Estimated trans‐lamina cribrosa pressure difference versus intraocular pressure as biomarker for open‐angle glaucoma. The B eijing Eye Study 2011

Purpose To examine whether an estimated trans‐lamina cribrosa pressure difference ( TLCPD ) better than intraocular pressure ( IOP ) correlated with markers for glaucoma. Methods The population‐based B eijing E ye S tudy 2011 included 3468 individuals. Cerebrospinal fluid pressure ( CSFP ) was calculated as CSFP [mmHg] = 0.44 × Body Mass Index [kg/m 2 ] + 0.16 × Diastolic Blood Pressure [mmHg] − 0.18 × Age [Years] − 1.91. TLCPD was IOP – CSFP . Results In the non‐glaucomatous population, mean TLCPD was 5.8 ± 4.1 mmHg and mean estimated CSFP was 8.9 ± 3.7 mmHg. IOP was higher (p   =   0.008), CSFP was lower (p   <   0.001), and TLCPD was (p   <   0.001) higher in the glaucoma group than in the non‐glaucomatous group. The intergroup difference was highest for TLCPD (2.1 mmHg) followed by CSFP (1.7 mmHg) and IOP (0.4 mmHg). Open‐angle glaucoma ( OAG ) was associated with higher TLCPD [p   <   0.001; odds ratio ( OR ): 1.14; 95% confidence intervals ( CI ): 1.08, 1.19] but not with IOP (p   =   0.22; OR : 0.96; 95% CI : 0.89, 1.03). In contrast, angle‐closure glaucoma ( ACG ) was associated with higher IOP (p   =   0.03; B : 0.14; OR : 1.15; 95% CI : 1.01, 1.30) but not with TLCPD (p   =   0.98), after adjustment for age and anterior chamber depth. Retinal nerve fibre layer thickness was associated with lower TLCPD (p   =   0.036) but not with IOP (p   =   0.96), after adjusting for gender, age, region of habitation, optic disc area and refractive error. Neuroretinal area and volume were associated with smaller TLCPD (p   =   0.002, and p   <   0.001, respectively), after adjusting for gender, optic disc area and refractive error, but not with IOP (p   =   0.43 and p   =   0.25, resp.). 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 OAG .