Glaucoma specialists need to ask if cerebrospinal fluid (CSF) pressure in glaucoma matters, and if so, why, according to John Berdahl, MD.
"The underlying principles and underlying unmet needs make this an exciting topic to think about," said Dr. Berdahl, Vance Thompson Vision, Sioux Falls, SD.
He explained that glaucoma occurs at the optic nerve head, where there are two pressures: IOP and CSF pressure, both of which affect the nerve head.
"So there's a pressure differential, but we measure the pressure differential across the cornea," he said. "We use that differential to dictate what we do when disease occurs at the optic nerve head."
It is also important to consider that there are two pressurized fluids within 550 μm of the optic nerve and the lamina cribrosa, Dr. Berdahl said.
"It's really hard for me to believe that only the one on top matters and the other one doesn't," he said.