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Review of non-invasive intracranial pressure measurement techniques for ophthalmology applications
  1. David Andrew Price1,
  2. Andrzej Grzybowski2,3,
  3. Jennifer Eikenberry1,
  4. Ingrida Januleviciene4,
  5. Alice Chandra Verticchio Vercellin5,6,
  6. Sunu Mathew1,
  7. Brent Siesky7,
  8. Alon Harris7
  1. 1 Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
  2. 2 Department of Ophthalmology, Poznan City Hospital, Poznan, Poland
  3. 3 Medcial Faculty, University of Warmia and Mazury, Olsztyn, Poland
  4. 4 Eye Clinic of Lithuanian University of Health Sciences, Kaunas, Lithuania
  5. 5 Ophthalmology Department, University of Pavia, Pavia, Italy
  6. 6 Glaucoma Unit, IRCCS – Fondazione Bietti, Rome, Italy
  7. 7 Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York City, New York, USA
  1. Correspondence to Professor Alon Harris, Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York City, NY 10029, USA; palonharris{at}


Assessment and monitoring of intracranial pressure (ICP) are important in the management of traumatic brain injury and other cerebral pathologies. In the eye, ICP elevation and depression both correlate with optic neuropathies, the former because of papilledema and the latter related to glaucoma. While the relationship between ICP elevation and papilledema is well established, the relationship between low ICP and glaucoma is still poorly understood. So far, ICP monitoring is performed invasively, but this entails risks including infection, spurring the study of non-invasive alternatives. We review 11 methods of non-invasive estimation of ICP including correlation to optic nerve sheath diameter, intraocular pressure, ophthalmodynamometry and two-depth transcranial Doppler of the ophthalmic artery. While none of these methods can fully replace invasive techniques, certain measures show great potential for specific applications. Although only used in small studies to date, a MRI based method known as MR-ICP, appears to be the best non-invasive technique for estimating ICP, with two-depth transcranial ultrasound and ophthalmodynamometry showing potential as well.

  • glaucoma
  • imaging
  • intraocular pressure
  • optic nerve

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  • Funding The contribution of the author ACVV was supported by Fondazione Roma and by the Italian Ministry of Health.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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