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Abstract #75531 Published in IGR 19-2

Measurement and Associations of the Optic Nerve Subarachnoid Space in Normal Tension and Primary Open-Angle Glaucoma

Liu H; Yang D; Ma T; Shi W; Zhu Q; Kang J; Wang N
American Journal of Ophthalmology 2018; 186: 128-137

See also comment(s) by Hanspeter Killer •

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PURPOSE: To measure the area of the optic nerve subarachnoid space (ONSASA) in patients with normal tension glaucoma (NTG), primary open-angle glaucoma (POAG), and controls and examine its association with relevant ocular and systemic parameters. DESIGN: Cross-sectional study. METHODS: The study included 40 patients with NTG, 42 with POAG, and 45 healthy controls. B-scan ultrasound was performed binocularly, using a 12.5-MHz linear array probe. The measurement of the optic nerve subarachnoid space (ONSAS) and calculation of the ONSASA using ImageJ 1.51e analysis software was done by 2 experienced observers in a masked manner. RESULTS: The ONSASA between 3 and 7 mm behind the globe in NTG (5.15 ± 0.81 mm) was significantly smaller than that in the POAG (6.24 ± 1.62 mm, P = .0008) or control (6.40 ± 2.20 mm; P = .0007) groups. ONSASA in the POAG and control groups were not significantly different (P = .13). ONSASA was significantly associated with mean IOP (P = .0004) and highest IOP (P = .0007). The optic nerve sheath diameter in NTG compared to POAG was significantly different at 3 mm (4.46 ± 0.43 mm vs 4.79 ± 0.40 mm, P = .0007), 5 mm (4.40 ± 0.39 mm vs 4.65 ± 0.47 mm, P = .003), and 7 mm (4.36 ± 0.35 mm vs 4.61 ± 0.30 mm, P = .004) behind the globe. CONCLUSIONS: The ONSASA is smaller in NTG as compared to normal control. This is compatible with a lower cerebrospinal fluid pressure in the optic nerve in NTG, implying that trans-lamina cribrosa pressure difference might be abnormally higher in the NTG group than in normal controls.

Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Full article

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Classification:

9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
2.15 Optic nerve (Part of: 2 Anatomical structures in glaucoma)
6.12 Ultrasonography and ultrasound biomicroscopy (Part of: 6 Clinical examination methods)

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