The Manifestation of the Optic Nerve Head Under Simultaneous Intraocular Pressure and Intracranial Pressure Elevation
From the anatomical and biomechanical standpoints, the optic nerve fibers travel through two different fluid pressure cavities, the intraocular pressure space and the retrobulbar cerebrospinal pressure space. The lamina cribrosa forms the border between the higher-pressure intraocular space and the lower-pressure retrobulbar and cerebrospinal fluid space and hence is susceptible to pressure-induced mechanical damage. The pressure gradient that occurs across the lamina cribrosa (intraocular pressure–intracranial pressure) is called as “translaminar pressure gradient” in ophthalmology [1, 2, 4–6, 7]. From the perspective of integrative medicine, it is also referred to as the “ocular-cranial pressure gradient” . The variation of the ocular-cranial pressure gradient plays a pathophysiologic role in optic nerve head damage [1–4, 9]. When the optic nerve is experiencing elevated intraocular pressure and cerebrospinal fluid pressure, and the two pressures eventually stabilize at a new equilibrium, how will the optic nerve head respond to this new environment?
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