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Sonographic assessment of optic nerve and ophthalmic vessels in patients with idiopathic intracranial hypertension.
Neurol Res. 2018 Sep; 40(9):728-735.NR

Abstract

BACKGROUND

Early diagnosis and proper monitoring of intracranial pressure (ICP) in idiopathic intracranial hypertension (IIH) could reduce morbidity.

OBJECTIVES

The objective was to explore and monitor reflection of raised ICP in IIH on optic nerve sheath diameter (ONSD), papillary height and ophthalmic vessels hemodynamics, using transorbital sonography (TOS).

METHODS

The study included 24 IIH patients and 30 controls. Patients were compared to controls (phase I) then reassessed twice; 1 week and 4 weeks later (phase II). Both groups underwent clinical evaluation and TOS to measure ONSD, papillary elevation, and color Doppler indices of the ophthalmic vessels. Patients underwent lumbar puncture (LP) to measure cerebrospinal fluid (CSF) pressure.

RESULTS

ONSD was significantly higher in patients compared to controls (p < 0.001). The cut-off value was 6.2 mm. Papillary elevation (p = 0.006) and ONSD (p = 0.006) were significantly reduced 4 weeks following LP. Baseline color Doppler indices of the ophthalmic vessels were comparable between both groups and the changes observed during the follow-up visits in the patients were insignificant.

CONCLUSION

Reflected ICP changes on ONSD and papilla, measured by TOS, could be a valuable noninvasive additional tool to diagnose and monitor IIH patients. IIH insignificantly influences ophthalmic vessels hemodynamics. Abbreviation BMI: Body mass index. CSF: Cerebrospinal fluid. EDV: End diastolic velocity. ICP: Intracranial pressure. IH:intracranial hypertension. IIH: Idiopathic intracranial hypertension. LP: Lumbar puncture. MI: Mechanical index. MRI: Magnetic resonance imaging. MRV: Magnetic resonance venography. OA: Ophthalmic artery OND: Optic nerve diameter. ONSD: Optic nerve sheath diameter. OV: Ophthalmic vein. PIs: Pulsatility indices. PSV: Peak systolic velocity. ROC: Receiver operator characteristic. TOS: Trans-orbital sonography.

Authors+Show Affiliations

a Department of Neurology , Cairo University , Egypt.a Department of Neurology , Cairo University , Egypt.a Department of Neurology , Cairo University , Egypt.b Department of Ophthalmology , Cairo University , Egypt.a Department of Neurology , Cairo University , Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29799769

Citation

Ebraheim, Asmaa M., et al. "Sonographic Assessment of Optic Nerve and Ophthalmic Vessels in Patients With Idiopathic Intracranial Hypertension." Neurological Research, vol. 40, no. 9, 2018, pp. 728-735.
Ebraheim AM, Mourad HS, Kishk NA, et al. Sonographic assessment of optic nerve and ophthalmic vessels in patients with idiopathic intracranial hypertension. Neurol Res. 2018;40(9):728-735.
Ebraheim, A. M., Mourad, H. S., Kishk, N. A., Badr Eldin, N., & Saad, A. A. (2018). Sonographic assessment of optic nerve and ophthalmic vessels in patients with idiopathic intracranial hypertension. Neurological Research, 40(9), 728-735. https://doi.org/10.1080/01616412.2018.1473097
Ebraheim AM, et al. Sonographic Assessment of Optic Nerve and Ophthalmic Vessels in Patients With Idiopathic Intracranial Hypertension. Neurol Res. 2018;40(9):728-735. PubMed PMID: 29799769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sonographic assessment of optic nerve and ophthalmic vessels in patients with idiopathic intracranial hypertension. AU - Ebraheim,Asmaa M, AU - Mourad,Husam S, AU - Kishk,Nirmeen A, AU - Badr Eldin,Nashwa, AU - Saad,Abdullah A, Y1 - 2018/05/25/ PY - 2018/5/26/pubmed PY - 2018/11/9/medline PY - 2018/5/26/entrez KW - Idiopathic intracranial hypertension (IIH) KW - ophthalmic vessels hemodynamics KW - optic nerve sheath diameter (ONSD) KW - transorbital sonography (TOS) SP - 728 EP - 735 JF - Neurological research JO - Neurol Res VL - 40 IS - 9 N2 - BACKGROUND: Early diagnosis and proper monitoring of intracranial pressure (ICP) in idiopathic intracranial hypertension (IIH) could reduce morbidity. OBJECTIVES: The objective was to explore and monitor reflection of raised ICP in IIH on optic nerve sheath diameter (ONSD), papillary height and ophthalmic vessels hemodynamics, using transorbital sonography (TOS). METHODS: The study included 24 IIH patients and 30 controls. Patients were compared to controls (phase I) then reassessed twice; 1 week and 4 weeks later (phase II). Both groups underwent clinical evaluation and TOS to measure ONSD, papillary elevation, and color Doppler indices of the ophthalmic vessels. Patients underwent lumbar puncture (LP) to measure cerebrospinal fluid (CSF) pressure. RESULTS: ONSD was significantly higher in patients compared to controls (p < 0.001). The cut-off value was 6.2 mm. Papillary elevation (p = 0.006) and ONSD (p = 0.006) were significantly reduced 4 weeks following LP. Baseline color Doppler indices of the ophthalmic vessels were comparable between both groups and the changes observed during the follow-up visits in the patients were insignificant. CONCLUSION: Reflected ICP changes on ONSD and papilla, measured by TOS, could be a valuable noninvasive additional tool to diagnose and monitor IIH patients. IIH insignificantly influences ophthalmic vessels hemodynamics. Abbreviation BMI: Body mass index. CSF: Cerebrospinal fluid. EDV: End diastolic velocity. ICP: Intracranial pressure. IH:intracranial hypertension. IIH: Idiopathic intracranial hypertension. LP: Lumbar puncture. MI: Mechanical index. MRI: Magnetic resonance imaging. MRV: Magnetic resonance venography. OA: Ophthalmic artery OND: Optic nerve diameter. ONSD: Optic nerve sheath diameter. OV: Ophthalmic vein. PIs: Pulsatility indices. PSV: Peak systolic velocity. ROC: Receiver operator characteristic. TOS: Trans-orbital sonography. SN - 1743-1328 UR - https://www.unboundmedicine.com/medline/citation/29799769/Sonographic_assessment_of_optic_nerve_and_ophthalmic_vessels_in_patients_with_idiopathic_intracranial_hypertension_ L2 - https://www.tandfonline.com/doi/full/10.1080/01616412.2018.1473097 DB - PRIME DP - Unbound Medicine ER -