Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

Razek, Ahmed Abdel Khalek Abdel; Elsaid, Nada; Belal, Tamer; Batouty, Nihal M.; Azab, Ahmed

doi:10.14366/usg.20165

Cited by 7 publications

(10 citation statements)

References 37 publications

(30 reference statements)

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“…Our findings are in line with previous studies in which mean ONSD ranged from 5.2-6.8 mm in PTCS compared to 4.1-5.7 mm in controls (7,(12)(13)(14)(15)(16)(17)(18)(19). Most studies place mean ONSD in PTCS above 6.0 mm (7,12,14,(16)(17)(18)(19) and in healthy controls 5.5 mm (12,13,(15)(16)(17)(18). Mean ODE in PTCS range from 0.6-1.3 mm, but these studies did not measure ODE in controls, and therefore could not provide measures of diagnostic accuracy for ODE (7,12,14,18,19).…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

“…Studies which demonstrated no correlation either did not include OP in controls, included <20 measurements of OP in total, measured OP at separate time points from ONSD (e.g. ONSD measured one day after CSF withdrawal) or included patients with chronic PTCS (7,(15)(16)(17)(18)(19). Furthermore, up to four different marker positions for measurement of ONSD were described in a review of published studies (11).…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies ONSD cut-off points range from 4.8-6.3 mm, but most studies place them at 5.8-6.3 Sensitivity ranges from 73-95% and specificity from 67-100%, with most studies placing both !80% (7,(12)(13)(14)(15)(16)(17)(18)(19). This variation is also likely due to the heterogeneity of the study designs, and the methodological discrepancies in the sonographic technique, as described above.…”

Section: The Diagnostic Value Of Tosmentioning

confidence: 99%

“…However, the existing studies on PTCS and TOS leave several key questions unanswered. The diagnostic value is highly variable between studies, the methodology varies in terms of exact cursor placement, timing of measurements in relation to OP and the use of matched controls (7,(11)(12)(13)(14)(15)(16). ODE has only been investigated in few studies of PTCS, none of which investigated diagnostic cut-off points (7,12,14,(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

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Transorbital sonography: A non-invasive bedside screening tool for detection of pseudotumor cerebri syndrome

et al. 2022

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Background Our objective was to assess optic nerve sheath diameter (a marker of elevated intracranial pressure) and optic disc elevation (a marker of papilledema) in pseudotumor cerebri syndrome using transorbital sonography. Methods The study was a prospective case-control study. We included patients with new-onset pseudotumor cerebri syndrome and matched healthy controls. All had fundoscopy, lumbar puncture with opening pressure and transorbital sonography. Sonography was assessed by a blinded observer. Results We evaluated 45 patients and included 23 cases. We recruited 35 controls. Optic nerve sheath diameter was larger in pseudotumor cerebri syndrome compared to controls (6.3 ± 0.9 mm versus 5.0 ± 0.5 mm, p < 0.001) and so was optic disc elevation (0.9 ± 0.4 mm versus 0.4 ± 0.1 mm, p < 0.001). The optimal cut-off point for optic nerve sheath diameter was 6 mm with a sensitivity of 74% for prediction of pseudotumor cerebri syndrome and 68% for prediction of elevated opening pressure. Specificity was 94%. The optimal cut-off point for optic disc elevation was 0.6 mm. Sensitivity was 100% and specificity 83% for prediction of pseudotumor cerebri syndrome. Conclusion Optic disc elevation and optic nerve sheath diameter are increased in new-onset pseudotumor cerebri syndrome. Optic disc elevation achieved high specificity and excellent sensitivity for diagnosis of pseudotumor cerebri syndrome. Transorbital sonography (TOS) is a potential, non-invasive screening tool for pseudotumor cerebri syndrome in headache clinics.

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