{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:53:41Z","timestamp":1785405221626,"version":"3.56.0"},"reference-count":43,"publisher":"ASME International","issue":"7","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.asme.org\/publications-submissions\/publishing-information\/legal-policies"}],"funder":[{"DOI":"10.13039\/100006312","name":"BrightFocus Foundation","doi-asserted-by":"publisher","award":["G20210125"],"award-info":[{"award-number":["G20210125"]}],"id":[{"id":"10.13039\/100006312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["R01 036042"],"award-info":[{"award-number":["R01 036042"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The optic nerve head (ONH) is subjected to both intra-ocular pressure (IOP) and intracranial pressure (ICP). The translaminar pressure difference (TLPD) is defined as the difference between IOP and ICP. A change in TLPD, whether from changes in IOP or ICP, could subject the lamina cribrosa (LC) to altered deformation, potentially damaging the axons, activating the mechanosensitive glial cells, and promoting remodeling of the connective tissue structures in the ONH. In this study, we applied spectral domain optical coherence tomography (SD-OCT) and digital volume correlation (DVC) to calculate the deformation response of the LC in 7 eyes of 7 patients with normal pressure hydrocephalus (NPH). Radial SD-OCT scans centered on the ONH were acquired prior to and after therapeutic extended cerebrospinal fluid (CSF) drainage. IOP was measured immediately before imaging, and ICP was measured at the beginning and end of the drainage procedure. The procedure led to a mean ICP decrease of 11.24\u00b11.84 mmHg and a small, nonsignificant mean IOP increase of 0.67\u00b12.56 mmHg. ICP lowering produced a significant Ezz=\u22120.50%\u00b10.47%, Err=0.53%\u00b10.48%, and E\u03b8z=0.35%\u00b10.21% (p\u22640.031). A larger compressive Ezz was associated with a larger ICP decrease (p=0.007). Larger Err, Er\u03b8, maximum principal strain, Emax and maximum shear strain, Smax in the plane of the radial scans were associated with a larger increase in a calculated TLPD change (p\u22640.035).<\/jats:p>","DOI":"10.1115\/1.4068633","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T10:26:03Z","timestamp":1746786363000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":0,"title":["Deformation Response of the Human Lamina Cribrosa to Intracranial Pressure Lowering"],"prefix":"10.1115","volume":"147","author":[{"given":"Kelly A.","family":"Clingo","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, The Johns Hopkins University , Baltimore, MD 21218"},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1806-5593","authenticated-orcid":false,"given":"Cameron A.","family":"Czerpak","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, The Johns Hopkins University , Baltimore, MD 21218"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Grace","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins School of Medicine, Johns Hopkins University , Baltimore, MD 21287"},{"id":[{"id":"https:\/\/ror.org\/037zgn354","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins School of Medicine, Johns Hopkins University , Baltimore, MD 21287"},{"id":[{"id":"https:\/\/ror.org\/037zgn354","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal","family":"Favorito","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins School of Medicine, Johns Hopkins University , Baltimore, MD 21287"},{"id":[{"id":"https:\/\/ror.org\/05cb1k848","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anny","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins School of Medicine, Johns Hopkins University , Baltimore, MD 21287"},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Moghekar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins School of Medicine, Johns Hopkins University , Baltimore, MD 21287"},{"id":[{"id":"https:\/\/ror.org\/037zgn354","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry A.","family":"Quigley","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Wilmer Eye Institute , Baltimore, MD 21287"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0312-1583","authenticated-orcid":false,"given":"Thao D.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, The Johns Hopkins University , Baltimore, MD 21218 ; , Baltimore, MD 21287"},{"name":"Johns Hopkins School of Medicine, Wilmer Eye Institute , Baltimore, MD 21218 ; , Baltimore, MD 21287"},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"issue":"8","key":"2025060410593627900_bib1","first-page":"1419","article-title":"The Correlation Between Cerebrospinal Fluid Pressure and Retrolaminar Tissue Pressure","volume":"39","year":"1998","journal-title":"Investig. Ophthalmol. Visual Sci."},{"issue":"2","key":"2025060410593627900_bib2","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1097\/ICU.0b013e32833651d8","article-title":"Intracranial Pressure and Glaucoma","volume":"21","year":"2010","journal-title":"Curr. Opin. Ophthalmol."},{"issue":"3","key":"2025060410593627900_bib3","first-page":"71","article-title":"Intracranial Pressure and Its Relationship to Glaucoma: Current Understanding and Future Directions","volume":"4","year":"2015","journal-title":"Med. Hypothesis, Discovery Innovation. Ophthalmol. J."},{"issue":"5","key":"2025060410593627900_bib4","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.ophtha.2008.01.013","article-title":"Cerebrospinal Fluid Pressure Is Decreased in Primary Open-Angle Glaucoma","volume":"115","year":"2008","journal-title":"Ophthalmology"},{"issue":"12","key":"2025060410593627900_bib5","doi-asserted-by":"crossref","first-page":"5412","DOI":"10.1167\/iovs.08-2228","article-title":"Intracranial Pressure in Primary Open Angle Glaucoma, Normal Tension Glaucoma, and Ocular Hypertension: A Case-Control Study","volume":"49","year":"2008","journal-title":"Invest. Ophthalmol. Visual Sci."},{"issue":"2","key":"2025060410593627900_bib6","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.ophtha.2009.06.058","article-title":"Cerebrospinal Fluid Pressure in Glaucoma: A Prospective Study","volume":"117","year":"2010","journal-title":"Ophthalmology"},{"key":"2025060410593627900_bib7","first-page":"1","article-title":"The Difference in Translaminar Pressure Gradient and Neuroretinal Rim Area in Glaucoma and Healthy Subjects","volume":"2014","year":"2014","journal-title":"J. Ophthalmol."},{"issue":"7","key":"2025060410593627900_bib8","first-page":"e524","article-title":"Translaminar Pressure in Caucasian Normal Tension Glaucoma Patients","volume":"95","year":"2017","journal-title":"Acta Ophthalmol."},{"issue":"3","key":"2025060410593627900_bib9","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.ophtha.2017.09.022","article-title":"Normal-Tension Glaucoma Has Normal Intracranial Pressure","volume":"125","year":"2018","journal-title":"Ophthalmology"},{"issue":"5","key":"2025060410593627900_bib10","doi-asserted-by":"crossref","first-page":"481","DOI":"10.3171\/2010.8.PEDS1042","article-title":"Visual Field Constriction in Children With Shunt-Treated Hydrocephalus","volume":"6","year":"2010","journal-title":"J. Neurosurg. Pediatr."},{"issue":"4","key":"2025060410593627900_bib11","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.3171\/2017.5.JNS163062","article-title":"Glaucoma in Patients With Shunt-Treated Normal Pressure Hydrocephalus","volume":"129","year":"2018","journal-title":"J. Neurosurg."},{"issue":"5","key":"2025060410593627900_bib12","doi-asserted-by":"crossref","first-page":"3067","DOI":"10.1167\/iovs.13-13657","article-title":"Optic Neuropathy Induced by Experimentally Reduced Cerebrospinal Fluid Pressure in Monkeys","volume":"55","year":"2014","journal-title":"Invest. Ophthalmol. Visual Sci."},{"issue":"5","key":"2025060410593627900_bib13","doi-asserted-by":"crossref","first-page":"2833","DOI":"10.1167\/iovs.14-15869","article-title":"Influence of Translaminar Pressure Dynamics on the Position of the Anterior Lamina Cribrosa Surface","volume":"56","year":"2015","journal-title":"Investig. Opthalmology Visual Sci."},{"key":"2025060410593627900_bib14","first-page":"3979","article-title":"In-Vivo 3D Deformation of Lamina Cribrosa Microstructure in Response to Acute Changes in Intraocular and Cerebrospinal Fluid Pressures","volume-title":"Invest. Ophthalmol. Vis. Sci.","year":"2015"},{"key":"2025060410593627900_bib15","article-title":"Mapping in-Vivo Optic Nerve Head Strains Caused by Intraocular and Intracranial Pressures","volume-title":"Proc. SPIE Int. Soc. Opt. Eng.","year":"2017"},{"key":"2025060410593627900_bib16","doi-asserted-by":"crossref","first-page":"108809","DOI":"10.1016\/j.exer.2021.108809","article-title":"Interplay Between Intraocular and Intracranial Pressure Effects on the Optic Nerve Head in Vivo","volume":"213","year":"2021","journal-title":"Exp. Eye Res."},{"issue":"1","key":"2025060410593627900_bib17","doi-asserted-by":"crossref","first-page":"12639","DOI":"10.1038\/s41598-018-31052-x","article-title":"In Vivo Optic Nerve Head Mechanical Response to Intraocular and Cerebrospinal Fluid Pressure: Imaging Protocol and Quantification Method","volume":"8","year":"2018","journal-title":"Sci. Rep."},{"key":"2025060410593627900_bib18","article-title":"In Vivo Modulation of Intraocular and Intracranial Pressures Causes Nonlinear and Non-monotonic Deformations of the Lamina Cribrosa and Scleral Canal","volume-title":"bioRxiv","year":"2023"},{"issue":"4","key":"2025060410593627900_bib19","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1167\/iovs.15-17573","article-title":"Finite Element Modeling of Factors Influencing Optic Nerve Head Deformation Due to Intracranial Pressure","volume":"57","year":"2016","journal-title":"Investig. Opthalmol. Visual Sci."},{"issue":"1","key":"2025060410593627900_bib20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1167\/iovs.17-22488","article-title":"Cerebrospinal Fluid Pressure: Revisiting Factors Influencing Optic Nerve Head Biomechanics","volume":"59","year":"2018","journal-title":"Invest. Ophthalmol. Visual Sci."},{"key":"2025060410593627900_bib21","first-page":"3064949","article-title":"Relative Contributions of Intracranial Pressure and Intraocular Pressure on Lamina Cribrosa Behavior","volume":"2019","year":"2019","journal-title":"J. Ophthalmol."},{"key":"2025060410593627900_bib22","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.actbio.2021.07.010","article-title":"Modeling the Biomechanics of the Lamina Cribrosa Microstructure in the Human Eye","volume":"134","year":"2021","journal-title":"Acta Biomater."},{"issue":"3","key":"2025060410593627900_bib23","first-page":"031003","article-title":"Intracranial Pressure Influences the Behavior of Optic Nerve Head","volume":"139","year":"2016","journal-title":"ASME J. Biomech. Eng."},{"key":"2025060410593627900_bib24","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.actbio.2019.06.050","article-title":"In Vivo Characterization of the Deformation of the Human Optic Nerve Head Using Optical Coherence Tomography and Digital Volume Correlation","volume":"96","year":"2019","journal-title":"Acta Biomater."},{"issue":"10","key":"2025060410593627900_bib25","doi-asserted-by":"crossref","first-page":"101005","DOI":"10.1115\/1.4062846","article-title":"The Curvature, Collagen Network Structure, and Their Relationship to the Pressure-Induced Strain Response of the Human Lamina Cribrosa in Normal and Glaucoma Eyes","volume":"145","year":"2023","journal-title":"ASME J. Biomech. Eng."},{"key":"2025060410593627900_bib26","unstructured":"Hannay, V., 2023, \u201cIn Vivo Biomechanical Strain Response of the Lamina Cribrosa to Pressure Change as a Result of Glaucoma Medication Change,\u201d Ph.D. thesis, Johns Hopkins University, Baltimore, MD.10.1016\/j.xops.2024.100473"},{"issue":"2","key":"2025060410593627900_bib27","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1227\/00006123-198802000-00020","article-title":"Predictive Value of Temporary External Lumbar Drainage in Normal Pressure Hydrocephalus","volume":"22","year":"1988","journal-title":"Neurosurgery"},{"key":"2025060410593627900_bib28","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/978-3-031-36522-5_12","article-title":"Extended Lumbar Drainage: Supplementary Test to Diagnose Shunt Responsive iNPH","volume-title":"Normal Pressure Hydrocephalus","year":"2023"},{"issue":"7","key":"2025060410593627900_bib29","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/nmeth.2019","article-title":"Fiji: An Open-Source Platform for Biological-Image Analysis","volume":"9","year":"2012","journal-title":"Nat. Methods"},{"key":"2025060410593627900_bib30","first-page":"2492","article-title":"Semi-Automated Segmentation of ONH Tissues Using Deep Learning","volume":"65","year":"2024","journal-title":"Invest. Ophthalmol. Visual Sci."},{"issue":"1","key":"2025060410593627900_bib31","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s11340-014-9874-2","article-title":"A Fast Iterative Digital Volume Correlation Algorithm for Large Deformations","volume":"55","year":"2015","journal-title":"Exp. Mech."},{"issue":"1","key":"2025060410593627900_bib32","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ogla.2022.07.005","article-title":"The Strain Response to Intraocular Pressure Decrease in the Lamina Cribrosa of Patients With Glaucoma","volume":"6","year":"2023","journal-title":"Ophthalmol. Glaucoma"},{"issue":"3","key":"2025060410593627900_bib33","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.ogla.2024.01.003","article-title":"Long-Term Remodeling Response in the Lamina Cribrosa Years After Intraocular Pressure Lowering by Suturelysis After Trabeculectomy","volume":"7","year":"2024","journal-title":"Ophthalmol. Glaucoma"},{"issue":"10","key":"2025060410593627900_bib34","first-page":"3236","article-title":"Optic Disc Movement With Variations in Intraocular and Cerebrospinal Fluid Pressure","volume":"43","year":"2002","journal-title":"Invest. Ophthalmol. Visual Sci."},{"issue":"8","key":"2025060410593627900_bib35","doi-asserted-by":"crossref","first-page":"e12507","DOI":"10.14814\/phy2.12507","article-title":"The Effect of Intraocular and Intracranial Pressure on Retinal Structure and Function in Rats","volume":"3","year":"2015","journal-title":"Physiol. Rep."},{"issue":"5","key":"2025060410593627900_bib36","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s10237-023-01752-z","article-title":"Computational Study of the Mechanical Behavior of the Astrocyte Network and Axonal Compartments in the Mouse Optic Nerve Head","volume":"22","year":"2023","journal-title":"Biomech. Model. Mechanobiol."},{"key":"2025060410593627900_bib37","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.actbio.2017.05.042","article-title":"Effects of Collagen Microstructure and Material Properties on the Deformation of the Neural Tissues of the Lamina Cribrosa","volume":"58","year":"2017","journal-title":"Acta Biomater."},{"issue":"1","key":"2025060410593627900_bib38","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1167\/iovs.09-4016","article-title":"Correlation Between Local Stress and Strain and Lamina Cribrosa Connective Tissue Volume Fraction in Normal Monkey Eyes","volume":"51","year":"2010","journal-title":"Invest. Opthalmol. Visual Sci."},{"key":"2025060410593627900_bib39","first-page":"4277","article-title":"Multiscale Finite Element Modeling of the Lamina Cribrosa Microarchitecture in the Eye","volume-title":"Annual International Conference of the IEEE Engineering in Medicine and Biology Society","year":"2009"},{"issue":"11","key":"2025060410593627900_bib40","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1016\/j.ophtha.2018.05.011","article-title":"Long-Term Shape, Curvature, and Depth Changes of the Lamina Cribrosa After Trabeculectomy","volume":"125","year":"2018","journal-title":"Ophthalmology"},{"issue":"11","key":"2025060410593627900_bib41","doi-asserted-by":"crossref","first-page":"e0206040","DOI":"10.1371\/journal.pone.0206040","article-title":"Relationship Between the Rate of Change in Lamina Cribrosa Depth and the Rate of Retinal Nerve Fiber Layer Thinning Following Glaucoma Surgery","volume":"13","year":"2018","journal-title":"PLoS One"},{"issue":"4","key":"2025060410593627900_bib42","first-page":"791","article-title":"Evaluating Displacement of Lamina Cribrosa Following Glaucoma Surgery. Graefe's Arch","volume":"256","year":"2018","journal-title":"Clin. Exp. Ophthalmol."},{"issue":"1","key":"2025060410593627900_bib43","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ophtha.2022.08.007","article-title":"Differing Associations Between Optic Nerve Head Strains and Visual Field Loss in Patients With Normal- and High-Tension Glaucoma","volume":"130","year":"2023","journal-title":"Ophthalmology"}],"container-title":["Journal of Biomechanical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/147\/7\/071008\/7511312\/bio_147_07_071008.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/147\/7\/071008\/7511312\/bio_147_07_071008.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T10:59:50Z","timestamp":1749034790000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article\/147\/7\/071008\/1217238\/Deformation-Response-of-the-Human-Lamina-Cribrosa"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":43,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1115\/1.4068633","relation":{},"ISSN":["0148-0731","1528-8951"],"issn-type":[{"value":"0148-0731","type":"print"},{"value":"1528-8951","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,4]]},"article-number":"071008"}}