A theoretical model to allow prediction of the CSF pressure from observing the retinal venous pulse

Stewart, P. S. , Jensen, O. E. and Foss, A. J. E. (2014) A theoretical model to allow prediction of the CSF pressure from observing the retinal venous pulse. Investigative Ophthalmology and Visual Science, 55(10), pp. 6319-6323. (doi: 10.1167/iovs.14-14331)

Abstract

<b>Purpose:</b> There is no easy way to estimate the intracranial pressure (ICP) non-invasively. The retinal vein can exhibit large amplitude oscillations at the level of the lamina cribrosa under certain circumstances. The aim of this study was to develop a theoretical understanding of the conditions required to establish this vigorous oscillatory behaviour and whether observations of it could lead to a non-invasive estimate of the ICP.<p></p> <b>Methods:</b> A mathematical model was constructed in which the central retinal vein was modelled as two Starling resistors in series, one located in the eye and the other in the cerebrospinal fluid (CSF) space, separated by a region where it was not collapsible corresponding to its course within the optic nerve itself. The intraocular pressure (IOP) and ICP were modelled as sinusoidal wave forms.<p></p> <b>Results:</b> The model predicts an approximately linear relationship between the IOP and the ICP at the point of onset of oscillatory behaviour. The predicted onset IOP also depends weakly on the retinal blood flow rate and the vein diameter and is only mildly sensitive to the phase difference between the two pressure waveforms. The predicted onset curve shows encouraging agreement with measurements in canines.<p></p> <b>Conclusions:</b> The model suggests that it may be possible to estimate of the ICP from observations of the retinal venous pulse using a modified form of ophthalmodynamometry.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stewart, Professor Peter
• Authors: Stewart, P. S., Jensen, O. E., and Foss, A. J. E.
• College/School: College of Science and Engineering > School of Mathematics and Statistics > Mathematics
• Journal Name: Investigative Ophthalmology and Visual Science
• Publisher: Association for Research in Vision and Ophthalmology (ARVO)
• ISSN: 0146-0404
• ISSN (Online): 1552-5783