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L-PGD synthase: does its concentration in the optic nerve subarachnoid space correlate to the structural damage of the nerve in papilloedema or glaucoma?
  1. Sajid Adhi Raja
  1. Correspondence to Dr Raja Sajid Adhi, Department of Ophthalmology, PMMPMHAMB Hospital, Tutong, Negara Brunei Darussalam, Tutong TA1341, Brunei Darussalam; drsajideye{at}

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Professor Hanspeter Esriel Killer et al, in a series of excellent original articles on cerebrospinal fluid (CSF) dynamics in the subarachnoid spaces (SAS) of the optic nerve, holds the view that CSF is compartmentalised within the trabecular SAS of the optic nerve causing stasis or reduced CSF flow.1 As a result, the CSF composition is altered. Increased concentration of molecules such as Lipocalin-type prostaglandin D synthase (L-PGDS) supposedly causes toxic damage to the optic nerve. The ratio …

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  • Competing interests None.

  • Patient consent This is only a scientific response to article published recently in the BJO.

  • Provenance and peer review Not commissioned; internally peer reviewed.