Detection of intracranial hypertension in children using optical coherence tomography: a systematic review protocol

Abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p>Intracranial hypertension (ICH) in children can have deleterious effects on the brain and vision. It is notoriously difficult to estimate intracranial pressure (ICP) in children and existing methods deliver suboptimal diagnostic accuracy to be used as screening tools. Optical coherence tomography (OCT) may represent a valuable, non-invasive surrogate measure of ICP, as has been demonstrated in a number of associated conditions affecting adults. More recently, OCT has been employed within the paediatric age group. However, the role of OCT in detecting ICH in children has not been rigorously assessed in a systematic review for all relevant conditions. Here, we propose a systematic review protocol to examine the role of OCT in the detection of ICH in children.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>Electronic searches in the Cochrane Central Register of Controlled Trials, Medline, Embase, Web of Science and PubMed will identify studies featuring OCT in detecting ICH in children. Two independent screeners will identify studies for inclusion using a screening questionnaire. The systematic search and screening will take place between 2 April 2020 and 1 June 2020, while we aim to complete data analysis by 1 September 2020. Quality assessment will be performed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The primary outcome measure is the sensitivity and specificity of OCT in detecting ICH in children. Secondary outcomes measures include conditions associated with ICH per study, direct ICP monitoring, sensitivity and specificity of other measures for ICP and OCT parameters used.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>Ethical approval is not required for the proposed systematic review as no primary data will be collected. The findings will be disseminated through presentations at scientific meetings and peer-reviewed journal publication.</jats:p></jats:sec><jats:sec><jats:title>PROSPERO registration number</jats:title><jats:p>CRD42019154254.</jats:p></jats:sec>

Detection of intracranial hypertension in children using optical coherence tomography: a systematic review

“…Of note, handheld OCT has been recently used to describe the normal development of the optic nerve 27 and fovea 15 16 in infants and children, with excellent feasibility. Handheld OCT has also been utilised in a wide range of other pedatric conditions including retinopathy of prematurity, 56 nystagmus, 57 albinism, 58 achromatopsia, 59 foveal hypoplasia, 60 optic nerve hypoplasia, 61 primary congenital glaucoma, 62 microcephaly 63 and others.…”

“…This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 24 and the Cochrane Handbook. 25 The protocol is registered on PROSPERO 26 and published in BMJ Open. 27 Eligibility criteria for considering studies for this review Eligibility criteria were established a priori and included OCT studies of children (aged under 18 years) with IH.…”

“…25 The protocol is registered on PROSPERO 26 and published in BMJ Open. 27 Eligibility criteria for considering studies for this review Eligibility criteria were established a priori and included OCT studies of children (aged under 18 years) with IH. Our data extraction tool was adapted from the Cochrane Collaboration (online supplemental appendix 3).…”

“…By contrast, this review found that the portable iVue device was successfully used for on-table OCTs in young infants under general anaesthesia, 22 23 while the Envisu handheld OCT was used in conscious newborns without the need for general anaesthesia or pupil dilation in one feasibility study. 38 Of note, handheld OCT has been recently used to describe the normal development of the optic nerve 27 and fovea 15 16 in infants and children, with excellent feasibility. Handheld OCT has also been utilised in a wide range of other pedatric conditions including retinopathy of prematurity, 56 nystagmus, 57 albinism, 58 achromatopsia, 59 foveal hypoplasia, 60 optic nerve hypoplasia, 61 primary congenital glaucoma, 62 microcephaly 63 and others.…”

“…PRISMA guidelines 24 and rigorous Cochrane Open access methods were followed. 25 Our protocol was registered on PROSPERO 26 and published 27 prior to this study, to promote transparency and avoid duplication. Two independent screeners (SRR and RJM) conducted the systematic search and two independent graders (SRR and MH) completed the quality assessment.…”