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J GlaucomaNovember 20176 citations

Is the Optic Nerve Head Structure Impacted by a Diagnostic Lumbar Puncture in Humans?

Poli Muriel, Denis Philippe, Sellem Eric, Aho-Glélé Ludwig-Serge, Bron Alain M


AI Summary

This study found diagnostic lumbar puncture caused no optic nerve head structural changes in healthy eyes, suggesting it's safe for deep ONH structures in non-glaucoma patients.

Abstract

Purpose

The purpose of this study is to assess in vivo whether diagnostic lumbar puncture (LP) is followed by optic nerve head (ONH) and parapapillary anatomic changes in normal human eyes.

Materials and methods

Prospective, single-center, observational case series. ONH structures (prelaminar tissue surface, anterior surface of the lamina cribrosa, central retinal vessels) and parapapillary structures (internal limiting membrane, posterior surfaces of retinal nerve fiber layer and Bruch membrane/retinal pigment epithelium complex, Bruch membrane opening, posterior surface of the choroid) were quantitatively evaluated by means of swept-source optical coherence tomography (Triton Ver.10.05, Topcon, Tokyo, Japan) before and after LP (5, 60, and 360 min). Each of these structures was manually delineated for measurement before being superimposed to detect any displacement, using peripheral margins of parapapillary structures as a reference plane.

Results

A total of 16 eyes of 8 nonglaucomatous patients were evaluated. The CSF volume was median (IQR), 1.65 mL (1.16 to 2.00) and none of the ONH structures showed any anatomic changes at any time point after LP.

Conclusions

According to the design of this study, diagnostic LP is a safe procedure regarding deep ONH structures in nonglaucomatous subjects.


MeSH Terms

Cerebrospinal FluidCerebrospinal Fluid PressureFemaleHumansIntraocular PressureMaleMiddle AgedOptic DiskProspective StudiesSpinal PunctureTomography, Optical Coherence

Key Concepts5

Diagnostic lumbar puncture (LP) is not followed by optic nerve head (ONH) and parapapillary anatomic changes in normal human eyes, as assessed by swept-source optical coherence tomography before and after LP (5, 60, and 360 min).

PrognosisCase seriesProspective, single-center, observational case seriesn=16 eyes of 8 nonglaucomatous patientsCh5

None of the optic nerve head (ONH) structures showed any anatomic changes at any time point (5, 60, and 360 minutes) after diagnostic lumbar puncture (LP) in 16 eyes of 8 nonglaucomatous patients, with a median CSF volume removed of 1.65 mL (IQR: 1.16 to 2.00 mL).

PrognosisCase seriesProspective, single-center, observational case seriesn=16 eyes of 8 nonglaucomatous patientsCh5

Diagnostic lumbar puncture (LP) is a safe procedure regarding deep optic nerve head (ONH) structures in nonglaucomatous subjects, based on a prospective, single-center, observational case series.

PrognosisCase seriesProspective, single-center, observational case seriesn=16 eyes of 8 nonglaucomatous patientsCh5

Optic nerve head (ONH) structures, including the prelaminar tissue surface, anterior surface of the lamina cribrosa, and central retinal vessels, were quantitatively evaluated using swept-source optical coherence tomography (Triton Ver.10.05, Topcon, Tokyo, Japan) before and after diagnostic lumbar puncture.

MethodologyCase seriesProspective, single-center, observational case seriesn=16 eyes of 8 nonglaucomatous patientsCh5

Parapapillary structures, including the internal limiting membrane, posterior surfaces of the retinal nerve fiber layer and Bruch membrane/retinal pigment epithelium complex, Bruch membrane opening, and posterior surface of the choroid, were quantitatively evaluated using swept-source optical coherence tomography (Triton Ver.10.05, Topcon, Tokyo, Japan) before and after diagnostic lumbar puncture.

MethodologyCase seriesProspective, single-center, observational case seriesn=16 eyes of 8 nonglaucomatous patientsCh5

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