Zerebrale und liquorspezifische Besonderheiten beim primären Offenwinkelglaukom und Normaldruckglaukom

Zusammenfassung

Neben dem Kammerwasser und dem Blut spielt auch der Liquor cerebrospinalis eine wesentliche Rolle in der Pathophysiologie des primären Offenwinkelglaukoms (POWG) und insbesondere auch beim Normaldruckglaukom (NDG). Neben dem Liquordruck, der eine wichtige Rolle bei der Stauungspapille spielt, ist vor allem die Zusammensetzung des Liquors sowie die Fließgeschwindigkeit von Bedeutung. Der Liquor steht sowohl mit dem Gehirn, dem Spinalkanal als auch mit dem Sehnerv im Kontakt. Bei neurodegenerativen Erkrankungen wird neben einer veränderten Zusammensetzung des Liquors auch ein eine verlangsamte Flussgeschwindigkeit als möglicher pathophysiologischer Faktor beschrieben. Auch im perioptischen Subarachnoidalraum des Sehnervs sind bei Patienten mit Normaldruckglaukom Veränderungen der Liquorzusammensetzung wie auch der Flussgeschwindigkeit beschrieben. Diese Befunde legen nahe, dass es sich beim primären POWG, insbesondere aber beim NDG um einen neurodegenerativen Prozess handeln kann.

Schlüsselwörter

Normaldruckglaukom - Liquor cerebrospinalis - Neurodegeneration - Morbus Alzheimer - primäres Offenwinkelglaukom

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