Optic nerve ultrasonography for evaluating increased intracranial pressure in severe preeclampsia

Bernardo, Maddalena De; Vitiello, Livio; Rosa, Nicola

doi:10.1016/j.ijoa.2018.12.010

Cited by 31 publications

(15 citation statements)

References 7 publications

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“…In cases of increased ICP, the nerve and sheath are stretched as the globe turns temporally, resulting in a shorter measurement value compared to the primary gaze. On the other hand, in the case of solid lesions, the ONSD will appear enlarged but the measurement does not change between the primary gaze and 30° ( 37 , 38 ). Nonetheless, this is a more complicated test, taking considerable expertise, and not all ultrasound devices have the technological capability ( 39 ).…”

Section: Discussionmentioning

confidence: 97%

Optic Nerve Ultrasound Evaluation in Idiopathic Intracranial Hypertension

et al. 2022

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Idiopathic intracranial hypertension (IIH) is a disease with a heterogeneity of possible causes, which needs to be quickly diagnosed. Ocular ultrasonography could be considered a useful tool to diagnose this condition in a fast and non-invasive way. In fact, Karl Ossoinig had already proposed this diagnostic tool in the 1970s for the evaluation of intracranial pressure changes under several pathological conditions, including idiopathic intracranial hypertension. The aim of this review is to analyze scientific articles published in the last 30 years concerning the use of ocular ultrasonography to assess optic nerve indices in patients with idiopathic intracranial hypertension. Specifically, 15 published articles found in PubMed database were included and analyzed in the present review. Our conclusion suggests that ocular ultrasonography is a reliable diagnostic technique to be utilized in all the cases of suspected raised intracranial pressure. To obtain the best possible accuracy and precision in the least invasive way, standardized A-scan seems to be the best choice.

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Section: Discussionmentioning

confidence: 97%

Optic Nerve Ultrasound Evaluation in Idiopathic Intracranial Hypertension

et al. 2022

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“…Except for the study by Garcia et al ( 20 ), in all the papers discussed in this review the echographic probe was positioned on the closed eyelids, making impossible to visualize the ocular globe and the patient's gaze direction. This could lead to errors during the ultrasound examination, providing less objective data ( 61 ). For this reason, the B- or A-scan probe should be usually used with open eyelids, utilizing methylcellulose and anesthetic drops, thus avoiding mistakes in the eye position visualization and making the probe orientation much more reliable ( 62 ).…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Ultrasound Evaluation in Animals and Normal Subjects

et al. 2022

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In recent years, ultrasonographic measurement of the optic nerve sheath diameter (ONSD) has been widely used to identify the presence of increased intracranial pressure (ICP). Intracranial hypertension is a life-threatening condition that can be caused by various neurological and non-neurological disorders, and it is associated to poor clinical results. Ultrasonography could be used to qualitatively and efficiently detect ICP increases, but to reach this purpose, clear cut-off values are mandatory. The aim of this review is to provide a wide overview of the most important scientific publications on optic nerve ultrasound normal values assessment published in the last 30 years. A total of 42 articles selected from PubMed medical database was included in this review. Our analysis showed that ocular ultrasonography is considered to be a valuable diagnostic tool, especially when intracranial hypertension is suspected, but unfortunately this research provided conflicting results that could be due to the different ultrasound protocols. This is mainly caused by the use of B scan alone, which presents several limitations. The use of B-scan coupled with the standardized A-scan approach could give more accurate, and reliable ultrasound evaluation, assuring higher data objectivity.

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“…Due to non-standardized gain settings used to acquire images, a “blooming effect” occurs, where larger gains cause the ONS to appear larger, and smaller gains cause it to appear smaller ( 40 ). This effect leads to artifacts ( 41 ) and decreased repeatability of measurements between ONSD studies ( 42 ). As in real life, gain was not standardized across devices during the present study, which may account for some of the variation observed.…”

Section: Discussionmentioning

confidence: 99%

“…The MI and TI are based upon the frequency output of the device, the depth of exam, and the tissue properties being examined. Manufacturer presets use software to limit the ultrasound focal length and energy output so that they do not exceed these safety thresholds ( 41 ). During our data collection, the Lumify and IVIZ did not have ocular ultrasound manufacturer presets, so we did not maintain their MI below the safety threshold during our study, which was part of the rationale to use a simulation model rather than human subjects for our measurements.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Optic Nerve Sheath Diameter Measurements in Pocket-Sized Ultrasound Devices in a Simulation Model

et al. 2022

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IntroductionTransorbital sonographic measurement of optic nerve sheath diameter (ONSD) is an emerging non-invasive technique for the identification and monitoring of intracranial hypertension. In recent years, new pocket ultrasound devices have become available, and it is uncertain if they have the resolution to measure such small structures appropriately as compared to their predecessors. In this study, we measure the performance of three ultrasound units on a simulation model to establish their precision and accuracy.MethodsONSD was measured by three expert point-of-care sonographers using ultrasound machines three times on each of seven discrete ONS model sizes ranging from 3.5 to 7.9 mm. Two pocket ultrasounds (IVIZ, Sonosite, and Lumify, Philips) and one standard-sized portable ultrasound (M-Turbo, Sonosite) were used. Measurements were analyzed for mean error and variance and tested for significance using blocked covariance matrix regression analyses.ResultsThe devices differed in their variances (Lumify: 0.19 mm2, M-Turbo: 0.26 mm2, IVIZ: 0.34 mm2) and their mean error (Lumify: −0.05 mm, M-Turbo: 0.10 mm, IVIZ: −0.10 mm). The difference in mean error between users is not significant (p = 0.45), but there is a significant difference in mean error between devices (p = 0.02).ConclusionsAccurate ONSD measurement is possible utilizing pocket-sized ultrasound, and in some cases, may be more accurate than larger portable ultrasound units. While the differences in these devices were statistically significant, all three were highly accurate, with one pocket device (Lumify) outperforming the rest. Further study in human subjects should be conducted prior to using pocket ultrasound devices for in vivo diagnosis of intracranial hypertension.

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Optic nerve ultrasonography for evaluating increased intracranial pressure in severe preeclampsia

Cited by 31 publications

References 7 publications

Optic Nerve Ultrasound Evaluation in Idiopathic Intracranial Hypertension

Optic Nerve Ultrasound Evaluation in Idiopathic Intracranial Hypertension

Optic Nerve Ultrasound Evaluation in Animals and Normal Subjects

Accuracy of Optic Nerve Sheath Diameter Measurements in Pocket-Sized Ultrasound Devices in a Simulation Model

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