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

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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“…). A total of 34 studies provided mean values for ONSD measurement . The pool of mean ONSD measurements was 4.78 mm (95% CI, 4.63‐4.94 mm; Fig.…”

Section: Resultsmentioning

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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“…Simultaneous measurement of ONSD with initial CT and ICP are correlated and ONSD is indicative of intracranial hypertension in patients with severe traumatic brain injury 22,23) . Although ONSD is considered an indirect marker for ICP, its optimal cut-off for an abnormal ONSD indicating elevated ICP and its associated factors have been unclear 8) . In addition, there are limited studies reporting the role of ONSD modifications or indices in detecting intracranial hypertension compared with absolute ONSD 1,24) .…”

Section: Discussionmentioning

confidence: 99%

“…ONSD correlates strongly with ETD in healthy people. ONSD/ETD ratio may provide highly reliable data than absolute ONSD as a marker of ICP 8) . However, in this study, there were no significant differences between ONSD/ETD ratio and absolute ONSD for predicting poor neurological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Optic Nerve Sheath Diameter in Patients after Extracorporeal Cardiopulmonary Resuscitation

Kim

Ryu

Kim

et al. 2019

J Neurointensive Care

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To determine whether optic nerve sheath diameter (ONSD) could be used to predict neurological outcomes in patients after extracorporeal cardiopulmonary resuscitation (ECPR). Methods This was a retrospective and observational study of adult unconscious patients who were evaluated by brain computed tomography (CT) scan within 48 hours after ECPR between May 2010 and December 2016. ONSDs were estimated on initial brain CT. The primary outcome was neurological status upon hospital discharge assessed with Cerebral Performance Categories (CPC) scale. CPC scores of 1 and 2 indicated good neurological outcome while CPC scores of 3, 4, and 5 indicated poor neurological outcome. Results Among 52 unconscious patients, survival to discharge was identified in 19 (36.5%) patients. Of these 19 survivors, 13 (25.0%) had good neurological outcome (CPC score of 1 or 2). ONSDs and their modification in the poor neurological outcome group were significantly greater than those in the good neurological outcome group (all p≤0.003). However, eyeball transverse diameter was not significantly different between the two groups (p=0.770). Analysis of the receiver operating characteristic curves for predicting poor neurological outcome showed that ONSDs had considerable predictive value (C-statistics: 0.735 to 0.812). In addition, ONSDs and their modification had similar performances for predicting poor neurological outcome. Conclusion ONSDs measured with CT may be used to predict neurological outcomes of ECPR survivors.

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“…The mean ONSD should be calculated by averaging these measurement results. 26 One can provide ONSD images via axial or coronal approach (►Fig. 2A,2B).…”

Section: Ultrasonographic Technique For Onsd Measurementsmentioning

confidence: 99%

Is Ocular Sonography a Reliable Method for the Assessment of Elevated Intracranial Pressure in Children?

Yıldızdaş

Aslan

2020

J Pediatr Intensive Care

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Point-of-care ultrasound has been widely used by clinicians at the bedside in recent years. Various types of point-of-care ultrasound practices are employed, especially in pediatric emergency rooms and intensive care units. Pediatric intensive care specialists perform point-of-care ultrasound virtually as a part of physical examination since it provides just-in-time vital clinical information, which could assist in acute management strategies in critically ill patients. Measurement of optic nerve sheath diameter using point-of-care ultrasound is a noninvasive and radiation-free technique to determine raised intracranial pressure. Ophthalmic artery and central retinal artery Doppler indices can be used as transcranial Doppler to assess raised intracranial pressure. The aim of this review was to provide detailed information on ultrasonographic measurements of optic nerve sheath diameter and central retinal artery Doppler indices as techniques of interest for predicting increased intracranial pressure in pediatric patients in view of the literature.

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

Cited by 60 publications

References 47 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

Prognostic Value of Optic Nerve Sheath Diameter in Patients after Extracorporeal Cardiopulmonary Resuscitation

Is Ocular Sonography a Reliable Method for the Assessment of Elevated Intracranial Pressure in Children?

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