Motschmann M, Müller C, Kuchenbecker J, Walter S, Schmitz K, Schütze M, Behrens-Baumann W, Firsching R
Department of Ophthalmology, Ohrekreis-Klinikum, Haldensleben, Germany.
Strabismus. 2001 Mar;9(1):13-6. doi: 10.1076/stra.9.1.13.711.
Under physiological conditions, the pressure in the central retinal vein is equal to or higher than the intracranial pressure (ICP) because the cerebrospinal fluid (CSF) passes the sheath of the optic nerve before draining into the cavernous sinus. The optic nerve sheath is where the ICP affects the retinal venous pressure. Ophthalmodynamometry (ODM) is a useful method for determining the central retinal artery pressure. While papilledema and a lack of venous pulsations are commonly used as a vague indication of the ICP, ODM may be advantageous for determining the pressure in the central retinal vein. Until now, however, the venous pressure has never been compared with the intracranial pressure. In the present study, the pressure in the central retinal vein was recorded in 31 patients while the ICP was simultaneously being recorded for various reasons. The results demonstrate a linear correlation (r = 0.968) between the pressure in the central retinal vein and the ICP. This correlation is of great practical value since until now, reliable intracranial pressure monitoring has only been possible by invasive means, by placing a probe either in the brain parenchyma or the ventricle. Ophthalmodynamometry is useful for momentary assessment of the ICP, can easily be repeated, and may be used whenever an elevated ICP is suspected in hydrocephalus, brain tumors and after head injury. However, it is not suitable for continuous ICP monitoring.
在生理条件下，视网膜中央静脉的压力等于或高于颅内压（ICP），因为脑脊液（CSF）在排入海绵窦之前会通过视神经鞘。视神经鞘是颅内压影响视网膜静脉压力的部位。眼压计（ODM）是测定视网膜中央动脉压力的一种有用方法。虽然视乳头水肿和静脉搏动缺失通常被用作颅内压的一种模糊指标，但眼压计在测定视网膜中央静脉压力方面可能具有优势。然而，到目前为止，静脉压力从未与颅内压进行过比较。在本研究中，对31例患者记录了视网膜中央静脉压力，同时因各种原因同步记录了颅内压。结果表明视网膜中央静脉压力与颅内压之间存在线性相关性（r = 0.968）。这种相关性具有很大的实用价值，因为到目前为止，可靠的颅内压监测只能通过侵入性手段实现，即将探头置于脑实质或脑室中。眼压计有助于对颅内压进行即时评估，易于重复使用，并且在怀疑脑积水、脑肿瘤及头部受伤后颅内压升高时均可使用。然而，它不适用于连续的颅内压监测。
