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Related Experiment Video

Updated: May 23, 2025

Translaminar Autonomous System Model for the Modulation of Intraocular and Intracranial Pressure in Human Donor Posterior Segments

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Published on: April 24, 2020

Peripapillary alterations in Idiopathic Normal Pressure Hydrocephalus.

Nicola Valsecchi^1,2, Matilde Roda^1,2, Matteo Elifani^1,2

¹Ophthalmology Unit, DIMEC, Alma Mater Studiorum University of Bologna, Italy.

Retina (Philadelphia, Pa.)

|March 11, 2025

Summary

Shunt surgery for Idiopathic Normal Pressure Hydrocephalus (iNPH) reduced peripapillary choroidal thickness and improved ocular findings. This suggests venous overload choroidopathy in iNPH, relieved by surgical intervention.

Keywords:

Spaceflight associated neuro-ocular syndrome choroidal congestion iNPH peripapillary choroid shunt surgery

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Area of Science:

Ophthalmology
Neurology
Neurosurgery

Background:

Idiopathic Normal Pressure Hydrocephalus (iNPH) is a neurological condition characterized by gait disturbance, urinary incontinence, and cognitive impairment.
Ophthalmological manifestations in iNPH are not fully understood, but may involve venous congestion.

Purpose of the Study:

To evaluate peripapillary choroidal thickness (PPCT) and associated ocular findings in iNPH patients before and after shunt surgery.
To investigate the impact of ventriculoperitoneal (VP) shunt surgery on peripapillary changes in iNPH.

Main Methods:

Prospective study of 20 iNPH patients and 20 age-matched healthy controls.
Enhanced depth imaging-optical coherence tomography (EDI-OCT) used to measure PPCT.
PPCT assessed before and after VP shunt surgery (at least 6 months post-op) in 12 iNPH patients.

Main Results:

Non-shunted iNPH patients showed significantly increased PPCT compared to controls (113 ± 39 vs 82 ± 43 μm, p=0.026).
Common OCT findings in iNPH included peripapillary atrophy (85%), pachyvessels (70%), and choroidal folds (40%).
Following VP shunt surgery, 84% of patients showed reduced PPCT (111 ± 47 vs 95 ± 49 μm, p=0.011), with resolution of optic disc edema and intraretinal cysts.

Conclusions:

Ophthalmological findings in iNPH suggest a venous overload choroidopathy.
VP shunt surgery effectively reduces peripapillary choroidal congestion and improves OCT parameters in iNPH patients.
Surgical intervention may alleviate ocular manifestations associated with iNPH.