Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
Ophthalmology. 2012 Oct;119(10):2065-2073.e1. doi: 10.1016/j.ophtha.2012.03.054. Epub 2012 Jun 28.
Low cerebrospinal fluid pressure (CSF-P) may be involved in the pathogenesis of glaucoma. We measured the optic nerve subarachnoid space width (ONSASW) as a surrogate for orbital CSF-P in patients with primary open-angle glaucoma (POAG) with normal and high pressure and a control group.
Prospective observational study.
The study included 39 patients with POAG; 21 patients had normal pressure (intraocular pressure [IOP] 21 mmHg), and 18 patients had high pressure (IOP >21 mmHg); 21 subjects formed the control group.
By using magnetic resonance imaging (MRI) with fat-suppressed fast recovery fast spin echo (FRFSE) T2-weighted sequence, we determined the ONSASW at 3, 9, and 15 mm posterior to the globe.
The ONSASW and optic nerve diameter.
At all 3 measurement locations of 3, 9, and 15 mm, the ONSASW was significantly (P<0.001, P<0.001, and P = 0.003, respectively) narrower in the normal-pressure group (0.67±0.16, 0.55±0.09, and 0.51±0.12 mm, respectively) than in the high-pressure group (0.93±0.21, 0.70±0.12, and 0.62±0.11 mm, respectively) or the control group (0.87±0.15, 0.67±0.07, and 0.61±0.07 mm, respectively). The high-pressure and control groups did not vary significantly at 3, 9, and 15 mm (P = 0.31, P = 0.39, and P = 0.44, respectively). At all 3 measurement locations, ONSASW was narrower in the normal-pressure group compared with the high-pressure and control groups after adjustment for optic nerve diameter (P<0.01). Correspondingly, the width of the optic nerve subarachnoid space measured at 3, 9, and 15 mm behind the globe, respectively, was significantly (all P<0.05) associated with IOP after adjustment for optic nerve diameter and visual field defect.
The narrower orbital optic nerve subarachnoid space in patients with POAG with normal pressure compared with high pressure suggests a lower orbital CSF-P in patients with POAG with normal pressure.
脑脊液压力降低（CSF-P）可能与青光眼的发病机制有关。我们通过测量原发性开角型青光眼（POAG）患者视神经蛛网膜下腔宽度（ONSASW），作为眶内 CSF-P 的替代指标，该测量方法在压力正常和压力高的患者以及对照组中均适用。
前瞻性观察性研究。
该研究纳入了 39 名 POAG 患者；21 名患者眼压正常（眼压 [IOP] 21mmHg），18 名患者眼压高（IOP>21mmHg）；21 名受试者构成对照组。
使用带有脂肪抑制快速恢复快速自旋回波（FRFSE）T2 加权序列的磁共振成像（MRI），我们在眼球后 3、9 和 15mm 处确定 ONSASW。
ONSASW 和视神经直径。
在眼球后 3、9 和 15mm 的所有 3 个测量位置，正常眼压组的 ONSASW 明显更窄（P<0.001、P<0.001 和 P=0.003），分别为（0.67±0.16、0.55±0.09 和 0.51±0.12mm），而高眼压组（0.93±0.21、0.70±0.12 和 0.62±0.11mm）和对照组（0.87±0.15、0.67±0.07 和 0.61±0.07mm）则没有明显差异。在眼球后 3、9 和 15mm 处，高眼压组和对照组之间也没有明显差异（P=0.31、P=0.39 和 P=0.44）。在所有 3 个测量位置，在调整视神经直径后，正常眼压组的 ONSASW 明显比高眼压组和对照组更窄（P<0.01）。相应地，在调整视神经直径和视野缺损后，分别在眼球后 3、9 和 15mm 处测量的视神经蛛网膜下腔宽度与眼压显著相关（均 P<0.05）。
与压力高的 POAG 患者相比，压力正常的 POAG 患者的眶内视神经蛛网膜下腔更窄，提示压力正常的 POAG 患者的眶内 CSF-P 较低。
