Pressure balance and imbalance in the optic nerve chamber： The Beijing Intracranial and Intraocular Pressure (iCOP) Study

作     者：Ruowu Hou Zheng Zhang Diya Yang Huaizhou Wang Weiwei Chen Zhen Li Jinghong Sang Sumeng Liu Yiwen Cao Xiaobin Xie Ruojing Ren Yazhuo Zhang Bernhard A. Sabel Ningli Wang 

作者机构：Department of Neurosurgery Beijing Tongren Hospital Capital Medical University Beijing 100730 China Beijing Tongren Eye Center Beijing Tongren Hospital Capital Medical University Beijing Ophthalmology and Visual Sciences Key Laboratory Beijing 100730 China Beijing Institute of Ophthalmology Beijing Tongren Hospital Capital Medical University Beijing 100730 China Department of Ophthalmology Xuanwu Hospital Capital Medical University Beijing 100053 China Department of Ophthalmology Eye Hospital of China Academy of Chinese Medical Sciences Beijing 100040 China Eye center New York Eye and Ear Infirmary New York 10003 USA Department of Endoscopic and Microinvasive Neurosurgery Beijing Neurosurgery Institute Beijing Tiantian Hospital Capital Medical University Beijing 100050 China Institute of Medical Psychology Medical Faculty Otto-v.-Guericke University of Magdeburg Magdeburg 39120 Germany 

出 版 物：《Science China(Life Sciences)》 (中国科学（生命科学英文版）)

年 卷 期：2016年第59卷第5期

页      面：495-503页

核心收录：

学科分类：0710[理学-生物学] 0830[工学-环境科学与工程（可授工学、理学、农学学位）] 1002[医学-临床医学] 100212[医学-眼科学] 100204[医学-神经病学] 10[医学] 

基　　金：supported by the National Natural Science Foundation of China (81271005, 81300767) Beijing Natural Science Foundation (7122038) two separate donations by the China Health and Medical Development Foundation B.A.S. was supported by the BMBF network ERA-net Neuron “Restoration of Vision after Stroke (REVIS)” (BMBF 01EW1210) by the “Hai-ju” Beijing Overseas Talents Program Ruowu Hou was supported by the Beijing Tongren Hospital Foundation (2015-YJJ-GGL-013) 

主　　题：glaucoma optic neuropathy trans-lamina cribrosa pressure gradient (TLPG) trans-optic canal pressure gradient(TCPG) trans-optic nerve pressure gradient (TOPG) optic nerve pressure gradient (ONPG) 

摘      要：To determine the interdependence of intracranial pressure(ICP) and intraocular pressure(IOP) and how it affects optic nerve pressures, eight normal dogs were examined using pressure-sensing probes implanted into the left ventricle, lumbar cistern, optic nerve subarachnoid space in the left eye, and anterior chamber in the left eye. This allowed ICP, lumbar cistern pressure(LCP), optic nerve subarachnoid space pressure(ONSP) and IOP to be simultaneously recorded. After establishing baseline pressure levels, pressure changes that resulted from lowering ICP(via shunting cerebrospinal fluid(CSF) from the ventricle) were recorded. At baseline, all examined pressures were different(ICPLCPONSP), but correlated(P0.001). As ICP was lowered during CSF shunting, IOP also dropped in a parallel time course so that the trans-lamina cribrosa gradient(TLPG) remained stable(ICP-IOP dependent zone). However, once ICP fell below a critical breakpoint, ICP and IOP became uncoupled and TLPG changed as ICP declined(ICP-IOP independent zone). The optic nerve pressure gradient(ONPG) and trans-optic nerve pressure gradient(TOPG) increased linearly as ICP decreased through both the ICP-IOP dependent and independent zones. We conclude that ICP and IOP are coupled in a specific pressure range, but when ICP drops below a critical point, IOP and ICP become uncoupled and TLPG increases. When ICP drops, a rise in the ONPG and TOPG creates more pressure and reduces CSF flow around the optic nerve. This change may play a role in the development and progression of various ophthalmic and neurological diseases, including glaucoma.