Purpose: To assess associations of the trans-lamina cribrosa pressure difference (TLCPD) with glaucomatous optic neuropathy. Methods: The population-based Central India Eye and Medical Study included 4711 subjects. Based on a previous study with lumbar cerebrospinal fluid pressure (CSFP) measurements, CSFP was calculated as CSFP[mmHg]=0.44 Body Mass Index[kg/m2]+0.16 Diastolic Blood Pressure[mmHg]-0.18xAge[Years]-1.91. TLCPD was IOP-CSFP. Results: Mean TLCPD was 3.64 +/- 4.25 mm Hg in the non-glaucomatous population and 9.65 +/- 8.17 mmHg in the glaucomatous group. In multivariate analysis, TLCPD was associated with older age (P < 0.001; standardized coefficient beta: 0.53; regression coefficient B: 0.18; 95% confidence interval (CI): 0.17, 0.18), lower body mass index (P < 0.001; beta: -0.28; B: -0.36; 95% CI: -0.38, -0.31), lower diastolic blood pressure (P < 0.001; beta: -0.31; B: -0.12; 95% CI: -0.13, -0.11), higher pulse (P < 0.001; beta: 0.05; B: 0.02; 95% CI: 0.01,0.2), lower body height (P = 0.02; beta: -0.02; B: -0.01; 95% CI: -0.02,0.00), higher educational level (P < 0.001; beta: 0.04; B: 0.15; 95% CI: 0.09,0.22), higher cholesterol blood concentrations (P < 0.001; beta: 0.04; B: 0.01; 95% CI: 0.01,0.01), longer axial length (P=0.006; beta: 0.03; B: 0.14; 95% CI: 0.04,0.24), thicker central cornea (P < 0.001; beta: 0.15; B: 0.02; 95% CI: 0.02,0.02), higher corneal refractive power (P < 0.001; beta: 0.07; B: 0.18; 95% CI: 0.13,0.23) and presence of glaucomatous optic neuropathy (P < 0.001; beta: 0.11; B: 3.43; 95% CI: 2.96,3.99). Differences between glaucomatous subjects and non-glaucomatous subjects in CSFP were more pronounced for open-angle glaucoma (OAG) than for angle-closure glaucoma (ACG) (3.0 mmHg versus 1.8 mmHg), while differences between glaucomatous subjects and non-glaucomatous subjects in IOP were higher for ACG than for OAG (8.5 mmHg versus 3.0 mmHg). Presence of OAG was significantly associated with TLCPD (P < 0.001; OR: 1.24; 95% CI: 1.19,1.29) but not with IOP (P = 0.08; OR: 0.96; 95% CI: 0.91,1.00). Prevalence of ACG was significantly associated with IOP (P = 0.04; OR: 1.19; 95% CI: 1.01,1.40) but not with TLCPD (P = 0.92). Conclusions: In OAG, but not in ACG, calculated TLCPD versus IOP showed a better association with glaucoma presence and amount of glaucomatous optic neuropathy. It supports the notion of a potential role of low CSFP in the pathogenesis of open-angle glaucoma.
基金：
This study was supported by an unrestricted grant from Om Drishti Trust, Nagpur, India; Heidelberg Engineering Co., Heidelberg, Germany; Rotary
Sight Saver Netherlands; ORBIS International; and Carl Zeiss Meditec Co., Jena, Germany.
第一作者机构：[1]Suraj Eye Inst, Nagpur, Maharashtra, India[2]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany
共同第一作者：
通讯作者：
通讯机构：[1]Suraj Eye Inst, Nagpur, Maharashtra, India[2]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany
推荐引用方式(GB/T 7714)：
Jonas Jost B.,Nangia Vinay,Wang Ningli,et al.Trans-Lamina Cribrosa Pressure Difference and Open-Angle Glaucoma. The Central India Eye and Medical Study[J].PLOS ONE.2013,8(12):doi:10.1371/journal.pone.0082284.
APA：
Jonas, Jost B.,Nangia, Vinay,Wang, Ningli,Bhate, Karishma,Nangia, Prabhat...&Panda-Jonas, Songhomitra.(2013).Trans-Lamina Cribrosa Pressure Difference and Open-Angle Glaucoma. The Central India Eye and Medical Study.PLOS ONE,8,(12)
MLA：
Jonas, Jost B.,et al."Trans-Lamina Cribrosa Pressure Difference and Open-Angle Glaucoma. The Central India Eye and Medical Study".PLOS ONE 8..12(2013)
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