Ventriculoperitoneal shunt patients and glaucoma: a cohort analysis of the NPH registry.

IF 5.9 1区医学 Q1 NEUROSCIENCES

Fluids and Barriers of the CNS Pub Date : 2024-07-09 DOI:10.1186/s12987-024-00558-0

Benjam Kemiläinen, Kai Kaarniranta, Ville Leinonen

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引用次数: 0

Abstract

Background: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a chronic condition affecting the elderly. It is characterized by a triad of symptoms and radiological findings. Glaucoma is the leading cause of irreversible blindness worldwide. Earlier studies have proposed that the rate of glaucoma is higher in iNPH patients, and of a possible link between ventriculoperitoneal shunt (VP) treatment and the development of glaucoma.

Objectives: This study aimed to determine the prevalence of glaucoma among iNPH patients and assess the impact of VPs on glaucoma prevalence.

Methods: A cohort study was conducted at Kuopio University Hospital (KUH), including 262 patients with a ventriculoperitoneal shunt. Clinical data were obtained from the Kuopio NPH Registry and medical records. Patients were grouped by iNPH status: iNPH (+) - probable/possible iNPH (n = 192), and iNPH (-) - other causes of hydrocephalus (congenital, secondary, obstructive) (n = 70). We conducted statistical analysis using the Independent Samples T-test, Fisher's exact test, and Pearson Chi-Square. We compared demographics, glaucoma prevalence, brain biopsies positive for Amyloid-β (Aβ) and hyperphosphorylated tau (HPτ) as well as comorbidities for hypertension and diabetes medication. Age stratification assessed glaucoma prevalence in the full cohort.

Results: Both iNPH (+) and iNPH (-) groups had comparable demographic and comorbidity profiles. The prevalence of glaucoma in the iNPH (+) group was 11.5% (n = 22) and 11.4% (n = 8) in the iNPH (-) group without a statistically significant difference (p = 1.000). Brain biopsies positive for Amyloid-β (Aβ) and hyperphosphorylated tau (HPτ) were similar.

Conclusions: Neither shunted iNPH patients nor those with a comorbid condition other than iNPH showed a markedly higher prevalence of glaucoma. Instead, both groups exhibited age-related increases in glaucoma prevalence, similar to the trends observed in population-based studies. Our data does not suggest a correlation between VP shunts and an elevated rate of glaucoma.

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脑室腹腔分流术患者与青光眼：NPH 登记的队列分析。

背景：特发性正常压力脑积水（iNPH）是一种影响老年人的慢性疾病。它以三联症状和放射学检查结果为特征。青光眼是导致全球不可逆失明的主要原因。早期研究认为，iNPH 患者的青光眼发病率较高，而且脑室腹腔分流术（VP）治疗与青光眼发病之间可能存在联系：本研究旨在确定 iNPH 患者的青光眼患病率，并评估 VP 对青光眼患病率的影响：库奥皮奥大学医院（Kuopio University Hospital，KUH）开展了一项队列研究，其中包括 262 名患有脑室腹腔分流术的患者。临床数据来自库奥皮奥 NPH 登记处和医疗记录。患者按 iNPH 状态分组：iNPH (+) - 可能/可能的 iNPH（n = 192），iNPH (-) - 其他原因导致的脑积水（先天性、继发性、阻塞性）（n = 70）。我们采用独立样本 T 检验、费雪精确检验和 Pearson Chi-Square 进行了统计分析。我们比较了人口统计学、青光眼患病率、淀粉样蛋白-β（Aβ）和高磷酸化tau（HPτ）阳性的脑活检结果以及高血压和糖尿病的合并症。年龄分层评估了整个队列中的青光眼患病率：结果：iNPH (+) 组和 iNPH (-) 组的人口统计学和合并症情况相当。iNPH（+）组的青光眼患病率为 11.5%（n = 22），iNPH（-）组的青光眼患病率为 11.4%（n = 8），两组患病率差异无统计学意义（p = 1.000）。淀粉样蛋白-β（Aβ）和高磷酸化tau（HPτ）阳性的脑活检结果相似：结论：无论是分流后的iNPH患者，还是合并iNPH以外疾病的患者，其青光眼患病率都没有明显升高。相反，两组患者的青光眼患病率都呈现出与年龄相关的增长，这与基于人群的研究中观察到的趋势相似。我们的数据并不表明 VP 分流与青光眼发病率升高之间存在关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fluids and Barriers of the CNS Neuroscience-Developmental Neuroscience

CiteScore

10.70

自引率

8.20%

发文量

审稿时长

14 weeks

期刊介绍： "Fluids and Barriers of the CNS" is a scholarly open access journal that specializes in the intricate world of the central nervous system's fluids and barriers, which are pivotal for the health and well-being of the human body. This journal is a peer-reviewed platform that welcomes research manuscripts exploring the full spectrum of CNS fluids and barriers, with a particular focus on their roles in both health and disease. At the heart of this journal's interest is the cerebrospinal fluid (CSF), a vital fluid that circulates within the brain and spinal cord, playing a multifaceted role in the normal functioning of the brain and in various neurological conditions. The journal delves into the composition, circulation, and absorption of CSF, as well as its relationship with the parenchymal interstitial fluid and the neurovascular unit at the blood-brain barrier (BBB).