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Reference values for trans-laminar cribrosa pressure difference and its association with systemic biometric factors



To provide reference values of trans-laminar cribrosa pressure difference (TLCPD) and reveal the association of TLCPD with systemic biometric factors.


In this cross-sectional study, 526 quasi-healthy subjects (including 776 eyes) who required lumbar puncture for medical reasons were selected from 4915 neurology inpatients from 2019 to 2022. Patients with any diseases affecting intraocular pressure (IOP) or intracranial pressure (ICP) were excluded. The ICPs of all subjects were obtained by lumbar puncture in the left lateral decubitus position. IOP was measured in the seated position by a handheld iCare tonometer prior to lumbar puncture. TLCPD was calculated by subtracting ICP from IOP. Systemic biometric factors were assessed within 1 h prior to TLCPD measurement.


The TLCPD (mean ± standard deviation) was 4.4 ± 3.6 mmHg, and the 95% reference interval (defined as the 2.5th–97.5th percentiles) of TLCPD was −2.27 to 11.94 mmHg. The 95% reference intervals for IOP and ICP were 10–21 and 6.25–15.44 mmHg, respectively. IOP was correlated with ICP (r = 0.126, p < 0.001). TLCPD was significantly negatively correlated with body mass index (r = −0.086, p = 0.049), whereas it was not associated with age, gender, height, weight, blood pressure, pulse, or waist and hip circumference.


This study provides reference values of TLCPD and establishes clinically applicable reference intervals for normal TLCPD. Based on association analysis, TLCPD is higher in people with lower BMI.

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Fig. 1: Histograms of trans-laminar cribrosa pressure difference, intraocular pressure, and intracranial pressure.
Fig. 2: Scatterplots of trans-laminar cribrosa pressure difference, intraocular pressure, and intracranial pressure.
Fig. 3: Box plots of trans-laminar cribrosa pressure difference, intraocular pressure, and intracranial pressure.

Data availability

All data generated or analysed during this study are included in this published article and its supplementary information files.


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The authors thank AiMi Academic Services ( for the English language editing and review services.


The study was funded by the National Natural Science Foundation of China (82130029). The funding organization had no role in the design or conduct of this research.

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Authors and Affiliations



NLW and JWW contributed to the design, acquisition of funding and general supervision of the research group. RQP and DTL contributed to the design, acquired data, analysis of results and drafting of the manuscript. XMD, XYL, LHG, JC, YJ and YPW contributed to the acquired data and advised on the research. KC, TMR and YC contributed to the data analysis.

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Correspondence to Jiawei Wang or Ningli Wang.

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Pang, R., Lin, D., Di, X. et al. Reference values for trans-laminar cribrosa pressure difference and its association with systemic biometric factors. Eye (2022).

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