Associations between intracranial pressure, intraocular pressure and mean arterial pressure in patients with traumatic and non-traumatic brain injuries

Czarnik, Tomasz; Gawda, Ryszard; Kolodziej, Waldemar; Łątka, Dariusz; Sznajd-Weron, Katarzyna; Weron, Rafał

doi:10.1016/j.injury.2008.10.010

Cited by 27 publications

(24 citation statements)

References 33 publications

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“…The remaining 12 studies enrolling 546 participants identified in our literature search were included in our meta-analysis (Table 1). 2,4,5,11,15,16,19,24,25,31,32,35,36 Although all of these 12 studies contributed to the calculation of a pooled estimated correlation coefficient, only 4 presented outcomes required for the calculation of summary diagnostic accuracy estimates (Table 2). 16,19,25,36 …”

Section: Resultsmentioning

confidence: 99%

“…3). 2,4,5,11,15,16,19,24,25,31,32,35,36 A high degree of heterogeneity was present between studies (I 2 = 97.7%, p < 0.0001).…”

Section: Pooled Estimates Of Correlation Between Iop and Icpmentioning

confidence: 98%

“…36 In half of the included studies, invasive ICP measurement was obtained through lumbar puncture (LP) 11,15,19,25,31,32 while the remainder measured ICP through intracranial monitors. 2,4,5,16,24,35,36 The interval between IOP and ICP measurement ranged from simultaneous measurements 4,5,16,24,35,36 to up to 5 hours. 11 Among studies reporting diagnostic accuracy estimates, the thresholds for assigning elevated IOP and intracranial hypertension were defined as a measurement greater than 20 cm H 2 0.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…2,4,5,11,15,16,19,24,25,31,32,35,36 As these often small, disparate reports have produced conflicting results, IOP measurement in the evaluation of patients suspected of intracranial hypertension has yet to be adopted into clinical practice. We therefore conducted a systematic review and meta-analysis to determine the correlation between IOP and ICP and the diagnostic accuracy of IOP measurement for detecting raised ICP among patients with suspected intracranial hypertension.…”

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confidence: 99%

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Diagnostic accuracy of intraocular pressure measurement for the detection of raised intracranial pressure: meta-analysis

Yavin¹,

Luu²,

James

et al. 2014

JNS

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Object Because clinical examination and imaging may be unreliable indicators of intracranial hypertension, intraocular pressure (IOP) measurement has been proposed as a noninvasive method of diagnosis. The authors conducted a systematic review and meta-analysis to determine the correlation between IOP and intracranial pressure (ICP) and the diagnostic accuracy of IOP measurement for detection of intracranial hypertension. Methods The authors searched bibliographic databases (Ovid MEDLINE, Ovid EMBASE, and the Cochrane Central Register of Controlled Trials) from 1950 to March 2013, references of included studies, and conference abstracts for studies comparing IOP and invasive ICP measurement. Two independent reviewers screened abstracts, reviewed full-text articles, and extracted data. Correlation coefficients, sensitivity, specificity, and positive and negative likelihood ratios were calculated using DerSimonian and Laird methods and bivariate random effects models. The I2 statistic was used as a measure of heterogeneity. Results Among 355 identified citations, 12 studies that enrolled 546 patients were included in the meta-analysis. The pooled correlation coefficient between IOP and ICP was 0.44 (95% CI 0.26–0.63, I2 = 97.7%, p < 0.001). The summary sensitivity and specificity for IOP for diagnosing intracranial hypertension were 81% (95% CI 26%–98%, I2 = 95.2%, p < 0.01) and 95% (95% CI 43%–100%, I2 = 97.7%, p < 0.01), respectively. The summary positive and negative likelihood ratios were 14.8 (95% CI 0.5–417.7) and 0.2 (95% CI 0.02–1.7), respectively. When ICP and IOP measurements were taken within 1 hour of another, correlation between the measures improved. Conclusions Although a modest aggregate correlation was found between IOP and ICP, the pooled diagnostic accuracy suggests that IOP measurement may be of clinical utility in the detection of intracranial hypertension. Given the significant heterogeneity between included studies, further investigation is required prior to the adoption of IOP in the evaluation of intracranial hypertension into routine practice.

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Section: Resultsmentioning

confidence: 99%

“…3). 2,4,5,11,15,16,19,24,25,31,32,35,36 A high degree of heterogeneity was present between studies (I 2 = 97.7%, p < 0.0001).…”

Section: Pooled Estimates Of Correlation Between Iop and Icpmentioning

confidence: 98%

Section: Study Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic accuracy of intraocular pressure measurement for the detection of raised intracranial pressure: meta-analysis

Yavin¹,

Luu²,

James

et al. 2014

JNS

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“…Some investigators have argued that IOP is correlated with ICP (Lashutka et al, 2004;Li et al, 2012), but others argue that they are unrelated (Czarnik et al, 2009;Kirk et al, 2011). Still others have concluded that, although there is a correlation between ICP and IOP, IOP is a "poor predictor" of ICP (Golan et al, 2013;Spentzas et al, 2010;Yavin et al, 2014).…”

Section: Figure 4 Pressures Around the Optic Nerve (On)mentioning

confidence: 99%

Pressure balance and imbalance in the optic nerve chamber: The Beijing Intracranial and Intraocular Pressure (iCOP) Study

Hou

Zheng

Yang

et al. 2016

Sci. China Life Sci.

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To determine the interdependence of intracranial pressure (ICP) and intraocular pressure (IOP) and how it affects optic nerve pressures, eight normal dogs were examined using pressure-sensing probes implanted into the left ventricle, lumbar cistern, optic nerve subarachnoid space in the left eye, and anterior chamber in the left eye. This allowed ICP, lumbar cistern pressure (LCP), optic nerve subarachnoid space pressure (ONSP) and IOP to be simultaneously recorded. After establishing baseline pressure levels, pressure changes that resulted from lowering ICP (via shunting cerebrospinal fluid (CSF) from the ventricle) were recorded. At baseline, all examined pressures were different (ICP>LCP>ONSP), but correlated (P<0.001). As ICP was lowered during CSF shunting, IOP also dropped in a parallel time course so that the trans-lamina cribrosa gradient (TLPG) remained stable (ICP-IOP dependent zone). However, once ICP fell below a critical breakpoint, ICP and IOP became uncoupled and TLPG changed as ICP declined (ICP-IOP independent zone). The optic nerve pressure gradient (ONPG) and trans-optic nerve pressure gradient (TOPG) increased linearly as ICP decreased through both the ICP-IOP dependent and independent zones. We conclude that ICP and IOP are coupled in a specific pressure range, but when ICP drops below a critical point, IOP and ICP become uncoupled and TLPG increases. When ICP drops, a rise in the ONPG and TOPG creates more pressure and reduces CSF flow around the optic nerve. This change may play a role in the development and progression of various ophthalmic and neurological diseases, including glaucoma. glaucoma, optic neuropathy, trans-lamina cribrosa pressure gradient (TLPG), trans-optic canal pressure gradient (TCPG), trans-optic nerve pressure gradient (TOPG), optic nerve pressure gradient (ONPG) Citation:

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Measurement of intraocular and intracranial pressure: Is there a relationship?

Kirk

Jones

Miller

et al. 2011

Annals of Neurology

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Associations between intracranial pressure, intraocular pressure and mean arterial pressure in patients with traumatic and non-traumatic brain injuries

Cited by 27 publications

References 33 publications

Diagnostic accuracy of intraocular pressure measurement for the detection of raised intracranial pressure: meta-analysis

Diagnostic accuracy of intraocular pressure measurement for the detection of raised intracranial pressure: meta-analysis

Pressure balance and imbalance in the optic nerve chamber: The Beijing Intracranial and Intraocular Pressure (iCOP) Study

Measurement of intraocular and intracranial pressure: Is there a relationship?

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