机构:[1]Capital Med Univ, Beijing Tongren Hosp, Beijing Tongren Eye Ctr, Beijing Ophthalmol & Visual Sci Key Lab, Beijing 100730, Peoples R China首都医科大学附属北京同仁医院首都医科大学附属同仁医院[2]Capital Med Univ, Beijing Tongren Hosp, Beijing Inst Ophthalmol, Beijing 100730, Peoples R China首都医科大学附属北京同仁医院研究所眼科研究所[3]Capital Med Univ, Beijing Tongren Hosp, Dept Neurosurg, Beijing 100730, Peoples R China临床科室神经外科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[4]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany[5]Capital Med Univ, Xuanwu Hosp, Dept Ophthalmol, Beijing 100730, Peoples R China首都医科大学宣武医院[6]China Acad Chinese Med Sci, Hosp Eye, Dept Ophthalmol, Beijing, Peoples R China[7]Univ Calif San Diego, Hamilton Glaucoma Ctr, La Jolla, CA 92093 USA[8]Univ Calif San Diego, Dept Ophthalmol, La Jolla, CA 92093 USA
PURPOSE. To examine the influence of experimentally reduced cerebrospinal fluid pressure (CSFP) on retinal nerve fiber layer (RNFL) thickness and neuroretinal rim area of the optic nerve head. METHODS. This experimental study included nine monkeys that underwent implantation of a lumbar-peritoneal cerebrospinal fluid (CSF) shunt. In the study group (n = 4 monkeys), the shunt was opened to achieve a CSF of approximately 40 mm H2O, while the shunt remained closed in the control group (n = 5 monkeys). At baseline and in monthly intervals thereafter, optical coherence tomographic and photographic images of the optic nerve head and RNFL were taken of all monkeys. RESULTS. Two out of four monkeys in the study group showed bilaterally a progressive reduction in RNFL thickness between 12% and 30%, reduction in neuroretinal rim area and volume, and increase in cup-to-disc area ratios. A third monkey developed a splinter-like disc hemorrhage in one eye. The fourth monkey in the study group did not develop morphologic changes during follow-up, nor did any monkey in the control group. CONCLUSIONS. Experimental and chronic reduction in CSF in monkeys was associated with the development of an optic neuropathy in some monkeys.
基金:
National Natural Science Foundation of China
(81271005, 81300767), Beijing Natural Science Foundation
(7122038), and two separate donations by China Health and
Medical Development Foundation.