hypertension Patients: A Resting-State fMRI Study

Characteristics of the Fractional Amplitude of Low-Frequency Fluctuation in Ocular Hypertension Patients: A Resting-State fMRI Study

How Myopia and Glaucoma Influence the Biomechanical Susceptibility of the Optic Nerve Head

Differing Associations between Optic Nerve Head Strains and Visual Field Loss in Normal- and High-Tension Glaucoma Subjects

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