Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma

Dirk Boye; Margherita Montali; Neil R. Miller; Achmed Pircher; Philipp Gruber; Hanspeter E. Killer; Luca Remonda; Jatta Berberat

doi:10.1111/ceo.13116

Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma

Dirk Boye, Margherita Montali, Neil R. Miller, Achmed Pircher, Philipp Gruber, Hanspeter E. Killer, Luca Remonda, Jatta Berberat

School of Medicine

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Importance: This study offers a new approach for the quantification of CSF dynamics. Background: Non-invasive method to quantify the CSF dynamics in the subarachnoid space of the optic nerve is highly desirable. The aim of the study was to measure slow-flow CSF velocities in healthy controls and normal tension glaucoma patients between the intracranial cavity and the subarachnoid space of the optic nerve. Design: Prospective observational study. Participants: Eleven age-matched healthy volunteers and 15 normal tension glaucoma patients. Methods: Using phase contrast images, the phase shift in MRI diffusion images can be used to determine the flow velocity. Flow-range ratio between the intracranial cavity and the subarachnoid space of the optic nerve was calculated. Main Outcome Measure: Flow-range ratio between the intracranial cavity and the subarachnoid space of the optic nerve was calculated. Results: First, phantom measurements were provided to validate the slow-flow velocity calculations. Second, flow-range ratio was validated for the healthy controls (0.63 ± 0.05), with the range being similar for the right and left optic nerve (P = 0.1). Statistically significant results were obtained (P < 0.05) when comparing the flow-range ratio in the optic nerve of healthy controls (n = 22 eyes, 0.63 ± 0.05) with the flow-range ratio in pathological optic nerves (n = 23, 0.55 ± 0.08) of normal tension glaucoma patients. MANOVA revealed no dependency between flow-range ratio and patient dependent variables. Conclusion and Relevance: Diffusion-weighted imaging provides a method to evaluate CSF flow within the subarachnoid space of the optic nerve in a non-invasive manner. Compared to healthy controls, patients with normal tension glaucoma measure a significantly lower flow-range ratio. This finding suggests a possible role of impaired CSF dynamics in the pathophysiology in normal tension glaucoma.

Original language	English (US)
Pages (from-to)	511-518
Number of pages	8
Journal	Clinical and Experimental Ophthalmology
Volume	46
Issue number	5
DOIs	https://doi.org/10.1111/ceo.13116
State	Published - Jul 2018

Keywords

CSF flow
MRI
diffusion imaging
normal tension glaucoma

ASJC Scopus subject areas

Ophthalmology

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Boye, D., Montali, M., Miller, N. R., Pircher, A., Gruber, P., Killer, H. E., Remonda, L., & Berberat, J. (2018). Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma. Clinical and Experimental Ophthalmology, 46(5), 511-518. https://doi.org/10.1111/ceo.13116

Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma. / Boye, Dirk; Montali, Margherita; Miller, Neil R. et al.
In: Clinical and Experimental Ophthalmology, Vol. 46, No. 5, 07.2018, p. 511-518.

Research output: Contribution to journal › Article › peer-review

Boye, D, Montali, M, Miller, NR, Pircher, A, Gruber, P, Killer, HE, Remonda, L & Berberat, J 2018, 'Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma', Clinical and Experimental Ophthalmology, vol. 46, no. 5, pp. 511-518. https://doi.org/10.1111/ceo.13116

Boye D, Montali M, Miller NR, Pircher A, Gruber P, Killer HE et al. Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma. Clinical and Experimental Ophthalmology. 2018 Jul;46(5):511-518. doi: 10.1111/ceo.13116

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title = "Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma",

abstract = "Importance: This study offers a new approach for the quantification of CSF dynamics. Background: Non-invasive method to quantify the CSF dynamics in the subarachnoid space of the optic nerve is highly desirable. The aim of the study was to measure slow-flow CSF velocities in healthy controls and normal tension glaucoma patients between the intracranial cavity and the subarachnoid space of the optic nerve. Design: Prospective observational study. Participants: Eleven age-matched healthy volunteers and 15 normal tension glaucoma patients. Methods: Using phase contrast images, the phase shift in MRI diffusion images can be used to determine the flow velocity. Flow-range ratio between the intracranial cavity and the subarachnoid space of the optic nerve was calculated. Main Outcome Measure: Flow-range ratio between the intracranial cavity and the subarachnoid space of the optic nerve was calculated. Results: First, phantom measurements were provided to validate the slow-flow velocity calculations. Second, flow-range ratio was validated for the healthy controls (0.63 ± 0.05), with the range being similar for the right and left optic nerve (P = 0.1). Statistically significant results were obtained (P < 0.05) when comparing the flow-range ratio in the optic nerve of healthy controls (n = 22 eyes, 0.63 ± 0.05) with the flow-range ratio in pathological optic nerves (n = 23, 0.55 ± 0.08) of normal tension glaucoma patients. MANOVA revealed no dependency between flow-range ratio and patient dependent variables. Conclusion and Relevance: Diffusion-weighted imaging provides a method to evaluate CSF flow within the subarachnoid space of the optic nerve in a non-invasive manner. Compared to healthy controls, patients with normal tension glaucoma measure a significantly lower flow-range ratio. This finding suggests a possible role of impaired CSF dynamics in the pathophysiology in normal tension glaucoma.",

keywords = "CSF flow, MRI, diffusion imaging, normal tension glaucoma",

author = "Dirk Boye and Margherita Montali and Miller, {Neil R.} and Achmed Pircher and Philipp Gruber and Killer, {Hanspeter E.} and Luca Remonda and Jatta Berberat",

note = "Funding Information: Funding sources: Cantonal Hospital Aarau Research Fond, Grant No. 1410.000.033. Publisher Copyright: {\textcopyright} 2017 Royal Australian and New Zealand College of Ophthalmologists",

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AB - Importance: This study offers a new approach for the quantification of CSF dynamics. Background: Non-invasive method to quantify the CSF dynamics in the subarachnoid space of the optic nerve is highly desirable. The aim of the study was to measure slow-flow CSF velocities in healthy controls and normal tension glaucoma patients between the intracranial cavity and the subarachnoid space of the optic nerve. Design: Prospective observational study. Participants: Eleven age-matched healthy volunteers and 15 normal tension glaucoma patients. Methods: Using phase contrast images, the phase shift in MRI diffusion images can be used to determine the flow velocity. Flow-range ratio between the intracranial cavity and the subarachnoid space of the optic nerve was calculated. Main Outcome Measure: Flow-range ratio between the intracranial cavity and the subarachnoid space of the optic nerve was calculated. Results: First, phantom measurements were provided to validate the slow-flow velocity calculations. Second, flow-range ratio was validated for the healthy controls (0.63 ± 0.05), with the range being similar for the right and left optic nerve (P = 0.1). Statistically significant results were obtained (P < 0.05) when comparing the flow-range ratio in the optic nerve of healthy controls (n = 22 eyes, 0.63 ± 0.05) with the flow-range ratio in pathological optic nerves (n = 23, 0.55 ± 0.08) of normal tension glaucoma patients. MANOVA revealed no dependency between flow-range ratio and patient dependent variables. Conclusion and Relevance: Diffusion-weighted imaging provides a method to evaluate CSF flow within the subarachnoid space of the optic nerve in a non-invasive manner. Compared to healthy controls, patients with normal tension glaucoma measure a significantly lower flow-range ratio. This finding suggests a possible role of impaired CSF dynamics in the pathophysiology in normal tension glaucoma.

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Flow dynamics of cerebrospinal fluid between the intracranial cavity and the subarachnoid space of the optic nerve measured with a diffusion magnetic resonance imaging sequence in patients with normal tension glaucoma

Abstract

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