A new diagnostic method in ischemic and hemorrhagic stroke: Doppler ultrasound of ophthalmic artery

Abstract

Objective

Timely and accurate diagnosis of ischemic and hemorrhagic stroke is critical for optimizing early management and improving outcomes. However, reliance on advanced neuroimaging may cause delays, especially in resource-limited settings. This study evaluates the role of ophthalmic artery Doppler ultrasound (OAD-US) in assessing stroke-related hemodynamic alterations and its potential as a bedside diagnostic tool.

Methods

This prospective observational study included ischemic and hemorrhagic stroke patients admitted to the emergency department with confirmed diagnoses via computed tomography (CT) or magnetic resonance imaging (MRI). OAD-US was performed to measure peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) in both eyes. To assess hemispheric hemodynamic asymmetry, PSV and EDV ratios were calculated by comparing the affected and unaffected sides. A control group of healthy individuals determined baseline values.

Results

Both ischemic and hemorrhagic stroke patients showed significantly different PSV and EDV ratios compared to controls (p < 0.001 and p = 0.001, respectively). ROC analysis demonstrated high diagnostic accuracy, with the PSV ratio achieving an AUC of 0.913 (85.7 % sensitivity, 91.3 % specificity) and the EDV ratio an AUC of 0.724 in distinguishing stroke patients from controls. RI did not differ significantly between groups.

Conclusions

OAD-US provides a rapid, non-invasive, and bedside-accessible method for detecting stroke-related cerebrovascular alterations. The significant differences in PSV and EDV ratios between stroke and control groups suggest OAD-US may serve as a valuable adjunct in acute stroke assessment, particularly where immediate neuroimaging is unavailable. Further multicenter studies are needed to validate its clinical utility.