Optic nerve sheath diameter measurement by ultrasound: Evaluation of a standardized protocol

Pansell, Jakob; Bell, Max; Rudberg, Peter; Friman, Ola; Cooray, Charith

doi:10.1111/jon.12936

Cited by 26 publications

(33 citation statements)

References 15 publications

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“…This protocol was further evaluated in a prospective study that demonstrated excellent inter‐ and intrarater reliability for ONSDint and ONSDext assessment. The sample images showed excellent anatomic differentiation with correct marker placement according to author definitions 54 . However, measurements with and without RA Doppler were not performed in this study and it is unclear whether the excellent reliability was due to the protocolized use of RA Doppler or the use of images with good anatomic differentiation and vertical ON orientation.…”

Section: Discussionmentioning

confidence: 78%

“…The sample images showed excellent anatomic differentiation with correct marker placement according to author definitions. 54 However, measurements with and without RA Doppler were not performed in this study and it is unclear whether the excellent reliability was due to the protocolized use of RA Doppler or the use of images with good anatomic differentiation and vertical ON orientation. Additionally, lateral gaze can lead to ONSD deformation and smaller ONSD measurements.…”

Section: Other Identified Parametersmentioning

confidence: 91%

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Quality assessment of optic nerve sheath diameter ultrasonography: Scoping literature review and Delphi protocol

Hirzallah

Lochner

Hafeez

et al. 2022

Journal of Neuroimaging

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Background and Purpose:The optic nerve is surrounded by the extension of meningeal coverings of the brain. When the pressure in the cerebrospinal fluid increases, it causes a distention of the optic nerve sheath diameter (ONSD), which allows the use of this measurement by ultrasonography (US) as a noninvasive surrogate of elevated intracranial pressure. However, ONSD measurements in the literature have exhibited significant heterogeneity, suggesting a need for consensus on ONSD image acquisition and measurement. We aim to establish a consensus for an ONSD US Quality Criteria Checklist (ONSD US QCC).Methods: A scoping systematic review of published ultrasound ONSD imaging and measurement criteria was performed to guide the development of a preliminary ONSD US QCC that will undergo a modified Delphi study to reach expert consensus on ONSD quality criteria. The protocol of this modified Delphi study is presented in this manuscript.Results: A total of 357 ultrasound studies were included in the review. Quality criteria were evaluated under five categories: probe selection, safety, positioning, image acquisition, and measurement.

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Section: Discussionmentioning

confidence: 78%

Section: Other Identified Parametersmentioning

confidence: 91%

Quality assessment of optic nerve sheath diameter ultrasonography: Scoping literature review and Delphi protocol

Hirzallah

Lochner

Hafeez

et al. 2022

Journal of Neuroimaging

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show abstract

“…Topcuoglu et al ( 24 ) suggested to measure both the outermost hypoechogenic space, which they claimed to correspond to the subarachnoid space and the diameter of the hyperechogenic space around the nerve. This way to measure the optic nerve was taken up in other studies ( 25 , 26 ).…”

Section: Resultsmentioning

confidence: 99%

Ultrasound Detection of Intracranial Hypertension in Brain Injuries

et al. 2022

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In recent years, the measurement of optic nerve sheath diameter with ultrasound to detect the presence of increased intracranial pressure has widely spread. It can be qualitatively and effectively used to identify intracranial hypertension. Intracranial pressure can rise due to acute injury, cerebral bleeding, hydrocephalus, brain tumors and other space-occupying abnormalities, and it is linked to a high death rate. The purpose of this review is to give a general overview of the most relevant scientific publications on ultrasonographic evaluation of the optic nerve in case of brain injuries published in the last 30 years, as well as to analyze the limits of the most extensively used B-scan approach. Fifty-two papers chosen from the PubMed medical database were analyzed in this review. Our findings revealed that ocular ultrasound is an useful diagnostic tool in the management of intracranial hypertension when it exceeds a certain value or after head trauma. As a result, an ultrasound of the optic nerve can be extremely helpful in guiding diagnosis and treatment. The blooming effect is one of the most critical restrictions to consider when using B-scan ultrasonography. Since amplitude-scan ultrasound, also known as A-scan, does not have this limit, these two diagnostic techniques should always be used together for a more full, accurate, and trustworthy ultrasound examination, ensuring more data objectivity.

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“…ONSD divided by ED increased precision in ICP estimation in two previously published studies 12 , 13 and in one study from our research group, currently undergoing peer review. We therefore used this approach, with a method that has been described in previous publications 14 . In the two previously published studies the optimal cut-off to identify elevated ICP was 0.26 13 and 0.25 12 respectively.…”

Section: Introductionmentioning

confidence: 99%

“…We therefore set this as the threshold for elevated ONSD/ED. A recent study from our group showed that ONSD measurements could be performed with excellent inter-rater reliability using a standardized protocol 14 .…”

Section: Introductionmentioning

confidence: 99%

Optic nerve sheath diameter is associated with outcome in severe Covid-19

Pansell

Rudberg

Bell

et al. 2022

Sci Rep

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Neurological symptoms are common in Covid-19 and cerebral edema has been shown post-mortem. The mechanism behind this is unclear. Elevated intracranial pressure (ICP) has not been extensively studied in Covid-19. ICP can be estimated noninvasively with measurements of the optic nerve sheath diameter (ONSD). We performed a cohort study with ONSD ultrasound measurements in severe cases of Covid-19 at an intensive care unit (ICU). We measured ONSD with ultrasound in adults with severe Covid-19 in the ICU at Karolinska University Hospital in Sweden. Patients were classified as either having normal or elevated ONSD. We compared ICU length of stay (ICU-LOS) and 90 day mortality between the groups. 54 patients were included. 11 of these (20.4%) had elevated ONSD. Patients with elevated ONSD had 12 days longer ICU-LOS (95% CI 2 to 23 p = 0.03) and a risk ratio of 2.3 for ICU-LOS ≥ 30 days. There were no significant differences in baseline data or 90 day mortality between the groups. Elevated ONSD is common in severe Covid-19 and is associated with adverse outcome. This may be caused by elevated ICP. This is a clinically important finding that needs to be considered when deciding upon various treatment strategies.

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Optic nerve sheath diameter measurement by ultrasound: Evaluation of a standardized protocol

Cited by 26 publications

References 15 publications

Quality assessment of optic nerve sheath diameter ultrasonography: Scoping literature review and Delphi protocol

Quality assessment of optic nerve sheath diameter ultrasonography: Scoping literature review and Delphi protocol

Ultrasound Detection of Intracranial Hypertension in Brain Injuries

Optic nerve sheath diameter is associated with outcome in severe Covid-19

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