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Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension.
J Neuroradiol. 2021 Jun 08 [Online ahead of print]JN

Abstract

PURPOSE

To assess changes in central retinal artery (CRA) blood flow by orbital color-coded Doppler ultrasonography in patients with idiopathic intracranial hypertension (IIH) and their relation with optic nerve (ON) elasticity assessed by shear wave elastography (SWE).

METHODS

This study was carried out on 68 eyes of patients diagnosed with IIH and 32 eyes of healthy controls. The severity of papilledema in IIH patients was sub-classified into mild and moderate/severe groups. Color-coded Doppler was used to measure peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (Vmean) and pulsatility index (PI) of the CRA.

RESULTS

PSV, Vmean, and SWE were significantly higher in patients with IIH than in controls (p = 0.001). The optimal cut-off values of PSV and Vmean for differentiating IIH patients from controls were 11.25 and 6.75 cm/s with AUC 0.81 and 0.785 respectively. AUC was 0.92 and accuracy 91% for combined PSV, Vmean and SWE differentiation between IIH patients and controls. PSV, Vmean and SWE were significantly different between mild versus moderate/severe papilledema (p = 0.001). PSV and Vmean were correlated with papilledema (r = 0.790 and 0.722 respectively) and SWE (r = 0.818 and 0.761 respectively).

CONCLUSION

IIH is associated with decreased ON elasticity and reduced CRA blood flow. Individual and combined color-coded Doppler of the CRA and SWE help in diagnosis of IIH. CRA hemodynamic changes are correlated with papilledema severity and with the extent of biomechanical changes in the ON represented by SWE.

Authors+Show Affiliations

Department of Neurology, Faculty of Medicine, Mansoura University, Egypt. Electronic address: nadaabdelhameed@mans.edu.eg.Department of Neurology, Faculty of Medicine, Mansoura University, Egypt.Department of Radiology, Faculty of Medicine, Mansoura University, Egypt.Department of Radiology, Faculty of Medicine, Mansoura University, Egypt.Department of Neurology, Faculty of Medicine, Mansoura University, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34111478

Citation

Elsaid, Nada, et al. "Effect of Changes in Optic Nerve Elasticity On Central Retinal Artery Blood Flow in Patients With Idiopathic Intracranial Hypertension." Journal of Neuroradiology = Journal De Neuroradiologie, 2021.
Elsaid N, Belal T, Batouty N, et al. Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension. J Neuroradiol. 2021.
Elsaid, N., Belal, T., Batouty, N., Razek, A. A. K. A., & Azab, A. (2021). Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension. Journal of Neuroradiology = Journal De Neuroradiologie. https://doi.org/10.1016/j.neurad.2021.06.001
Elsaid N, et al. Effect of Changes in Optic Nerve Elasticity On Central Retinal Artery Blood Flow in Patients With Idiopathic Intracranial Hypertension. J Neuroradiol. 2021 Jun 8; PubMed PMID: 34111478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension. AU - Elsaid,Nada, AU - Belal,Tamer, AU - Batouty,Nihal, AU - Razek,Ahmed Abdel Khalek Abdel, AU - Azab,Ahmed, Y1 - 2021/06/08/ PY - 2021/04/23/received PY - 2021/05/31/revised PY - 2021/06/01/accepted PY - 2021/6/11/pubmed PY - 2021/6/11/medline PY - 2021/6/10/entrez KW - Central retinal artery KW - Color-coded Doppler KW - Idiopathic intracranial hypertension KW - Ultrasound elastography JF - Journal of neuroradiology = Journal de neuroradiologie JO - J Neuroradiol N2 - PURPOSE: To assess changes in central retinal artery (CRA) blood flow by orbital color-coded Doppler ultrasonography in patients with idiopathic intracranial hypertension (IIH) and their relation with optic nerve (ON) elasticity assessed by shear wave elastography (SWE). METHODS: This study was carried out on 68 eyes of patients diagnosed with IIH and 32 eyes of healthy controls. The severity of papilledema in IIH patients was sub-classified into mild and moderate/severe groups. Color-coded Doppler was used to measure peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (Vmean) and pulsatility index (PI) of the CRA. RESULTS: PSV, Vmean, and SWE were significantly higher in patients with IIH than in controls (p = 0.001). The optimal cut-off values of PSV and Vmean for differentiating IIH patients from controls were 11.25 and 6.75 cm/s with AUC 0.81 and 0.785 respectively. AUC was 0.92 and accuracy 91% for combined PSV, Vmean and SWE differentiation between IIH patients and controls. PSV, Vmean and SWE were significantly different between mild versus moderate/severe papilledema (p = 0.001). PSV and Vmean were correlated with papilledema (r = 0.790 and 0.722 respectively) and SWE (r = 0.818 and 0.761 respectively). CONCLUSION: IIH is associated with decreased ON elasticity and reduced CRA blood flow. Individual and combined color-coded Doppler of the CRA and SWE help in diagnosis of IIH. CRA hemodynamic changes are correlated with papilledema severity and with the extent of biomechanical changes in the ON represented by SWE. SN - 0150-9861 UR - https://www.unboundmedicine.com/medline/citation/34111478/Effect_of_changes_in_optic_nerve_elasticity_on_central_retinal_artery_blood_flow_in_patients_with_idiopathic_intracranial_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0150-9861(21)00132-2 DB - PRIME DP - Unbound Medicine ER -
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