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Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance.
Cureus. 2021 Jan 30; 13(1):e13008.C

Abstract

Background Ultrasonographic (USG) measurement of optic nerve sheath diameter (ONSD) has been proposed as a non-invasive, bedside method to detect raised intracranial pressure (ICP) in various clinical settings. We aimed to correlate the ONSD obtained from ultrasonography with the gold standard, intraventricular ICP, and to find out the cut-off point which predicts ICP accurately at different levels. Methodology A prospective double-blind study was carried out by performing ocular ultrasounds in 30 adult patients with features of intracranial hypertension. The ONSD was measured by USG intraoperatively along with direct intraventricular pressure measurement. The ONSD was compared with the intraventricular ICP and correlations were derived. The optimum cut-off of ONSD to predict ICP > 20 mm Hg, 25 mm Hg, 30 mm Hg, and 35 mm Hg was sought. Results There was a significant correlation of ONSD with ICP (r = 0.532, p = 0.002). An ONSD threshold of 5.5 mm predicted ICP > 20 mm Hg with high sensitivity (100%) and specificity (75%) (area under receiver operating characteristic [ROC] curve = 0.904, p=0.01). The optimum ONSD cut-off predicting ICP at values of 25 mm Hg, 30 mm Hg, and 35 mm Hg was 6.3 mm, 6.5 mm, and 6.7 mm, respectively. Conclusion Our study confirms the utility of optic nerve ultrasound in the diagnostic evaluation of patients with known or suspected intracranial hypertension. We recommend an ONSD cut-off of 5.5 mm for predicting ICP > 20 mm Hg.

Authors+Show Affiliations

Anaesthesiology, Tata Main Hospital, Jamshedpur, IND.Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.Anaesthesiology, Tata Main Hospital, Jamshedpur, IND.Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.Anaesthesiology and Critical Care, Command Hospital Airforce Bangalore, Bengaluru, IND.Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33659139

Citation

Sahu, Seelora, et al. "Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance." Cureus, vol. 13, no. 1, 2021, pp. e13008.
Sahu S, Panda N, Swain A, et al. Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance. Cureus. 2021;13(1):e13008.
Sahu, S., Panda, N., Swain, A., Mathew, P., Singla, N., Gupta, S., Jangra, K., Bhardwaj, A., & Bhagat, H. (2021). Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance. Cureus, 13(1), e13008. https://doi.org/10.7759/cureus.13008
Sahu S, et al. Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance. Cureus. 2021 Jan 30;13(1):e13008. PubMed PMID: 33659139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance. AU - Sahu,Seelora, AU - Panda,Nidhi, AU - Swain,Amlan, AU - Mathew,Preethy, AU - Singla,Navneet, AU - Gupta,Sunil, AU - Jangra,Kiran, AU - Bhardwaj,Avanish, AU - Bhagat,Hemant, Y1 - 2021/01/30/ PY - 2021/3/4/entrez PY - 2021/3/5/pubmed PY - 2021/3/5/medline KW - intracranial pressure KW - optic nerve sheath diameter KW - ultrasonography SP - e13008 EP - e13008 JF - Cureus JO - Cureus VL - 13 IS - 1 N2 - Background Ultrasonographic (USG) measurement of optic nerve sheath diameter (ONSD) has been proposed as a non-invasive, bedside method to detect raised intracranial pressure (ICP) in various clinical settings. We aimed to correlate the ONSD obtained from ultrasonography with the gold standard, intraventricular ICP, and to find out the cut-off point which predicts ICP accurately at different levels. Methodology A prospective double-blind study was carried out by performing ocular ultrasounds in 30 adult patients with features of intracranial hypertension. The ONSD was measured by USG intraoperatively along with direct intraventricular pressure measurement. The ONSD was compared with the intraventricular ICP and correlations were derived. The optimum cut-off of ONSD to predict ICP > 20 mm Hg, 25 mm Hg, 30 mm Hg, and 35 mm Hg was sought. Results There was a significant correlation of ONSD with ICP (r = 0.532, p = 0.002). An ONSD threshold of 5.5 mm predicted ICP > 20 mm Hg with high sensitivity (100%) and specificity (75%) (area under receiver operating characteristic [ROC] curve = 0.904, p=0.01). The optimum ONSD cut-off predicting ICP at values of 25 mm Hg, 30 mm Hg, and 35 mm Hg was 6.3 mm, 6.5 mm, and 6.7 mm, respectively. Conclusion Our study confirms the utility of optic nerve ultrasound in the diagnostic evaluation of patients with known or suspected intracranial hypertension. We recommend an ONSD cut-off of 5.5 mm for predicting ICP > 20 mm Hg. SN - 2168-8184 UR - https://www.unboundmedicine.com/medline/citation/33659139/Optic_Nerve_Sheath_Diameter:_Correlation_With_Intra_Ventricular_Intracranial_Measurements_in_Predicting_Dysfunctional_Intracranial_Compliance_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/33659139/ DB - PRIME DP - Unbound Medicine ER -
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