Jonas Jost B, Pfeil Katrin, Chatzikonstantinou Anastasios, Rensch Florian
Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.
Graefes Arch Clin Exp Ophthalmol. 2008 Jul;246(7):1059-60. doi: 10.1007/s00417-008-0780-0. Epub 2008 Feb 15.
Since a direct non-invasive measurement of the cerebrospinal fluid pressure is not available, it was the purpose of the study to describe the non-invasive determination of the central retinal vein pressure as an estimate of an elevated cerebrospinal fluid pressure.
A 28-year-old female patient with blurred vision, nuchal pain and prominent optic discs underwent modified ophthalmodynamometry to determine the central retinal vein pressure as surrogate of the intracranial pressure. A Goldmann contact lens with a pressure sensor mounted into its holding ring was placed onto the cornea. Pressure was applied to the globe by slightly pressing the contact lens until the central retinal vein started to pulsate/collapse.
Despite an abnormally high central retinal vein pressure (OD: 17 arbitrary units; OS: 33 arbitrary units), the neurological examination including magnetic resonance imaging of the brain was unremarkable on the first day. A lumbar puncture revealed a cerebrospinal fluid pressure of 25 cm H(2)O, which was at the upper limit of the normal range. Over the next 2 days, ophthalmodynamometry showed increasing measurements of the central retinal vein pressure for both eyes, parallel to elevated cerebrospinal fluid pressure measurements by lumbar puncture, leading to the diagnosis of idiopathic intracranial hypertension. After treatment, the cerebrospinal fluid pressure returned to normal levels, parallel to a decrease in the central retinal vein pressure as determined by ophthalmodynamometry.
Ophthalmodynamometry of the central retinal vein was helpful in the diagnosis of an elevated intracranial pressure, with direct lumbar pressure measurement running parallel to the ophthalmodynamometric measurements.
由于无法直接对脑脊液压力进行无创测量，本研究旨在描述通过无创测定视网膜中央静脉压力来估计升高的脑脊液压力。
一名28岁女性患者，有视力模糊、颈部疼痛和视盘突出症状，接受改良眼压描记法以测定视网膜中央静脉压力，作为颅内压的替代指标。将一个装有压力传感器的戈德曼接触镜置于角膜上，通过轻轻按压接触镜对眼球施加压力，直至视网膜中央静脉开始搏动/塌陷。
尽管视网膜中央静脉压力异常高（右眼：17个任意单位；左眼：33个任意单位），但第一天包括脑部磁共振成像在内的神经系统检查并无异常。腰椎穿刺显示脑脊液压力为25 cm H₂O，处于正常范围上限。在接下来的2天里，眼压描记法显示双眼视网膜中央静脉压力测量值增加，与腰椎穿刺测得的脑脊液压力升高平行，最终诊断为特发性颅内高压。治疗后，脑脊液压力恢复正常水平，与眼压描记法测定的视网膜中央静脉压力下降平行。
视网膜中央静脉眼压描记法有助于诊断颅内压升高，直接腰椎压力测量与眼压描记测量结果平行。
