Abstract
Idiopathic intracranial hypertension, space-flight associated neuro-ocular syndrome (SANS), and glaucoma are conditions that are among a spectrum of cerebrospinal fluid (CSF)-related ophthalmologic disease. This implies that local CSF pressures at the level of the optic nerve are involved to variable extent in these disease processes. However, CSF pressure measurements are problematic due to invasiveness and interpretation. The pressure measured by a lumbar puncture is likely not the same as the orbital CSF pressure. It is believed this is at least in part due to the flow restrictive properties of the optic canal. To investigate CSF flow within the orbit, a model for CSF dynamics was created using three medium-sized pigs. Contrast was administered through a lumbar subarachnoid space access. The contrast front was imaged with repeated computed tomographic (CT) imaging. Once contrast entered the orbit, rapid, sequential CT imaging was performed until the contrast reached the posterior globe. Head tilting was performed to highlight the role of gravitational dependence within the subarachnoid space.
Highlights
The primary circulating fluid of the central nervous system is the cerebrospinal fluid (CSF)
Images were primarily analyzed in a coronal view, defined by a plane that was tangential to the optic nerve
When a superior and an inferior aspect of the nerve sheath were highlighted by the contrast front, a separate ROI was placed at the initiation of the nerve from the optic canal and at its termination in the inferior or superior location, respectively
Summary
The primary circulating fluid of the central nervous system is the cerebrospinal fluid (CSF). The CSF and its flow is important in the context of ophthalmologic disease. Idiopathic intracranial hypertension (IIH), an uncommon disease that primarily affects young, obese women, is characterized by increased intracranial pressure in the absence of a secondary or identifiable cause. With the development of papilledema, swelling of the optic nerve, the condition can lead to significant vision loss and blindness. Cerebrospinal fluid pressure (CSFP) has re-emerged as a possible risk factor for glaucoma. Space flight-associated neuro-ocular syndrome (SANS), a condition that has affected astronauts returning from prolonged microgravitational exposure, can produce optic nerve swelling, hyperopia, and globe flattening [1]
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