Echographische Differenzialdiagnose von Optikusverbreiterungen

Abstract

The stretch-test provides a reliable tool for the differential diagnosis of widened optic nerves.

Authors’ Reply

“…Finally, the authors have advocated the use of the stretch test (originally called the "30 degrees test"), which differentiates ONSD widening by raised intracranial pressure compared with that caused by solid thickening of the optic nerve and/or its sheaths or by solid infiltration of the subarachnoid space [6]. The test requires an awake cooperative patient and thus cannot be of use in our subset of anesthetized patients.…”

Application of Orbital Sonography in Neurology

“…Pathologic changes in trabecular structures of the ONS might interfere with the physiologic bidirectional flow of the CSF to the basal cisterns leading to persistent optic disc swelling (Killer et al 2007). Years ago, Ossoinig suggested the use of the stretch-test (originally called the "30 degrees-test"): in widened optic nerve patterns due to fluid around the optic nerve parenchyma, a decreased optic nerve thickness was observed after performing the stretch-test (positive test result), whereas in solid lesions of the optic nerve no change of optic nerve thickness was found (negative test result) (Haritoglou et al 2002). In patients with increased ICP due to any cause, either ophthalmoscopic evaluation or bilateral retrobulbar ultrasound is mandatory, as asymmetric and unilateral papilledemae in patients with IIH are well described (Seggia and De Menezes 1993).…”

Standardisation in Ultrasonography: Principle and Diagnostic Significance

“…Standardised A-scan is used preferably for reflectivity assessment enabling differentiation of various ocular lesions (retinal detachment, tumour, foreign body). Particularly useful is standardized A-scan in examination of extraocular muscles (2,9,12) and of optic nerve (5). In evaluation of extraocular muscles results of measurement with ultrasound are comparable to those with MRI (2).…”