Valsecchi Nicola, Roda Matilde, Febbraro Simone, Trolli Eleonora, Palandri Giorgio, Giannini Giulia, Milletti David, Schiavi Costantino, Fontana Luigi
Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Int Ophthalmol. 2024 Feb 2;44(1):1. doi: 10.1007/s10792-024-02922-3.
Idiopathic normal pressure hydrocephalus (iNPH) is associated with an increased prevalence of open-angle glaucoma, attributed to variations of the pressure gradient between intraocular and intracranial compartments at the level of the lamina cribrosa (LC). As ocular biomechanics influence the behavior of the LC, and a lower corneal hysteresis (CH) has been associated to a higher risk of glaucomatous optic nerve damage, in this study we compared ocular biomechanics of iNPH patients with healthy subjects.
Twenty-four eyes of 24 non-shunted iNPH patients were prospectively recruited. Ocular biomechanical properties were investigated using the ocular response analyzer (Reichert Instruments) for the calculation of the CH, corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc). Results were compared with those of 25 eyes of 25 healthy subjects.
In iNPH eyes, the median CH value and interquartile range (IQR) were 9.7 mmHg (7.8-10) and 10.6 mmHg (9.3-11.3) in healthy controls (p = 0.015). No significant differences were found in IOPcc [18.1 mmHg (14.72-19.92) vs. 16.4 mmHg (13.05-19.6)], IOPg [15.4 mmHg (12.82-19.7) vs. 15.3 mmHg (12.55-17.35)], and CRF [9.65 mmHg (8.07-11.65) vs. 10.3 mmHg (9.3-11.5)] between iNPH patients and controls.
In iNPH patients, the CH was significantly lower compared to healthy subjects. This result suggests that ocular biomechanical properties may potentially contribute to the risk of development of glaucomatous optic nerve damage in iNPH patients.
特发性正常压力脑积水（iNPH）与开角型青光眼患病率增加有关，这归因于筛板（LC）水平眼内和颅内腔室之间压力梯度的变化。由于眼部生物力学影响LC的行为，并且较低的角膜滞后（CH）与青光眼性视神经损伤的较高风险相关，在本研究中，我们比较了iNPH患者与健康受试者的眼部生物力学。
前瞻性招募了24例未分流的iNPH患者的24只眼睛。使用眼反应分析仪（Reichert仪器）研究眼部生物力学特性，以计算CH、角膜阻力因子（CRF）、Goldmann相关眼压（IOPg）和角膜补偿眼压（IOPcc）。将结果与25例健康受试者的25只眼睛的结果进行比较。
在iNPH眼中，CH值的中位数和四分位数间距（IQR）在健康对照组中分别为9.7 mmHg（7.8 - 10）和10.6 mmHg（9.3 - 11.3）（p = 0.015）。在iNPH患者和对照组之间，IOPcc [18.1 mmHg（14.72 - 19.92）对16.4 mmHg（13.05 - 19.6）]、IOPg [15.4 mmHg（12.82 - 19.7）对15.3 mmHg（12.55 - 17.35）]和CRF [9.65 mmHg（8.07 - 11.65）对10.3 mmHg（9.3 - 11.5）]未发现显著差异。
与健康受试者相比，iNPH患者的CH显著更低。该结果表明，眼部生物力学特性可能潜在地导致iNPH患者发生青光眼性视神经损伤的风险。
