颅内压与青光眼及其无创测量技术的研究进展

青光眼是世界上第二位致盲性眼病，第一位不可复性致盲性眼病。尽管眼压增高被认为是青光眼性视神经损害的主要危险因素，但是50%的原发性开角型青光眼患者的日常眼压正常，还有一些患者尽管眼压控制良好，但青光眼性视神经损害仍继续发展。这些现象无法用高眼压理论来解释，青光眼患者视神经损害的发病机制仍待探讨。目前国内外的一些研究表明：（1）视神经周围的生物力学的解剖结构包括眼内压，筛板和球后的脑脊液压力在原发性开角型青光眼的发病机制中发挥重要的作用；（2）正常眼压性青光眼患者的脑脊液压力比正常人低，而跨筛板压力差比正常人高；（3）高眼压症患者的脑脊液压力比正常人群高，而跨筛板压力差和正常人之间没有统计学意义。基于以上研究，本文就颅内压与青光眼性视神经损害之间关系的相关研究进展及临床上可行的无创颅内压测量方法作一综述。

Study on intracranial pressure, glaucoma and research advance in noninvasive measurements about intracranial pressure

Glaucoma is the first leading cause of irreversible blindness and the second leading cause of blindness worldwide. Numerous studies have shown that elevated intraocular pressure(IOP)is one of the major risk factors for the development and progression of glaucomatous optic nerve damage. However, there have been 50% of primary open-angle glaucoma(POAG)patients with typical glaucomatous optic neuropathy in whom the IOP measurements have always been in the normal range, and some patients develop typical glaucomatous optic neuropathy with the well controlled IOP. These phenomena cannot be explained by the theory of high intraocular pressure. The pathogenesis of glaucomatous optic nerve damage in these patients with normal IOP needs to be further discussed. Numerous studies at home and abroad have shown that: 1. the surrounding anatomy of the optic nerve including the IOP, the anatomy and biomechanics of the lamina cribrosa and retrobulbar orbital cerebrospinal fluid pressure may be of importance for the pathogenesis of the POAG; 2. patients with normal tension glaucoma had significantly lower cerebrospinal fluid pressure and a higher trans-lamina cribrosa pressure difference compared with normal subjects; 3. patients with ocular hypertension had significantly higher cerebrospinal fluid pressure, however, there is no difference in trans-lamina cribrosa pressure compared with normal subjects. Based on the above research, now we make a review about the research advance of the relation between intracranial pressure and glaucoma optic nerve damage and the available measurements about noninvasive intracranial pressure in clinical in this paper.