Assessment of the optic nerve using strain and shear-wave elastography in patients with pseudotumour cerebri

To evaluate the optic nerve using strain elastography (SE) and shear-wave elastography (SWE) in idiopathic intracranial hypertension (IIH) patients in comparison to participants in the control group.

Eighty eyes were evaluated in 40 cases consisting of 20 IIH patients and 20 participants in the control group. This study was conducted using SE and SWE in addition optic nerve sonography measurements of participants in the IIH patient group and the control group. SE patterns were categorised using three main types and two subtypes. Quantitative measurements of optic nerve stiffness with SWE were expressed in kilopascals.

In the IIH patient group, type 2 and type 1 elasticity patterns were primarily observed, followed by type 3 patterns. In the control group, type 3 elasticity patterns were most often observed, while type 2 elasticity patterns were seen less frequently. Statistically significance differences in the types of elasticity strain patterns were observed between the groups (p<0.01). Quantitative analysis was also performed, and the SWE moduli were obtained for the control group (10.1±0.28 kPa) and the IIH patient group (26.97±1 kPa). A statistically significant difference in the SWE modulus was found between the groups (p<0.01).

Biomechanical changes may have occurred in the optic nerve secondary to increased intracranial pressure in IIH patients. Strain and shear elastography may have potential as assistive diagnostic techniques for the detection and follow-up of these changes.