Intraindividual Optic Nerve Sheath Variation and Intracranial Pressure Changes: A Systematic Review and Meta-Analysis

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY
Henrique Azevedo, Lia Lucas Neto, David Berhanu
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Abstract

Background and Purpose

To review the existing evidence on multiple timepoint assessments of optic nerve sheath diameter (ONSD) as an indicator of intraindividual variation of intracranial pressure (ICP).

Methods

A systematic search identified studies assessing intraindividual variation in ICP through multiple timepoint measurements of ONSD using ultrasonography. Meta-analysis of studies assessing intraindividual correlation coefficients between ONSD and ICP was performed using a random effects model, and we calculated the weighted correlation coefficient for the expected change in ICP associated with variations in ONSD.

Results

A total of five studies, comprising 157 patients, were included in the review. ONSD was compared with invasive ICP measurement methods at multiple timepoints. Meta-analysis of intraindividual ONSD–ICP correlation demonstrated a correlation coefficient of 0.62 (CI: 0.50–0.71). Individual linear correlation analyses were performed in two of the studies, yielding correlation coefficients ranging from 0.79 to 1.00; however, widely variable individual slopes were found (1.51–41.43 mm/mmHg). ONSD variations ranged from 0.12 to 3.30 mm per 5 mmHg change in ICP, with a variation of 0.55 mm in adults with hypoxic brain injury and 0.77 mm in children with idiopathic intracranial hypertension.

Conclusions

Our findings indicate that ONSD significantly correlates with ICP, and longitudinal intraindividual assessment shows a predominantly linear correlation between both variables. A personalized ONSD–ICP correlation equation may enable accurate ICP prediction, making ONSD a useful tool for follow-up in patients with previous invasive ICP measurements, when adjusted to each patient's characteristics and pathologies.

Abstract Image

个体视神经鞘变异和颅内压变化:系统回顾和荟萃分析
背景与目的回顾视神经鞘直径(ONSD)作为个体颅内压(ICP)变化指标的多时间点评估的现有证据。方法系统检索了通过超声多时间点测量ONSD来评估ICP个体差异的研究。使用随机效应模型对评估ONSD与ICP之间个体内相关系数的研究进行了meta分析,并计算了与ONSD变化相关的ICP预期变化的加权相关系数。结果共纳入5项研究,157例患者。在多个时间点比较ONSD与有创ICP测量方法。个体间ONSD-ICP相关性的meta分析显示相关系数为0.62 (CI: 0.50-0.71)。在两项研究中进行了单独的线性相关分析,得出的相关系数范围为0.79至1.00;然而,个体坡度变化很大(1.51-41.43 mm/mmHg)。在ICP中,ONSD的变化范围为每5mmhg变化0.12 ~ 3.30 mm,在缺氧脑损伤的成人中为0.55 mm,在特发性颅内高压的儿童中为0.77 mm。结论:我们的研究结果表明,ONSD与ICP显著相关,纵向个人评估显示这两个变量之间主要呈线性相关。个性化的ONSD - ICP相关方程可以实现准确的ICP预测,使ONSD成为随访既往有创ICP测量患者的有用工具,当调整到每个患者的特征和病理时。
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来源期刊
Journal of Neuroimaging
Journal of Neuroimaging 医学-核医学
CiteScore
4.70
自引率
0.00%
发文量
117
审稿时长
6-12 weeks
期刊介绍: Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!
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