Ophthalmic evaluation of intracranial venous return and cerebrospinal fluid circulation disorders in patients with Chiari malformation
LI Li
LI Weina
ZHAO Yue
CHEN Lin
DUAN Haijun
SUN Cheng
CHEN Peng
Abstract：Objective To investigate the clinical significance of ophthalmic examination in the evaluation of venous return and cerebrospinal fluid circulation disorders in patients with Chiari malformation.Methods A retrospective analysis was performed on the cranial MRI and fundus examination data of 138 patients with Chiari malformation admitted to the First Affili-ated Hospital of Army Medical University from 2017 to 2023.The optic nerve sheath diameter(ONSD)and the fundus artery-to-vein diameter(A/V)ratio were measured,and fundus edema and optic nerve sheath morphology were observed.Results Among the 138 cases of Chiari malformation,there were 48 cases of isolated tonsillar herniation(Group A),11 cases of tonsillar her-niation+ventriculomegaly(Group B),55 cases of tonsillar herniation+syringomyelia(Group C),and 24 cases of tonsillar herniation+ventriculomegaly+syringomyelia(Group D).The ONSD was largest in Group B patients[5.82(4.56-6.49)mm],followed by Group D[5.05(4.83-5.55)mm],Group C[5.00(4.66-5.47)mm],and smallest in Group A[4.97(4.67-5.58)mm].The incidence of fundus edema and optic nerve sheath morphological changes was highest in Group B patients[81.82%(9/11)],significantly higher than that in Group A[6.25%(3/48)],Group C[7.28%(4/55)],and Group D[4.17%(1/24)].The incidence of decreased fundus A/V ratio was high in all four groups:37.50%(18/48)in Group A,45.45%(5/11)in Group B,50.91%(28/55)in Group C,and 41.67%(10/24)in Group D.Conclusion Chiari malformation patients with concomitant ventriculomegaly alone have a high incidence of cerebrospinal fluid circulation disorders;regardless of whether ventriculomegaly or syringomye-lia is present,Chiari malformation patients have a high incidence of intracranial venous return disorders.This suggests that the pathogenesis and clinical manifestations of Chiari malformation may result from the combined effects of cerebrospinal fluid cir-culation disorders and intracranial venous return disorders.
Keywords：Chiari malformationophthalmic examinationvenous return disorderscerebrospinal fluid circulation disorders
Publication Date：2025-10-25
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：4( 577-580 )