Value of Optic Nerve Sheath Diameter in Diagnosis and Follow Up of Patients with Disturbed Conscious Level.

IF 3.1 Q1 OPHTHALMOLOGY

Eye and Brain Pub Date : 2022-09-27 eCollection Date: 2022-01-01 DOI:10.2147/EB.S369813

Osama Mahmoud Momtaz, Omar M Said, Amany Mahmoud Mohamed, Tamer Sayed Abdel Mawla

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引用次数: 0

Abstract

Background: Ultrasonographic measurement of optic nerve sheath diameter is a simple, non-invasive, and reliable method of detecting elevated intracranial pressure (ICP) in critical patients. Optic nerve sheath communicates with the dura mater covering the brain and contains cerebrospinal fluid, allowing pressure transmission from the cranium. Therefore, changes in cerebrospinal fluid (CSF) pressure have been shown to produce changes in ONSD.

Objective: This study aimed to assess the accuracy of optic nerve sheath diameter (ONSD) in diagnosis and follow-up patients with disturbed conscious levels compared with CT brain and fundus examination.

Patients and methods: One hundred forty-one participants were included in the study, classified into 76 cases admitted with disturbed conscious levels due to elevated ICP and 65 controls. All patients were subjected to CT brain and optic nerve US and fundus examination at the time of admission and follow-up after 48 h after proper management.

Results: The current study showed that ONSD is significant in predicting elevated ICP at the cut-off point of average ONSD of 5.19 mm with 97% sensitivity and 98% specificity, and the area under the curve (AUC) was 0.996. The present study revealed a significant inverse correlation between ONSD and GCS in patients with increased ICP.

Conclusion: Ultrasonic measurement of ONSD is a promising technique in diagnosing and following patients with disturbed conscious levels.

Abstract Image

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视神经鞘径在意识水平紊乱患者诊断及随访中的价值。

背景:超声测量视神经鞘直径是检测危重患者颅内压升高的一种简单、无创、可靠的方法。视神经鞘与覆盖大脑的硬脑膜相通，并含有脑脊液，使压力从头盖骨传递。因此，脑脊液(CSF)压力的变化已被证明会引起ONSD的变化。目的:本研究旨在评价视神经鞘直径(ONSD)在诊断和随访意识水平紊乱患者中的准确性，并与CT脑和眼底检查进行比较。患者和方法:141名参与者被纳入研究，分为76例因ICP升高而入院的意识水平紊乱患者和65例对照组。所有患者入院时行CT脑、视神经US及眼底检查，处理妥当后48 h随访。结果:目前的研究表明，在平均ONSD为5.19 mm的截断点上，ONSD对ICP升高有显著的预测意义，灵敏度为97%，特异性为98%，曲线下面积(AUC)为0.996。本研究显示，ICP升高患者的ONSD与GCS呈显著负相关。结论:超声测量ONSD是一种很有前途的诊断和跟踪意识水平紊乱患者的技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eye and Brain OPHTHALMOLOGY-

CiteScore

7.90

自引率

2.30%

发文量

审稿时长

16 weeks

期刊介绍： Eye and Brain is an international, peer-reviewed, open access journal focusing on basic research, clinical findings, and expert reviews in the field of visual science and neuro-ophthalmology. The journal’s unique focus is the link between two well-known visual centres, the eye and the brain, with an emphasis on the importance of such connections. All aspects of clinical and especially basic research on the visual system are addressed within the journal as well as significant future directions in vision research and therapeutic measures. This unique journal focuses on neurological aspects of vision – both physiological and pathological. The scope of the journal spans from the cornea to the associational visual cortex and all the visual centers in between. Topics range from basic biological mechanisms to therapeutic treatment, from simple organisms to humans, and utilizing techniques from molecular biology to behavior. The journal especially welcomes primary research articles or review papers that make the connection between the eye and the brain. Specific areas covered in the journal include: Physiology and pathophysiology of visual centers, Eye movement disorders and strabismus, Cellular, biochemical, and molecular features of the visual system, Structural and functional organization of the eye and of the visual cortex, Metabolic demands of the visual system, Diseases and disorders with neuro-ophthalmic manifestations, Clinical and experimental neuro-ophthalmology and visual system pathologies, Epidemiological studies.