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Glaucomatous Disease in Patients With Normal Pressure Hydrocephalus

PurposeTo investigate the relative prevalence of glaucomatous disease in patients with normal pressure hydrocephalus (NPH) compared with age-matched non-NPH controls with hydrocephalus. DesignCase-control study. ParticipantsUsing International Classification of Diseases (ICD-9) codes, we identified the medical records of 72 NPH cases and 72 age-matched controls with hydrocephalus treated at Stanford University Hospital between 1996 and 2007. MethodsAll available electronic medical records were reviewed. The diagnosis of NPH was verified based on clinical presentation, neuroimaging results, and opening pressure on initial access to cerebrospinal fluid space. Glaucoma status was determined based on history and prior medical, laser, or surgical intraocular pressure-lowering therapy. Main Outcome MeasureThe proportion of subjects determined as having glaucomatous disease in cases and controls. ResultsThe prevalence of glaucoma in NPH cases was estimated to be 18.1% in contrast to 5.6% in controls (χ2=5.403, P=0.0201). The average age of NPH cases and non-NPH controls was 75.40±13.4 and 73.96±9.92 years (mean±SD), respectively. ConclusionsWe found the prevalence of a glaucoma diagnosis to be 3-fold greater in patients with NPH as compared with age-matched non-NPH controls with hydrocephalus. These findings suggest the possiblity of an association between these 2 neurodegenerative diseases which should be studied prospectively.