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急性脑脊液压力降低与脉络膜厚度的关系。

The Association of Acute Cerebrospinal Fluid Pressure Reduction with Choroidal Thickness.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

Curr Eye Res. 2021 Aug;46(8):1193-1200. doi: 10.1080/02713683.2021.1874024. Epub 2021 Feb 1.

Abstract

PURPOSE

To investigate the changes in choroidal thickness (CT) after acute cerebrospinal fluid pressure (CSFP) reduction in human subjects.

METHODS

Before and 15 minutes after diagnostic lumbar puncture (LP), 44 patients underwent measurement of CT by swept-source optical coherence tomography. Thirty-two healthy volunteers imitated the body posture of LP procedure and underwent the same measurement before and 15 minutes after body posture change.

RESULTS

After CSFP reduction from 10.9 ± 2.1 mmHg at baseline to 8.1 ± 1.5 mmHg ( < 0.001), CT decreased in subfoveal region ( = 0.005), small to medium vessel layer (SMVL, < 0.001), peripapillary regions in temporal ( = 0.001), nasal ( < 0.001), superior ( < 0.001) and inferior ( < 0.001), respectively. However, no significant change in CT in the control group after body posture change (all > 0.05). A significant association between CSFP and the ratio of small to medium vessel layer to total choroidal thickness was found ( = 0.009). The CSFP reduction rate was associated with the change rate of SMVL to total CT portion, for each percent decrease in CSFP was associated with a decrease by 0.22% in the rate of SMVL to total CT portion (R = 0.125, = 0.018).

CONCLUSIONS

A significant decrease in subfoveal CT, small to medium vessel layer and peripapillary region were observed following acute CSFP reduction. The CSFP reduction rate was associated with the change rate of small to medium vessel layer to total CT portion.

摘要

目的

研究人类急性脑脊液压力(CSFP)降低后脉络膜厚度(CT)的变化。

方法

在诊断性腰椎穿刺(LP)前和 15 分钟后,44 例患者接受了扫频源光相干断层扫描测量 CT。32 名健康志愿者模拟 LP 过程中的体位,并在体位改变前后进行了相同的测量。

结果

CSFP 从基线时的 10.9 ± 2.1mmHg 降低到 8.1 ± 1.5mmHg(<0.001)后,在黄斑下区域( = 0.005)、小到中等血管层(SMVL,<0.001)、颞侧( = 0.001)、鼻侧(<0.001)、上侧(<0.001)和下侧(<0.001)的脉络膜厚度均有减小。然而,对照组在体位改变后 CT 无明显变化(均>0.05)。CSFP 与小到中等血管层与总脉络膜厚度的比值呈显著相关( = 0.009)。CSFP 降低率与 SMVL 与总 CT 比值的变化率相关,每降低 1%的 CSFP 与 SMVL 与总 CT 比值降低 0.22%相关(R = 0.125, = 0.018)。

结论

急性 CSFP 降低后,黄斑下 CT、小到中等血管层和视盘周围区域明显减小。CSFP 降低率与小到中等血管层与总 CT 比值的变化率相关。

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