Quantitative Association Between Peripapillary Bruch's Membrane Shape and Intracranial Pressure

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Intracranial pressure (ICP) is a critical parameter in neurological health.
• Peripapillary Bruch's membrane (pp-BM) shape is a potential indicator of ocular conditions.
• Understanding the relationship between ICP and pp-BM is crucial for diagnosing and managing related diseases.

Purpose of the Study:

• To establish a quantitative correlation between chronic ICP and pp-BM shape.
• To investigate if pp-BM shape changes can be detected within one hour after ICP reduction via lumbar puncture (LP).

Main Methods:

• Optical coherence tomography (OCT) B-scans were acquired before and after LP in 39 eyes.
• Geometric morphometric analysis was used to define and analyze pp-BM shape using 16 semi-landmarks.
• Generalized estimating equation models assessed associations between pp-BM shape parameters and ICP levels.

Main Results:

• A significant association was found between ICP and the primary component of pp-BM shape (Principal Component 1) (P < 0.0005).
• pp-BM shape (Principal Component 4) demonstrated significant changes within 1 hour post-LP (P = 0.003).
• Lower ICP correlated with a more posterior pp-BM position, and chronic ICP was linked to pp-BM width and anterior margin location.

Conclusions:

• pp-BM shape is quantitatively associated with chronic ICP levels.
• Acute changes in pp-BM shape are detectable shortly after ICP reduction.
• pp-BM shape may serve as a valuable biomarker for both chronic ICP and acute ICP fluctuations.