Deformation of the Lamina Cribrosa and Optic Nerve Due to Changes in Cerebrospinal Fluid Pressure (original) (raw)
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IEEE transactions on medical imaging, 2015
The lamina cribrosa (LC) is a complex mesh-like tissue in the posterior eye. Its biomechanical environment is thought to play a major role in glaucoma, the second most common cause of blindness. Due to its small size and relative inaccessibility, highresolution measurements of LC deformation, important in characterizing LC biomechanics, are challenging. Here we present a novel noninvasive imaging method, which enables measurement of the three-dimensional deformation of the LC caused by acute elevation of intraocular pressure (IOP). Posterior segments of porcine eyes were imaged using synchrotron radiation phase contrast micro-computed tomography (PC CT) at IOPs between 6 and 37mmHg. The complex trabecular architecture of the LC was reconstructed with an isotropic spatial resolution of 3.2 m. Scans acquired at different IOPs were analyzed with digital volume correlation (DVC) to compute full-field deformation within the LC. IOP elevation caused substantial tensile, shearing and compr...
In-vivo effects of intraocular and intracranial pressures on the lamina cribrosa microstructure
PloS one, 2017
There is increasing clinical evidence that the eye is not only affected by intraocular pressure (IOP), but also by intracranial pressure (ICP). Both pressures meet at the optic nerve head of the eye, specifically the lamina cribrosa (LC). The LC is a collagenous meshwork through which all retinal ganglion cell axons pass on their way to the brain. Distortion of the LC causes a biological cascade leading to neuropathy and impaired vision in situations such as glaucoma and idiopathic intracranial hypertension. While the effect of IOP on the LC has been studied extensively, the coupled effects of IOP and ICP on the LC remain poorly understood. We investigated in-vivo the effects of IOP and ICP, controlled via cannulation of the eye and lateral ventricle in the brain, on the LC microstructure of anesthetized rhesus monkeys eyes using the Bioptigen spectral-domain optical coherence tomography (OCT) device (Research Triangle, NC). The animals were imaged with their head upright and the re...
Intracranial and Intraocular Pressure at the Lamina Cribrosa: Gradient Effects
Current Neurology and Neuroscience Reports
Purpose of Review A pressure difference between the intraocular and intracranial compartments at the site of the lamina cribrosa has been hypothesized to have a pathophysiological role in several optic nerve head diseases. This paper reviews the current literature on the translamina cribrosa pressure difference (TLCPD), the associated pressure gradient, and its potential pathophysiological role, as well as the methodology to assess TLCPD. Recent Findings For normal-tension glaucoma (NTG), initial studies indicated low intracranial pressure (ICP) while recent findings indicate that a reduced ICP is not mandatory. Summary Data from studies on the elevated TLCPD as a pathophysiological factor of NTG are equivocal. From the identification of potential postural effects on the cerebrospinal fluid (CSF) communication between the intracranial and retrolaminar space, we hypothesize that the missing link could be a dysfunction of an occlusion mechanism of the optic nerve sheath around the optic nerve. In upright posture, this could cause an elevated TLCPD even with normal ICP and we suggest that this should be investigated as a pathophysiological component in NTG patients.
Influence of Translaminar Pressure Dynamics on the Position of the Anterior Lamina Cribrosa Surface
Investigative ophthalmology & visual science, 2015
To determine how the translaminar pressure difference (TLPD) and gradient (TLPG) influence the position of anterior lamina cribrosa (LC) surface. Twenty-six eyes of 26 healthy subjects were subjected to enhanced-depth-imaging volume scanning of the optic nerve using spectral-domain optical coherence tomography (SD-OCT). The anterior LC surface depth (LCD) relative to the Bruch's membrane (BM) opening was measured at 11 equidistant planes, and the LC thickness (LCT) was measured at three locations (superior midperipheral, midhorizontal, and inferior midperipheral). Intraocular pressure (IOP) and lumbar cerebrospinal fluid pressure (CSFP) were measured on the same day as the SD-OCT examination. The TLPD was defined as the difference between IOP and CSFP (i.e., IOP - CSFP), and the TLPG as the TLPD divided by LCT (i.e., TLPD/LCT). Subjects were aged 63.4±8.0 years and comprised 12 males and 14 females. Regression analyses revealed a significant association between a larger mean LCD...
The influence of cerebrospinal fluid pressure on the lamina cribrosa tissue pressure gradient
Investigative Ophthalmology & Visual Science
To measure the tissue pressure gradient through the optic disk and to determine the relationship between intraocular, cerebrospinal fluid, and retrolaminar tissue pressures. The relationship of optic nerve subarachnoid space pressure to intracranial cerebrospinal fluid pressure also was explored. Micropipettes coupled to a pressure transducer were passed through pars plana and vitreous to enter the optic disk in the anesthetized dog. Using a micromanipulator, pipettes penetrated the optic disk in steps while pressure measurements were taken. In some animals, pipettes also were passed into the optic nerve subarachnoid space. Lateral ventricle cerebrospinal fluid pressure, intraocular pressure, and arterial blood pressure were measured concurrently, and the effect of raising CSF pressure was explored. Retrolaminar tissue pressure was largely dependent on the surrounding cerebrospinal fluid pressure, which was on average 8.6 +/- 3.5 mm Hg (SD, n = 8) higher, and was independent of intr...
Relative Contributions of Intracranial Pressure and Intraocular Pressure on Lamina Cribrosa Behavior
Journal of Ophthalmology, 2019
Purpose. To characterize the relative contributions of intraocular pressure (IOP) and intracranial pressure (ICP) on lamina cribrosa (LC) behavior, specifically LC depth (LCD) and LC peak strain. Methods. An axially symmetric finite element model of the posterior eye was constructed with an elongated optic nerve and retro-orbital subarachnoid space ensheathed by pia and dura mater. The mechanical environment in LC was evaluated with ICP ranging from 5 to 15 mmHg and IOP from 10 to 45 mmHg. LCD and LC peak strains at various ICP and IOP levels were estimated using full factorial experiments. Multiple linear regression analyses were then applied to estimate LCD and LC peak strain using ICP and IOP as independent variables. Results. Both increased ICP and decreased IOP led to a smaller LCD and LC peak strain. The regression correlation coefficient for LCD was −1.047 for ICP and 1.049 for IOP, and the ratio of the two regression coefficients was −1.0. The regression correlation coeffici...
The Impact of Acutely Elevated Intraocular Pressure on the Porcine Optic Nerve Head
Investigative Opthalmology & Visual Science, 2011
PURPOSE. To investigate the effects of acute elevations in intraocular pressure (IOP) on the cup, prelaminar, and lamina cribrosa regions of the porcine optic nerve head (ONH). METHODS. Ex vivo imaging of 10 porcine ONHs was performed using spectral-domain optical coherence tomography (OCT). The IOP was manipulated with a pressure head and measured with a pressure transducer. Reference scans were taken at 0 mm Hg, before further scanning was performed at 7-mm Hg steps, up to 49 mm Hg. Morphometric parameters were measured across centrally located OCT B-scans at different IOPs, and the relationship between IOP and changes in these parameters was analyzed. RESULTS. As IOP increased from 0 to 49 mm Hg, mean crosssectional cup area increased (28% Ϯ 3%, P Ͻ 0.001), lamina cribrosa area decreased (18% Ϯ 2%, P Ͻ 0.001), and prelaminar tissue area decreased (5.5% Ϯ 0.5%, P Ͻ 0.001). Multivariate regression demonstrated that most of the change in cup area is associated with changes in both lamina cribrosa position and thickness (r ϭ 0.89, P Ͻ 0.001). CONCLUSIONS. Acute elevations in IOP were shown to result in posterior displacement of ONH, as well as lamina cribrosa and prelaminar tissue deformation in the porcine ONH.
Cerebrospinal fluid pressure and glaucoma: regulation of trans-lamina cribrosa pressure
British Journal of Ophthalmology, 2013
Increased trans-lamina cribrosa pressure difference (TLCPD), the difference of intraocular pressure (IOP) and orbital cerebrospinal fluid pressure (CSF-P), has been investigated as a possible risk factor in glaucoma pathogenesis. In fact, lower CSF-P in the setting of normal IOP has been implicated as a potential risk factor for normal tension glaucoma. Increased TLCPD has been associated with decreased neuroretinal rim area and increased visual field defects. Furthermore, dysregulation of systemic blood pressure has been associated with changes in IOP. Recent studies have also suggested that increased body mass index (BMI) is associated with decreased prevalence of glaucoma, which may be due to an increased CSF-P with increased BMI found in many studies. Given the interaction of various pressures, their role in glaucoma pathophysiology has come under investigation and warrants further study in order to better understand the aetiology and progression of glaucoma.
The correlation between cerebrospinal fluid pressure and retrolaminar tissue pressure
Investigative ophthalmology & visual science, 1998
To measure the effects of cerebrospinal fluid pressure (CSFp) on retrolaminar tissue pressure (RLTp) and the translaminar pressure gradient (TLPG), particularly at low CSFp, which is the normal situation in erect posture. Micropipettes coupled to a servonull pressure system were passed into eyes of anesthetized dogs to the optic disc and advanced in steps through the lamina cribrosa to the optic nerve subarachnoid space (ONSAS), while pressure measurements were taken. Cerebrospinal fluid pressure and intraocular pressure (IOP) were monitored and controlled. The TLPG was measured at varying IOPs and CSFps. The RLTp and ONSAS pressure (ONSASp) were measured at varying CSFps. In separate experiments, the optic nerve dura was incised, and pressure measurements were taken across the pia mater. The TLPG was strongly correlated to the difference between IOP and CSFp (r=0.93; n=18) when CSFp was more than zero. Mean RLTp was 3.7+/-0.2 mm Hg (SEM; n=15) when CSFp was 0 mm Hg. The ONSASp and ...