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  • Ultrasonic measurement of optic nerve sheath diameter: a non-invasive surrogate approach for dynamic, real-time evaluation of intracranial pressure

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Review
Ultrasonic measurement of optic nerve sheath diameter: a non-invasive surrogate approach for dynamic, real-time evaluation of intracranial pressure
  1. Li-min Chen,
  2. Li-juan Wang,
  3. Yang Hu,
  4. Xiao-han Jiang,
  5. Yu-zhi Wang,
  6. Ying-qi Xing
  1. Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
  1. Correspondence to Ying-qi Xing, The First Hospital of Jilin University, Changchun 130021, China; xingyq2009{at}sina.com

Abstract

The current study aimed to identify whether ultrasonographic measurements of optic nerve sheath diameter (ONSD) could dynamically and sensitively evaluate real-time intracranial pressure (ICP). ONSD measurements were performed approximately 5  min prior to and after a lumbar puncture (LP). A total of 84 patients (mean±SD age, 43.5±14.7 years; 41 (49%) men; 18 patients with elevated ICP) were included in the study. The Spearman correlation coefficients between the two observers were 0.779 and 0.703 in the transverse section and 0.751 and 0.788 in the vertical section for the left and right eyes, respectively. The median (IQR) change in ONSD (ΔONSD) and change in ICP (ΔICP) were 0.11 (0.05–0.21) mm and 30 (20–40) mmH2O, respectively, for all participants. With a reduction in cerebrospinal fluid pressure, 80 subjects (95%) showed an immediate drop in ONSD; the median (IQR) decreased from 4.13 (4.02–4.38) mm to 4.02 (3.90–4.23) mm (p<0.001). Significant correlations were found between ONSD and ICP before LPs (r=0.482, p<0.01) and between ΔONSD and ΔICP (r=0.451, p<0.01). Ultrasonic measurement of ONSD can reflect the relative real-time changes in ICP.

  • intracranial pressure
  • lumbar puncture
  • optic nerve
  • ultrasonic measurement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

https://doi.org/10.1136/bjophthalmol-2018-312934

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    Footnotes

    • L-mC and L-jW contributed equally.

    • Contributors Y-qX and L-jW conceived and designed the experiments. L-mC, X-hJ, YH, and Y-zW performed the experiments. L-mC analyzed the data and wrote the paper.

    • Funding This project was supported by the National Natural Science Foundation of China (no 8180070275).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was approved by the ethics committee of The First Hospital of Jilin University (approval number: 2016–375).

    • Provenance and peer review Not commissioned; externally peer reviewed.