The cost-effectiveness of different strategies to evaluate optic disk drusen in children

Jun

2017

Sci Rep

The optic nerve sheath diameter (ONSD) is considered as an indirect marker for intracranial pressure (ICP). However, the optimal cut-off value for an abnormal ONSD indicating elevated ICP and its associated factors have been unclear. Thus, we investigated normative values for the ONSD using ultrasonography and investigate the potential factors affecting it. We prospectively recruited healthy volunteers between September 2016 and March 2017. A total of 585 individuals were included, in which the mean ONSD was 4.11 mm [95% confidence interval (CI), 4.09–4.14 mm]. Although ONSD was correlated with sex (p = 0.015), height (p = 0.003), and eyeball transverse diameter (ETD) (p < 0.001) in simple linear regression analyses, multiple linear regression analysis revealed that only ETD was independently associated with ONSD (p < 0.001). Accordingly, we further established a normative value for the ONSD/ETD ratio and its associated factors. The mean ONSD/ETD ratio was 0.18 (95% CI, 0.18–0.18), but the ONSD/ETD ratio was not correlated with sex, height, weight, body mass index, and head circumference. Our findings suggest that the ONSD had a strong correlation with ETD, and ONSD/ETD ratio might provide more reliable data than ONSD itself as a marker of ICP.

Section: Discussionmentioning

confidence: 99%

Ultrasonographic measurement of the optic nerve sheath diameter and its association with eyeball transverse diameter in 585 healthy volunteers

Jun

2017

Sci Rep

“…Optic disc drusen (ODD), which are laminated hyaline bodies within the optic nerve head, could lead to hard amorphous optic disc elevations mimicking ODE (Auw-Haedrich et al 2002). Therefore, diagnosis of ODD is very important to prevent an extensive, invasive and unnecessary neuro-ophthalmologic work-ups (Leon et al 2014;Moosajee et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Differentiation between optic disc drusen and optic disc oedema using fundus photography

Lee

Woo

Hwang

2017

Acta Ophthalmologica

“…3,34,39 Ultrasound in children may have particular challenges and variation in measurements, and, because true disc oedema can coexist with ONHD in a minority, some patients may yet require further investigation in the presence of echogenic drusen. 40,41 Ultrasound provides little information about the nerve, besides the existence of ONHD. 42…”

Section: Ultrasonographymentioning

confidence: 99%

Optic Nerve Head Drusen: An Update

Palmer

Gale

Crowston

et al. 2018

Neuro-Ophthalmology

Optic nerve head drusen are benign acellular calcium concretions that usually form early in life, just anterior to the lamina cribrosa. Improving imaging using optical coherence tomography suggests they are common and may be present in many clinically normal discs. These drusen may change in appearance in early life, but are generally stable in adulthood, and may be associated with visual field defects, anterior ischaemic optic neuropathy, or rarer complications. Based on long-term clinical data and optical coherence tomography, we propose a refined hypothesis as to the cause of optic disc drusen. Here we summarise recent findings and suggest future studies to better understand the forces involved.