Optic nerve sheath diameter in patients with hepatic encephalopathy

Abstract

Background This study aims to reveal whether the optic nerve sheath diameter (ONSD) increases in hepatic encephalopathy (HE) patients, and to determine ONSD is associated with the poor prognosis of patients with HE. Methods and material In this retrospective case-control study, HE patients who underwent cranial computerized tomography (CT) were included in the case group; and the patients who underwent CT for other reasons for the same age and gender and were normally interpreted were included in the control group. ONSD measurements in the case and control groups and clinical grades of HE with in-hospital mortality and ONSD measurements were compared in the case group. Results This study was done with 74 acute HE patients and 74 control patients. The mean age was 62.9 ± 11.0 years and 67.6% of patients were male in both groups. The ONSD in the case group was higher than the control group (5.27-mm ± 0.82 vs 4.73 mm ± 0.57, p <0.001). In the case group, the ONSD was 5.30 mm ± 0.87 in survivors, and 5.21 ± 0.65 in non-survivors (P = 0.670). There was no significant difference between the West Haven HE grade (P = 0.348) and Child-Pugh Score (P = 0.505) with ONSD measurements. Conclusion We have shown that ONSD increases in HE patients compared to the control group. ONSD was not related to the Child-Pugh Score, HE grade, and in-hospital mortality.

Comment on: Optic nerve sheath diameter measurement by ultrasound and age group

“… 1 As a result, emergency physicians involved in the diagnosis and treatment of critically ill patients are familiar with B-scan ultrasound. 2 This technique is also considered a little bit easier to learn and perform compared to the A-scan, especially for doctors who are not specifically trained in ophthalmologic ultrasound. 3 Moreover, applying the probe on open eyelids can be impractical and poorly tolerated by emergency patients.…”

Diagnostic and prognostic efficacy of optic nerve sheath diameter in patients with dysnatremia

“…The optic nerve is a structure of the central nervous system surrounded by the dural sheath and has direct anatomical relationship with the intracranial subarachnoid space [11]. In recent years, many studies have examined the correlation of the optic nerve sheath diameter (ONSD) with ICP and conditions causing it [12][13][14][15][16][17][18]. In addition, although there are a few studies in the literature demonstrating the relationship between ONSD and hyponatremia, there is no study examining the relationship between ONSD and hypernatremia [11,19].…”