Tags

Type your tag names separated by a space and hit enter

Sonographic assessment of the optic nerve and the central retinal artery in idiopathic intracranial hypertension.
J Clin Neurosci. 2020 Feb; 72:292-297.JC

Abstract

PURPOSE

Transorbital sonography easily detects papilledema and enlarged optic nerve sheath diameters (ONSD) in IIH (idiopathic intracranial hypertension) patients. As the central retinal artery is located within the optic nerve, its hemodynamic properties might be affected by the increased pressure. In this study we assessed the diagnostic usefulness of transorbital sonography in IIH with a special focus on color Doppler imaging of the central retinal artery. IIH patients presented papilledema and enlarged ONSD. ONSD accurately predicted an increased intracranial pressure in IIH (cut-off: 5.8 mm, 81% sensitivity, 80% specificity). 24 h following therapeutic lumbar puncture ONSD diminished significantly, whereas papilledema was not changed. PSV (peak systolic velocity) and Vmean (mean flow velocity) of the central retinal artery were increased in IIH patients compared to controls. PSV accurately predicted an increase of intracranial pressure (cut-off: 11.0 cm/s, 70% sensitivity, 69% specificity). PI (pulsatility index), PSV and Vmean decreased following lumbar puncture. PSV and Vmean decreases were statistically significant for right eyes only in which the values changed to normal. In summary, besides ONSD enlargement and papilledema transbulbar sonography demonstrated an alteration of central retinal artery blood flow in IIH patients. Especially PSV might serve as valuable surrogate marker for intracranial pressure in IIH. Furthermore, the change of intra-individual central retinal arteries PI might be a valuable parameter to demonstrate response to lumbar puncture in IIH patients.

Authors+Show Affiliations

Department of Neurology, University of Bonn Medical Center, Bonn, Germany; Department of Epileptology, University of Bonn Medical Center, Bonn, Germany. Electronic address: monika.jeub@ukbonn.de.Department of Neurology, University of Bonn Medical Center, Bonn, Germany.Department of Neurology, University of Bonn Medical Center, Bonn, Germany.Department of Neurology, University of Bonn Medical Center, Bonn, Germany.Department of Radiology, University of Bonn Medical Center, Bonn, Germany.Department of Ophthalmology, University of Bonn Medical Center, Bonn, Germany.Department of Neurology, University of Bonn Medical Center, Bonn, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31540860

Citation

Jeub, Monika, et al. "Sonographic Assessment of the Optic Nerve and the Central Retinal Artery in Idiopathic Intracranial Hypertension." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 72, 2020, pp. 292-297.
Jeub M, Schlapakow E, Ratz M, et al. Sonographic assessment of the optic nerve and the central retinal artery in idiopathic intracranial hypertension. J Clin Neurosci. 2020;72:292-297.
Jeub, M., Schlapakow, E., Ratz, M., Kindler, C., Schievelkamp, A. H., Wabbels, B., & Kornblum, C. (2020). Sonographic assessment of the optic nerve and the central retinal artery in idiopathic intracranial hypertension. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 72, 292-297. https://doi.org/10.1016/j.jocn.2019.09.003
Jeub M, et al. Sonographic Assessment of the Optic Nerve and the Central Retinal Artery in Idiopathic Intracranial Hypertension. J Clin Neurosci. 2020;72:292-297. PubMed PMID: 31540860.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sonographic assessment of the optic nerve and the central retinal artery in idiopathic intracranial hypertension. AU - Jeub,Monika, AU - Schlapakow,Elena, AU - Ratz,Martina, AU - Kindler,Christine, AU - Schievelkamp,Arndt-Hendrik, AU - Wabbels,Bettina, AU - Kornblum,Cornelia, Y1 - 2019/09/17/ PY - 2019/08/06/received PY - 2019/09/05/accepted PY - 2019/9/22/pubmed PY - 2020/7/11/medline PY - 2019/9/22/entrez KW - Central retinal artery KW - Idiopathic intracranial hypertension KW - Optic nerve sheath diameter KW - Pseudotumor cerebri KW - Pulsatility index KW - Transorbital sonography SP - 292 EP - 297 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 72 N2 - PURPOSE: Transorbital sonography easily detects papilledema and enlarged optic nerve sheath diameters (ONSD) in IIH (idiopathic intracranial hypertension) patients. As the central retinal artery is located within the optic nerve, its hemodynamic properties might be affected by the increased pressure. In this study we assessed the diagnostic usefulness of transorbital sonography in IIH with a special focus on color Doppler imaging of the central retinal artery. IIH patients presented papilledema and enlarged ONSD. ONSD accurately predicted an increased intracranial pressure in IIH (cut-off: 5.8 mm, 81% sensitivity, 80% specificity). 24 h following therapeutic lumbar puncture ONSD diminished significantly, whereas papilledema was not changed. PSV (peak systolic velocity) and Vmean (mean flow velocity) of the central retinal artery were increased in IIH patients compared to controls. PSV accurately predicted an increase of intracranial pressure (cut-off: 11.0 cm/s, 70% sensitivity, 69% specificity). PI (pulsatility index), PSV and Vmean decreased following lumbar puncture. PSV and Vmean decreases were statistically significant for right eyes only in which the values changed to normal. In summary, besides ONSD enlargement and papilledema transbulbar sonography demonstrated an alteration of central retinal artery blood flow in IIH patients. Especially PSV might serve as valuable surrogate marker for intracranial pressure in IIH. Furthermore, the change of intra-individual central retinal arteries PI might be a valuable parameter to demonstrate response to lumbar puncture in IIH patients. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/31540860/Sonographic_assessment_of_the_optic_nerve_and_the_central_retinal_artery_in_idiopathic_intracranial_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(19)31528-0 DB - PRIME DP - Unbound Medicine ER -