B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

Lochner, Piergiorgio; Faßbender, Klaus; Knodel, Sophia; Andrejewski, Anika; Lesmeister, Martin; Wagenpfeil, Gudrun; Nardone, Raffaele; Brigo, Francesco

doi:10.1055/a-0719-4903

Cited by 36 publications

(27 citation statements)

References 27 publications

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“…With further technical and methodological development in the last decades, enabling the quantification of diameters of optic nerve and his sheaths, TOS became a promising novel diagnostic tool in neurology and intensive care medicine. The main areas of application are diseases with increased intracranial pressure such as idiopathic intracranial hypertension, intracranial hemorrhage, and neuro‐traumatological diseases . In this context, TOS provides a helpful diagnostic tool for early prognostication of hypoxic‐ischemic encephalopathy after cardiac arrest .…”

Section: Introductionmentioning

confidence: 99%

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Schroeder

Katsanos

Richter

et al. 2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE To date, normal values for optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) for transorbital sonography (TOS) have only been reported by individual small‐scale studies, exposing a great variability in the measurement of the OND and ONSD. METHODS We performed a systematic review and metanalysis of available to date studies on TOS evaluation of adults without elevated intracranial pressure to provide an overview of the published literature, measuring methods and further specify normal values for OND and ONSD. RESULTS In total, we included 39 studies with 2,927 healthy volunteers (mean age 36.1 years, 44.4% female), so that a total of 5,854 eyes were examined. All pooled analyses were based on random effect models. Mean values for OND were provided in 13 studies. Calculated mean pooled OND value was 3.08 mm (95% confidence interval [CI], 2.9‐3.25), with low heterogeneity across studies (I2 = 12.7%). Thirty‐four studies provided mean values for ONSD measurement. The pool of mean ONSD measurements was 4.78 mm (95% CI, 4.63‐4.94), with evidence of substantial heterogeneity between estimates ONSD (I2 = 50.6%). There were no significant differences (P = .139) in the subsequent subgroup analysis for the different geographic continents. Also, no significant differences could be recorded for the effect of age (P = .824) or gender (P = .093). CONCLUSIONS TOS is a frequently described and widely used method. We provide reference values of OND and ONSD that are based on metanalytical analysis. Different measuring methods of ONSD result in higher heterogeneity. Subgroup analysis revealed no significant correlation between ONSD and age, gender, or geographic origin.

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Section: Introductionmentioning

confidence: 99%

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Schroeder

Katsanos

Richter

et al. 2020

Journal of Neuroimaging

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“…Furthermore, they demonstrated that the ONSD reflects an immediate change in ICP and changes almost concurrently with rapid ICP variations [2,4]. However, the optimal ONSD cutoff point for detection of increased ICP has not been well established, the range of proposed values varies from 4.8 to 5.9 mm [5][6][7][8][9]. Available data regarding normal ONSD are also inconclusive, with a wide inter-individual range of ONSD in the general healthy population [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Optic nerve sheath diameter sonography during the acute stage of intracerebral hemorrhage: a potential role in monitoring neurocritical patients

et al. 2020

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Background Optic nerve sheath diameter (ONSD) sonography has been proposed as a reliable bedside tool for the detection of increased intracranial pressure (ICP). ONSD reacts almost simultaneously to oscillations in ICP. The aim of this study was to investigate the ONSD dynamics in the acute stage of intracerebral hemorrhage (ICH) and to compare ONSD dynamics to the clinical outcome. Methods We enrolled 35 acute ICH patients and 20 healthy volunteers in this prospective study. At the admission, all patients underwent brain CT scan and ONSD sonography. We repeated the ONSD on the second and the third day in all patients while CT scan was repeated if a patient condition deteriorated. The changes in serial ONSD measurements were termed as stable or unstable ONSD trend. ONSD trend was considered as unstable if variations of average ONSD were above 5%. The outcome of the patient was assessed with the Modified Rankin Scale (mRS) and Glasgow Outcome Scale (GOS). Results In healthy volunteers serial ONSD recordings for 3 days revealed a stable trend in 100%. However, in the study group, 23 patients had unstable and 12 had stable ONSD trend during the acute stage of ICH. The patients with unstable ONSD trend were more likely to have worse outcomes (p value 0.003). Conclusion In patients with ICH, the acute-phase ONSD dynamics can help in predicting the clinical outcome.

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“…In idiopathic normal-pressure hydrocephalus, sonography of ONSD was shown to be a reliable diagnostic supplement to spinal tap tests [27]. Furthermore, ONSD has consistently been found to be bigger in patients with idiopathic intracranial hypertension than in controls [28], whereas transorbital ultrasound of OND did not reveal such a difference [29]. In SIH, it has been shown that dynamic ultrasound of the ONSD can be used as a non-invasive tool for diagnosis [13] and follow-up after surgical treatment of the CSF leak [23].…”

Section: Discussionmentioning

confidence: 99%

Postural changes in optic nerve and optic nerve sheath diameters in postural orthostatic tachycardia syndrome and spontaneous intracranial hypotension: A cohort study

et al. 2019

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BackgroundPostural orthostatic tachycardia syndrome is a disorder of the autonomic nervous system. Approximately 30% of patients experience orthostatic headaches. Orthostatic headaches also are a hallmark symptom in spontaneous intracranial hypotension. While the cause of orthostatic headaches in spontaneous intracranial hypotension can be linked to the cerebrospinal fluid loss at the spinal level and consecutively reduced intracranial pressure in the upright position, the cause of orthostatic headaches in postural orthostatic tachycardia syndrome still remains unknown. The present study examined orthostatic changes of intracranial pressure using dynamic ultrasound of the optic nerve and optic nerve sheath diameter in postural orthostatic tachycardia syndrome, spontaneous intracranial hypotension and healthy subjects.MethodsData was obtained from postural orthostatic tachycardia syndrome patients with (n = 7) and without orthostatic headaches (n = 7), spontaneous intracranial hypotension patients (n = 5) and healthy subjects (n = 8). All participants underwent high-resolution transorbital ultrasound in the supine and upright position to assess optic nerve and optic nerve sheath diameter.ResultsGroup differences were found in percentage deviations when changing position of optic nerve sheath diameter (p < 0.01), but not regarding the optic nerve diameter. Pairwise comparisons indicated differences in optic nerve sheath diameter only between spontaneous intracranial hypotension and the other groups. No differences were found between postural orthostatic tachycardia syndrome patients with and without orthostatic headaches.ConclusionThis study shows that the size of the optic nerve sheath diameter dynamically decreases during orthostatic stress in spontaneous intracranial hypotension, but not in postural orthostatic tachycardia syndrome with or without orthostatic headaches, which indicates different underlying causes.

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B-Mode Transorbital Ultrasonography for the Diagnosis of Idiopathic Intracranial Hypertension: A Systematic Review and Meta-Analysis

Cited by 36 publications

References 27 publications

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Quantification of Optic Nerve and Sheath Diameter by Transorbital Sonography: A Systematic Review and Metanalysis

Optic nerve sheath diameter sonography during the acute stage of intracerebral hemorrhage: a potential role in monitoring neurocritical patients

Postural changes in optic nerve and optic nerve sheath diameters in postural orthostatic tachycardia syndrome and spontaneous intracranial hypotension: A cohort study

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