Optic Nerve Sheath Diameter Measurement During Diabetic Ketoacidosis: A Pilot Study

Bergmann, Kelly R.; Milner, Donna; Voulgaropoulos, Constantinos; Cutler, Gretchen J.; Kharbanda, Anupam B.

doi:10.5811/westjem.2016.6.29939

Cited by 8 publications

(25 citation statements)

References 56 publications

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“…ONSD values correlated negatively with many gasometry parameters and a tendency towards positive correlation with Na + level was also observed. Moreover, comparing the whole group of patients with T1D with the reference group, we have found significantly higher ONSD values, as in the research of Bergman et al [ 12 ].…”

Section: Discussionsupporting

confidence: 74%

“…So far, there have been single reports in the literature on the use of ONDS in the pediatric diabetic population which gives equivocal results. Bergmann et al did not note differences in ONSD between the studied groups with long-term T1D with DKA vs. non-DKA and hyperglycemic T1D, but they observed mean ONSD values in the group of T1D above the references range [ 12 ]. Hansen et al observed a tendency to decrease the dimensions of ONSD after compensation of metabolic disorders, but the study was carried out on a low number of patients [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…These methods should be, however, widely available and performable before the treatment is started and the classical methods of neuroimaging are applied. Some recent studies on the potential use of transorbital ultrasonography (USG) to evaluate the risk of CE in the small groups of pediatric patients with DKA revealed encouraging results [ 10 – 12 ]. Other promising methods allowing an assessment of retinal nervous layer seem to be the optical coherent tomography (OCT) study [ 13 ] and a pachymetry evaluating corneal thickness [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Measurement of corneal thickness, optic nerve sheath diameter and retinal nerve fiber layer as potential new non-invasive methods in assessing a risk of cerebral edema in type 1 diabetes in children

et al. 2018

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AimsSome patients with diabetic ketoacidosis develop cerebral edema (CE) in the course of type 1 diabetes mellitus (T1D), which may result in central nervous system disorders and high mortality. The imperfection of existing neuroimaging techniques for early recognition of CE forces us to search for the new and non-invasive methods. The aim of the study was to assess the usefulness of new methods (pachymetry, transorbital ultrasonography—USG, optical coherence tomography—OCT study) in the assessment of the risk of CE occurrence in children with newly diagnosed T1D.MethodsThe study group included 50 children with newly diagnosed T1D, 54 patients with long-term T1D as a reference group and 40 children without glucose tolerance disorders as controls. In all subjects, a corneal thickness (CCT) index with pachymeter, optic nerve sheath diameter (ONSD) using transorbital USG and retinal nerve fiber layer (RNFL) during OCT study were measured and compared with selected clinical parameters of T1D.ResultsIn patients from a study group at onset of T1D, the higher CCT (p < 0.001) and ONSD (p < 0.001) values were observed as compared to the results obtained after 48 h of metabolic compensation. The ONSD correlated negatively with pH value (r = − 0.64; p < 0.001), BE (r = − 0.54, p < 0.001) and HCO3− (r = − 0.50; p < 0.001). A positive correlation between RNFL and Na+ levels (r = 0.47; p < 0.005) was also observed.ConclusionsTransorbital USG and pachymetry may serve as the potential promising methods for the non-invasive assessment of the increased risk of development of CE in patients with T1D.Electronic supplementary materialThe online version of this article (10.1007/s00592-018-1242-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Measurement of corneal thickness, optic nerve sheath diameter and retinal nerve fiber layer as potential new non-invasive methods in assessing a risk of cerebral edema in type 1 diabetes in children

et al. 2018

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“…5,32,33 However, in a study on children with Type 1 DM, it was observed that no ONSD alterations occurred in association with disease severity. 3 Similarly, in our study, it was determined that the ONSD measurements in the DKA and HHS patients were not different compared to those in the patients with isolated hyperglycemia. It comes out that the ONSD does not change with the severity of the disease.…”

Section: Discussionsupporting

confidence: 57%

“…There was no difference identified between the ONSDs of these groups. 3 Another study investigated the change of ONSD by serial ONSD measurement during pediatric DKA treatment. In this study, it was observed that after the initiation of treatment, the ONSD showed a bell-shaped trajectory in the form of an increase in ONSD followed by a return to the baseline.…”

Section: Discussionmentioning

confidence: 99%

The measurement of ultrasonographic optic nerve sheath diameter in patients with hyperglycemia

Dönertaş

Kozacı

Avcı

2022

Hong Kong j. emerg. med.

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Background: Diabetes mellitus is a disease associated with several complications in its acute and chronic stages. Objective: The aim of the study was to determine the treatment-associated changes in optic nerve sheath diameter in patients admitted to the emergency department due to one of the acute hyperglycemic complications of diabetes mellitus. Materials and method: Diabetic patients with serum glucose levels of 250 mg/dL or higher were included in the study. Healthy volunteers were included in the control group. Optic nerve sheath diameter was measured at 0th hour and at the end of the second hour. Blood samples were collected simultaneously with optic nerve sheath diameter measurements. Results: The study included 100 individuals. Group 1 included 50 patients and Group 2 included 50 healthy adults. Optic nerve sheath diameter was 4.5 ± 0.4 mm in Group 1 and 4.4 ± 0.5 mm in Group 2 in 0th hour, and no statistical difference was found between the groups (p = 0.162). In Group 1, optic nerve sheath diameter increased 0.6 ± 0.4 mm after the treatment. Of the patients in Group 1, 22 (44%) patients with diabetic ketoacidosis or hyperosmolar hyperglycemic state were assigned to Group 1A and 28 (56%) patients with isolated hyperglycemia were assigned to Group 1B. There was not a difference between the pre- and post-treatment optic nerve sheath diameter values of the patients in Group 1A and Group 1B. Optic nerve sheath diameter was observed to enlarge after treatment. The difference in optic nerve sheath diameter was 0.6 ± 0.4 mm in Group 1A and 0.5 ± 0.4 mm in Group 1B (p = 0.294). Conclusion: Pre-treatment optic nerve sheath diameter values of the patients who were diagnosed with one of the acute hyperglycemic complications of diabetes mellitus are not different from healthy adults. Furthermore, optic nerve sheath diameter values do not change with the severity of the disease. However, optic nerve sheath diameter values change with treatment. For this reason, optic nerve sheath diameter can be used to following the development of brain edema.

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Diagnostic Applications of Point-of-Care Ultrasound in Pediatric Emergency Medicine

Lin‐Martore

Kornblith

2021

Emergency Medicine Clinics of North America

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Optic Nerve Sheath Diameter Measurement During Diabetic Ketoacidosis: A Pilot Study

Cited by 8 publications

References 56 publications

Measurement of corneal thickness, optic nerve sheath diameter and retinal nerve fiber layer as potential new non-invasive methods in assessing a risk of cerebral edema in type 1 diabetes in children

Measurement of corneal thickness, optic nerve sheath diameter and retinal nerve fiber layer as potential new non-invasive methods in assessing a risk of cerebral edema in type 1 diabetes in children

The measurement of ultrasonographic optic nerve sheath diameter in patients with hyperglycemia

Diagnostic Applications of Point-of-Care Ultrasound in Pediatric Emergency Medicine

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