Ultrasonography of the optic nerve in neurocritically ill patients

Moretti, Riccardo; Pizzi, Barbara

doi:10.1111/j.1399-6576.2011.02432.x

Cited by 152 publications

(143 citation statements)

References 55 publications

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“…OSKÇ değerinin KİB ile korelasyonu yüksek olup korrelasyon katsayısı 0,59-0,80 (ortalama 0,685) arasındadır (40,(42)(43)(44)(45)(46). KİB'nın eşik değerinin 20 mmHg ve üzerinde olmasını belirleyebilme açısından OSKÇ'nın sensitivitesi %74-100 (ortalama %87); spesifisitesi %23-100 (ortalama %80); negatif "likelihood" oranı 0,11-0,25 (ortalama 0,17) , pozitif "likelihood" oranı ise 3,28-5,58 (ortalama 4,28), pozitif prediktif değeri (%65,6-%79.5) (ortalama %73) ve negatif prediktif değeri %85,6-%94,2 (ortalama %90,5) arasındadır (40,(42)(43)(44)(46)(47).…”

Section: Orta-hat şIftinin Sonografik öLçümüunclassified

“…KİB'nın eşik değerinin 20 mmHg ve üzerinde olmasını belirleyebilme açısından OSKÇ'nın sensitivitesi %74-100 (ortalama %87); spesifisitesi %23-100 (ortalama %80); negatif "likelihood" oranı 0,11-0,25 (ortalama 0,17) , pozitif "likelihood" oranı ise 3,28-5,58 (ortalama 4,28), pozitif prediktif değeri (%65,6-%79.5) (ortalama %73) ve negatif prediktif değeri %85,6-%94,2 (ortalama %90,5) arasındadır (40,(42)(43)(44)(46)(47). ROC eğrisi altında kalan alan 0,79-0,99 arasında ve ortalama 0,92 civarında olup testin yüksek klinik yararlılığını ifade eder (40,46). OSKÇ için inter-observer değişkenlik "en çok" 0,25 mm olup kappa değeri 0,65 seviyesindedir (40).…”

Section: Orta-hat şIftinin Sonografik öLçümüunclassified

“…ROC eğrisi altında kalan alan 0,79-0,99 arasında ve ortalama 0,92 civarında olup testin yüksek klinik yararlılığını ifade eder (40,46). OSKÇ için inter-observer değişkenlik "en çok" 0,25 mm olup kappa değeri 0,65 seviyesindedir (40). KİB artışı olanlar ile olmayanlar arasında OSKÇ farkı "ortalama" 1,214 mm (%95 güven aralığı: 1,065-1,363 mm)'dir (40).…”

Section: Orta-hat şIftinin Sonografik öLçümüunclassified

“…KİB artışı olanlar ile olmayanlar arasında OSKÇ farkı "ortalama" 1,214 mm (%95 güven aralığı: 1,065-1,363 mm)'dir (40). Öğrenilmesi kolay bir teknik olup genellikle supervizyon altında 25 çalışma yapılmış olması deneyim için yeterli görülmektedir (40).…”

Section: Orta-hat şIftinin Sonografik öLçümüunclassified

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Neurosonology of intracranial pressure increase

Togcuoglu¹,

Arsava²

2011

Türk Beyin Damar Hast Derg

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Nörolojik yoğun bakımlarda kafa içi basıncı yükselmesi sadece sık görülmesinden dolayı değil aynı zamanda tedavi edilebilir olmasından dolayı da önemli bir problemdir. Birçok hastalığın seyrinde kafa içi basıncının doğrudan ölçümü ya da tahmin edilmesinin kritik önemi vardır. Non-invazif ve yatak başında kullanılabilen birçok nörosonolojik yöntem ile kafa içi basıncı monitörize edilebilir. Bu makalede bu yöntemler literatür bilgisi ışığında pratik uygulama temel alınarak gözden geçirilmektedir. Anahtar Sözcükler: Transkranial Doppler, B-mod, pulsatilite, orta hat şifti, orbital sonografi, otoregülasyon. NEUROSONOLOGY OF INTRACRANIAL PRESSURE INCREASE SUMMARYIncrease in intracranial pressure (ICP) is one of the most significant problems in the neurological intensive care units not only due to its high prevalence, but also due to its treatable nature. Direct measurement or indirect estimation of ICP during the course of many neurological diseases is of critical importance. A variety of neurosonogical methodologies, which are totally non invasive and applicable at the bed-side repeatedly, have extensively been used to evaluate and monitor ICP. These neurosonological techniques, including most recent developments, are herein reviewed primarily from the perspective of practical applications.

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Section: Orta-hat şIftinin Sonografik öLçümüunclassified

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Neurosonology of intracranial pressure increase

Togcuoglu¹,

Arsava²

2011

Türk Beyin Damar Hast Derg

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“…Compared to invasive monitoring of ICP, more studies have identified a cutoff between 4.8mm and 5.9mm for ONSD correlation with EICP. Moretti et al [9,10] compared ultrasound measurement of the ONSD to invasive ICP monitoring and found an ONSD cutoff of 5.2mm at the same time another author have a cutoff value of 4.8mm [11] specific for EICP. Even though no general consensus exists on the clinical applications of the ultrasonographic measurement of the ONSD, this has been proposed as a promising method to detect an increase of CSF pressure [12].…”

Section: Introductionmentioning

confidence: 99%

Demonstration of Optic Nerve Sheath Fenestration Success by Ultrasound Nerve Sheath Diameter assessment. A Case Report

Vidal

2017

JACCOA

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The aim of this study is to demonstrate the correlation between the decrease of the Ophthalmic Nerve Sheath Diameter (ONSD) assessed by Ultrasound after a Surgery of Optic Nerve Sheath Fenestration (ONSF) for the treatment of a Idiopathic Intracranial Hypertension (IIH) and its success in the perioperative period. A 21 year-old female diagnosed with IIH was scheduled for unilateral ONSF surgery. We evaluated the ONSD after and before the surgery. The measurements were: 71,5mm mean for the both eyes BEFORE the surgery (71,5mm for the LE and 71,5mm for the RE respectively) and 57,25mm, fifteen minutes AFTER the fenestration of the LE Optic Nerve Sheath (RE: 70mm LE: 44,5mm means). There was a difference in the Optic sheath in the Operated Left Eye (ONSD 54-35 mm) and we could estimate the location of the fenestration in the images. We think this is the ideal method to evaluate the response to the surgical treatment for the IIH patients as non-invasive, low cost and in-site technique. Having agreed consent for use of data and images we made an assessment of ONSD after the induction of the general anaesthesia for the surgery. Measurements were made applied the probe over the closed upper eyelid. A 10-MHz linear probe (Turbo, Sonosite, Bothell, WA) was placed with ultrasound gel over the eyelid. The two-dimensional mode was used and ONSD was measured 3mm posterior the outermost layer of the retina using the calliper of the machine and an axis perpendicular to the Nerve. CitationFor both optic nerves, two measurements were made, one in the horizontal plane and other in the perpendicular plane. The average of the two values corresponds as ONSD for each eye. For the Right Eye (RE) the measurement was 73-70mm (71,5mm average) and for the Left Eye (LE) was 75-68mm (71,5mm average). The global mean before surgery was 71,5mm.Fifteen minutes after the surgical closing of the eyelid we repeated the assessment of the ONSD and we tried to see the location of the cut in the Optic Nerve Sheath for the eye chosen by the surgeons (Figure 1 & 2). The new measurements were: RE: 70-70 mm and for the LE (the eye chosen for the fenestration): 54-35 mm. The global mean after the surgery was 57,25mm. A decrease in the sheath around the ON could demonstrate the place where the cut was made at the Nerve Sheath (Figure 2). DiscussionOptic nerve sheath fenestration provides an effective surgical treatment for patients in whom medical therapy fails. In our case, unilateral ONSF decreased the diameter of Nerve sheath in the ipsilateral (operated) eye almost immediately after the fenestration but not changes were seen in the contralateral (nonoperated) eye at the short time [2]. The reduction of grade of papilledema in operated eyes was greater than in nonoperated eyes, but nonoperated eyes also experienced significant reduction in the disc edema grade with the correct time [1,2]. Until this moment the mechanism for this bilateral surgical effect is not certain and could be related to decrease the CSF in both optic nerves sheath after ...

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“Blinding” Empty Sella—Reply

Frassanito¹,

Bonis²

2012

Arch Neurol

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Ultrasonography of the optic nerve in neurocritically ill patients

Cited by 152 publications

References 55 publications

Neurosonology of intracranial pressure increase

Neurosonology of intracranial pressure increase

Demonstration of Optic Nerve Sheath Fenestration Success by Ultrasound Nerve Sheath Diameter assessment. A Case Report

“Blinding” Empty Sella—Reply

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