Optic nerve sheath diameter and optic nerve sheath diameter/eyeball transverse diameter ratio in prediction of malignant progression in ischemic stroke

Guo, Yuan; Chen, Yinjuan; Shen, Chaoxiong; Fan, Daofeng; Hu, Xiaohong; Duan, Jiao-Jiao; Chen, Yangui

doi:10.3389/fneur.2022.998389

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…The ratio of the ONSD to eyeball transverse diameter (ETD) by ultrasound may be a reliable predictor of intracranial hypertension in patients with TBI (Du et al, 2020). In addition, the ONSD/ETD ratio may be more valuable than the ONSD in predicting malignant progression in patients with acute stroke (Guo et al, 2022). These methods have been studied not only in adults but also in children.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic optic disc height combined with the optic nerve sheath diameter as a promising non-invasive marker of elevated intracranial pressure

et al. 2023

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Background/aim: Patients with elevated intracranial pressure (ICP) tend to have optic disc edema and a thicker optic nerve sheath diameter (ONSD). However, the cut-off value of the optic disc height (ODH) for evaluating elevated ICP is not clear. This study was conducted to evaluate ultrasonic ODH and to investigate the reliability of ODH and ONSD for elevated ICP.Methods: Patients suspected of having increased ICP and who underwent a lumbar puncture were recruited. ODH and ONSD were measured before lumbar puncture. Patients were divided according to elevated and normal ICP. We analyzed the correlations between ODH, ONSD, and ICP. ODH and ONSD cut-off points for the identification of elevated ICP were determined and compared.Results: There were a total of 107 patients recruited for this study, 55 patients with elevated ICP and 52 with normal ICP. Both ODH and ONSD in the elevated ICP group were higher than in the normal group [ODH: median 0.81 (range 0.60–1.06) mm vs. 0.40 [0–0.60] mm, p < 0.001; ONSD: 5.01 ± 0.37 mm vs. 4.20 ± 0.38 mm, p < 0.001]. ICP was positively correlated with ODH (r = 0.613; p < 0.001) and ONSD (r = 0.792; p < 0.001). The cut-off values of ODH and ONSD for evaluating elevated ICP were 0.63 mm and 4.68 mm, respectively, with 73% and 84% sensitivity and 83% and 94% specificity, respectively. ODH combined with ONSD showed the highest value under the receiver operating characteristic curve of 0.965 with a sensitivity of 93% and a specificity of 92%.Conclusion: Ultrasonic ODH combined with ONSD may help monitor elevated ICP non-invasively.

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Section: Discussionmentioning

confidence: 99%

Ultrasonic optic disc height combined with the optic nerve sheath diameter as a promising non-invasive marker of elevated intracranial pressure

et al. 2023

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Comparison of models for predicting intracranial pressure by optic nerve sheath diameter in combination with other indicators: A study based on ultrasound measurements

cheng,

Liu,

Guo

et al. 2023

Preprint

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Introduction: The optic nerve sheath diameter (ONSD) assessment of elevated intracranial pressure is increasingly emphasized as a noninvasive modality. Still, quantitative assessment is less common in current studies, and study criteria are variable. We constructed four prediction models related to ONSD and compared their accuracy in predicting intracranial pressure (ICP). Methods This study included 223 patients who completed lumbar puncture (LP) at the First Hospital of Shanxi Medical University with values of ICP and Mindray-M58 ultrasound-measured ONSD, optic nerve sheath (OND), and eyeball transverse diameter (ETD). The patients were randomly assigned 7:3 to model and test groups, and predictive models (ONSD model, ONSD combined OND model, ΔONSD model, and ONSD/ETD model) were established in the model group using linear regression analysis. The test group evaluated the agreement between the models' predicted and actual ICP values using Bland‒Altman analysis and the intragroup correlation coefficient (ICC). Results ICP values were strongly correlated with ΔONSD, ONSD, and ONSD/ETD. The ONSD combined OND model showed the highest predictive power for increased ICP (area under the receiver operating characteristic curve [AUC] = 0.933). The four mathematical equations established in the model group (n = 154) were as follows: 1. ONSD combined OND model: predicted ICP = 139.394×ONSD-112.428×OND-267.461; 2. ONSD model: predicted ICP = 108.227× ONSD-404.446; 3. ΔONSD model: predicted ICP = 140.216 × ΔONSD-196.335; 4. ONSD/ETD model: predicted ICP = 1624.283×ONSD/ETD-196.904. In the test group (n = 66), it was shown that ONSD combined OND (ICC = 0.88) prediction accuracy was the highest. Conclusion Bedside ultrasound measurement of ONSD combined OND is a practical method to assess ICP values. This study indicated that the efficacy of the ONSD combined with the OND model and the ΔONSD model in predicting ICP was better than that of ONSD alone, reflecting the fact that intracranial pressure changes mainly affect the optic nerve sheath rather than the optic nerve.

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Tomographic index (ONSD/ETD) as a predictor of short-term neurological outcome in children with severe traumatic brain injury: A single-center retrospective observational study from Mexico

Maytorena,

Antonio,

Vázquez

et al. 2024

Journal of Pediatric Critical Care

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Background: Traumatic brain injury (TBI) is a prevalent condition in the pediatric population. An index between the diameter of the optic nerve sheath diameter (ONSD) and the transverse eyeball transverse diameter (ETD) measured in the tomographic scan has been described in adults, with a cutoff value of ≥0.25 for predicting poor neurologic prognoses. This study was conducted to analyze the relationship between the index ONSD/ETD with the neurological outcome in children with severe TBI. Subjects and Methods: This was single-center, retrospective study, conducted from March 2021 to November 2022. Patients older than 30 days and up to 16 years of age admitted with severe TBI were included in the study. Measurements of the ONSD/ETD index by cranial tomography were calculated. The population was divided into two groups, one with index ≥0.25 and other with index <0.25. Glasgow Outcome Scale-Extended (GOSE) and outcome were compared between groups. Results: Thirty patients were recruited. Patients with inde × 0.25 or higher had a lower GOSE (60% (1–2 points) vs. 60% (7–8 points)), more days of mechanical ventilation (MV) (8 days, interquartile range IQR 5–17 days vs. 3 days, IQR 2–4 days P = 0.005), and more length of pediatric intensive care unit (PICU) stay (12 days, IQR 9–23 days vs. 5 days, IQR 4–8 days P = 0.007) than patients with index <0.25. Conclusions: The ONSD/ETD index was a reliable indicator for predicting the neurological outcome of patients with severe TBI. An index ≥0.25 was associated with more days of PICU stay and MV with worse neurological outcomes.

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Optic nerve sheath diameter and optic nerve sheath diameter/eyeball transverse diameter ratio in prediction of malignant progression in ischemic stroke

Cited by 3 publications

References 26 publications

Ultrasonic optic disc height combined with the optic nerve sheath diameter as a promising non-invasive marker of elevated intracranial pressure

Ultrasonic optic disc height combined with the optic nerve sheath diameter as a promising non-invasive marker of elevated intracranial pressure

Comparison of models for predicting intracranial pressure by optic nerve sheath diameter in combination with other indicators: A study based on ultrasound measurements

Tomographic index (ONSD/ETD) as a predictor of short-term neurological outcome in children with severe traumatic brain injury: A single-center retrospective observational study from Mexico

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