Change and significance of optic nerve sheath pulsatile dynamics in normal-tension glaucoma

Authors: Pang Ruiqi,  Liu Hanruo,  Ma Teng,  Shi Wenyuan,  Cao Kai,  Yang Diya,  Zhu Qiang,  Wang Ningli
DOI: 10.3760/cma.j.cn115989-20190322-00129
Published 2020-05-10
Cite as Chin J Exp Ophthalmol, 2020,38(05): 427-432.

Abstract

Objective

To analyze the value and difference of the optic nerve sheath pulse dynamic deformation index (DI) in normal-tension glaucoma (NTG) and high-pressure primary open angle glaucoma (POAG).

Methods

A cross-sectional study was conducted to collect clinical data at the Eye Center of Beijing Tongren Hospital from June 2016 to March 2017, 32 patients with NTG and 35 patients with high-pressure POAG were sampled.For all subjects, their basic information, body mass index (BMI), mean arterial blood pressure (MAP), 24 hours intraocular pressure, and ophthalmologic examinations required for diagnosis were recorded.All subjects underwent transorbital ultrasonography and for each 15 seconds of consecutive ultrasound images were taken.The dynamic post-processing technique was used to calculate the DI.The difference in DI between the two groups and the correlation of DI with other variables were analyzed.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital.Written informed consent was obtained from all subjects prior to their entering the study cohort and receiving the transorbital ultrasound examination.

Results

The median level of DI in the NTG group was 0.51 (0.48, 0.54), which was higher than that in the high-pressure POAG group (0.23[0.20, 0.25]), exhibiting a significant difference (Z=-7.01, P<0.01). The mean BMI in the NTG group was lower than that in the high-pressure POAG group([21.29±4.64]kg/m2vs. [23.53±3.40]kg/m2), the mean MAP in the NTG group was lower than that in the high-pressure POAG group([91.44±14.30]mmHg vs. [104.05±13.96] mmHg), the differences between the two groups were statistically significant (t=-2.30, P<0.05; t=-3.65, P<0.01). There was no statistical association between the two groups of DI and age, MAP, BMI, mean intraocular pressure and maximum intraocular pressure (all at P>0.05).

Conclusions

The DI of the NTG patient is higher than that of the POAG patient, which indicates that the optic nerve sheath subarachnoid pressure and optic nerve sheath stiffness in NTG patients are lower than those in POAG patients.Therefore, the DI is a potential indicator of non-invasive intracranial pressure and translaminar cribrosa pressure difference detection in ophthalmology.

Key words:

Normal-tension glaucoma; Glaucoma, open-angle; Optic nerve sheath; Pulse dynamic deformation index; Ultrasonography; Orbit

Contributor Information

Pang Ruiqi
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
Liu Hanruo
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
Ma Teng
Department of Medical Ultrasonics, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Shi Wenyuan
Department of Medical Ultrasonics, Beijing Ertong Hospital, Capital Medical University, Beijing 100010, China
Cao Kai
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
Yang Diya
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
Zhu Qiang
Department of Medical Ultrasonics, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Wang Ningli
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
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Updated: June 24, 2020 — 11:36 am