Moss Heather E
Department of Ophthalmology, Stanford University, Palo Alto, CA, United States.
Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States.
Front Neurol. 2021 Oct 18;12:751370. doi: 10.3389/fneur.2021.751370. eCollection 2021.
Retinal vein changes, which can be observed on clinical exam or ophthalmic imaging, are promising non-invasive biomarkers for elevated intracranial pressure (ICP) as a complement to other markers of high ICP including optic nerve head swelling. Animal and human studies have demonstrated increase in retinal vein pressure associated with elevated ICP mediated by increase in cerebral venous pressure, compression of venous outflow by elevated cerebral spinal fluid pressure in the optic nerve sheath, and compression of venous outflow by optic nerve head swelling. Retinal vein pressure can be estimated using ophthalmodynamometry. Correlates of retinal vein pressure include spontaneous retinal venous pulsations, retinal vein diameter, and retinal vein tortuosity. All of these have potential for clinical use to diagnose and monitor elevated ICP. Challenges include diagnostic prediction based on single clinical measurements and accurate assessment of retinal vein parameters in cases where optic nerve head swelling limits visualization of the retinal veins.
视网膜静脉变化可在临床检查或眼科成像中观察到，作为颅内压升高（ICP）的一种有前景的非侵入性生物标志物，可作为包括视神经乳头肿胀在内的其他高ICP标志物的补充。动物和人体研究表明，视网膜静脉压力升高与ICP升高相关，其介导因素包括脑静脉压力增加、视神经鞘内脑脊液压力升高导致静脉流出道受压，以及视神经乳头肿胀导致静脉流出道受压。视网膜静脉压力可通过眼压描记法进行估计。视网膜静脉压力的相关因素包括视网膜静脉自发搏动、视网膜静脉直径和视网膜静脉迂曲度。所有这些都有临床应用潜力，可用于诊断和监测ICP升高。挑战包括基于单一临床测量的诊断预测，以及在视神经乳头肿胀限制视网膜静脉可视化的情况下准确评估视网膜静脉参数。
