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Detection of intracranial hypertension in children using optical coherence tomography: a systematic review protocol
Sohaib R Rufai1,2, Noor Ul Owase Jeelani3,4, Rebecca J McLean5
1Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, United Kingdom.
Insights
This systematic review protocol examines Optical Coherence Tomography (OCT) for detecting intracranial hypertension (ICH) in children. It aims to assess OCT
Area of Science:
- Ophthalmology and Neuroscience
- Pediatric Neurology
- Medical Imaging
Background:
- Intracranial hypertension (ICH) in children poses significant risks to brain development and vision.
- Current methods for measuring intracranial pressure (ICP) in children lack diagnostic accuracy for screening.
- Optical coherence tomography (OCT) shows promise as a non-invasive surrogate for ICP measurement, with prior adult studies.
Purpose of the Study:
- To systematically review the role of OCT in detecting ICH in pediatric populations.
- To evaluate the diagnostic accuracy of OCT as a screening tool for ICH in children.
- To consolidate evidence on OCT's utility across various pediatric conditions associated with ICH.
Main Methods:
- Systematic literature search of major databases (Cochrane, Medline, Embase, Web of Science, PubMed) for relevant studies.
- Two independent reviewers will screen studies for inclusion based on predefined criteria.
- Quality assessment using the NIH Quality Assessment Tool; primary outcome is OCT sensitivity and specificity for ICH detection.
Main Results:
- The review protocol is established; data collection and analysis are planned.
- Primary outcome will be the sensitivity and specificity of OCT in diagnosing pediatric ICH.
- Secondary outcomes include associated conditions, direct ICP monitoring data, and comparative diagnostic accuracy.
Conclusions:
- This systematic review will provide a comprehensive assessment of OCT for ICH detection in children.
- Findings are expected to inform clinical practice and guide future research in non-invasive ICP monitoring.
- Dissemination through scientific meetings and peer-reviewed publications is planned.
Introduction:
Intracranial hypertension (ICH) in children can have deleterious effects on the brain and vision. It is notoriously difficult to estimate intracranial pressure (ICP) in children and existing methods deliver suboptimal diagnostic accuracy to be used as screening tools. Optical coherence tomography (OCT) may represent a valuable, non-invasive surrogate measure of ICP, as has been demonstrated in a number of associated conditions affecting adults. More recently, OCT has been employed within the paediatric age group. However, the role of OCT in detecting ICH in children has not been rigorously assessed in a systematic review for all relevant conditions. Here, we propose a systematic review protocol to examine the role of OCT in the detection of ICH in children.
Methods And Analysis:
Electronic searches in the Cochrane Central Register of Controlled Trials, Medline, Embase, Web of Science and PubMed will identify studies featuring OCT in detecting ICH in children. Two independent screeners will identify studies for inclusion using a screening questionnaire. The systematic search and screening will take place between 2 April 2020 and 1 June 2020, while we aim to complete data analysis by 1 September 2020. Quality assessment will be performed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The primary outcome measure is the sensitivity and specificity of OCT in detecting ICH in children. Secondary outcomes measures include conditions associated with ICH per study, direct ICP monitoring, sensitivity and specificity of other measures for ICP and OCT parameters used.
Ethics And Dissemination:
Ethical approval is not required for the proposed systematic review as no primary data will be collected. The findings will be disseminated through presentations at scientific meetings and peer-reviewed journal publication.
Prospero Registration Number:
CRD42019154254.
