Posterior Scleral Biomechanics and the Translaminar Pressure Difference

Anterior Lamina Cribrosa Surface Position in Idiopathic Intracranial Hypertension and Glaucoma

“…The shallower LC location in patients with IIH indicates that the LC in these patients is anteriorly positioned, which may be a result of the TLPD as suggested by its positive correlation to the LC depth. Thus, our findings are in accordance with our initial assumptions and supports previous reports and hypotheses (3, 4, 24, 25). In a recent case report of a young woman diagnosed with IIH, a posterior movement of the LC in response to intracranial hypertension (ICP)-lowering surgery was described (18).…”

“…Studies have indicated that TLPD is increased and may possibly be implicated in the pathophysiology of glaucoma (9–10–11–12–13). The TLPD may also be involved in the pathophysiology of IIH (3, 4, 7), although pressure forces are opposite of those seen in glaucoma. However, this hypothesis has not yet been investigated.…”

“…Symptoms include headache, transitory visual obscurations, diplopia, and pulsatile tinnitus (2). According to recent studies, it has been suggested that changes in the LC are associated with the development of papilledema, a phenomenon usually seen in patients with IIH (3,4). evaluation (17).…”

Elevated intracranial pressure causes optic nerve and retinal ganglion cell degeneration in mice

“…It is therefore possible that increases in either ICP or IOP at the optic nerve head in mice result in a shared phenotype of optic nerve damage followed by RGC soma loss. This is potentially consistent with a biomechanical hypothesis of optic nerve damage in which the opposing forces of IOP and ICP interact to kink or bend the optic nerve fibers and surrounding structures (Fleischman and Berdahl, 2014). However, it is unlikely that an optic nerve head mechanism explains all the findings that have been observed with either elevated ICP or IOP.…”

“…In IIH, many patients also show evidence of optic nerve axon loss and RGC death (Keltner et al, 2014; Marzoli et al, 2013; Monteiro and Afonso, 2014; Padhye et al, 2013). Several reports have suggested that the balance between IOP and ICP is an important factor in optic neuropathies in general (Berdahl et al, 2008a; Berdahl et al, 2008b; Fleischman and Berdahl, 2014; Ren et al, 2010; Ren et al, 2011; Zhang and Hargens, 2014). …”