Abstract
We thank the authors for the interest in our study.1Lindén C. Qvarlander S. Jóhannesson G. et al.Normal tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions.Ophthalmology. 2018; 125: 361-368Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar The points raised by Liu et al are all relevant. Racial differences were, as they noted, not investigated and might be present. Regarding our findings, we made an effort to be as thorough as possible with respect to inclusion criteria of normal tension glaucoma and we used the same, well-documented, and established techniques for cerebrospinal fluid pressure assessment and analysis, both for patients with normal tension glaucoma and controls. The potential body mass index involvement is reported in a previous correspondence.2Lindén C. Qvarlander S. Jóhannesson G. et al.Reply.Ophthalmology. 2018; 125: e42-e43Abstract Full Text Full Text PDF Scopus (1) Google Scholar In summary, we had a negative study, but we agree that the use of different methods in different populations, all with small sample sizes, can contribute to the conflicting results.1Lindén C. Qvarlander S. Jóhannesson G. et al.Normal tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions.Ophthalmology. 2018; 125: 361-368Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar, 3Berdahl J.P. Fautsch M.P. Stinnett S.S. Allingham R.R. Intracranial pressure in primary open angle glaucoma, normal tension glaucoma, and ocular hypertension: a case-control study.Invest Ophthalmol Vis Sci. 2008; 49: 5412-5418Crossref PubMed Scopus (264) Google Scholar, 4Ren R. Jonas J.B. Tian G. et al.Cerebrospinal fluid pressure in glaucoma: a prospective study.Ophthalmology. 2010; 117: 259-266Abstract Full Text Full Text PDF PubMed Scopus (393) Google Scholar To move this research area forward, we support the idea of an international cooperative study as suggested by Liu et al. Re: Lindén et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368)OphthalmologyVol. 125Issue 10PreviewWe read with interest the article by Lindén et al1 presenting the prospective study on intracranial pressure (ICP) and intraocular pressure (IOP) in different body positions. Their study has provided a new method of measuring ICP in different body positions that further advances our understanding regarding the role of trans-lamina cribrosa pressure difference in glaucomatous neuropathy. We are indeed delighted that more colleagues are now working in this field and sharing their views, although their conclusion differed from that of the previous studies by Berdahl et al2 and our team. Full-Text PDF
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