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Optic Nerve Sheath Diameter in Preterm Infants: Suggested Values
Molly Rayner1, Tanya Holt2, Sibasis Daspal3
1College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Insights
Detecting elevated intracranial pressure (ICP) in preterm infants is crucial. This study found optic nerve sheath diameter (ONSD) measurements by MRI and ultrasound are similar, proposing new suggested ONSD values for clinical use.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
- Ophthalmology
Background:
- Elevated intracranial pressure (ICP) in high-risk preterm infants can lead to severe neurologic deficits.
- Optic nerve sheath diameter (ONSD) is a reliable indicator of ICP changes.
- Established ultrasonographic ONSD values exist for preterm infants.
Purpose of the Study:
- To compare MRI-measured ONSD with existing ultrasonographic ONSD data in preterm infants.
- To propose suggested ultrasonographic ONSD values based on corrected gestational age.
- To enhance the clinical utility of ONSD measurements for ICP assessment.
Main Methods:
- Retrospective analysis of ONSD measurements from preterm infant MRIs.
- Correlation of MRI ONSD with pre-existing ultrasonographic ONSD data.
- Stratification of data by corrected gestational age and application of linear regression.
Main Results:
- High correlation (R2 values 0.93-0.96) between MRI and ultrasound ONSD measurements.
- ONSD values showed a strong correlation with corrected gestational age.
- Suggested ONSD values were developed, increasing with gestational age.
Conclusions:
- MRI and ultrasound ONSD measurements are comparable in preterm infants.
- The proposed suggested ONSD values can aid clinicians in managing suspected or known ICP.
- Standardized ONSD values may improve early detection and intervention for ICP in neonates.
Objective:
Timely detection of elevated intracranial pressure (ICP) in highrisk preterm infants may be critical to avoid permanent neurologic sequelae. Size of optic nerve sheath diameter (ONSD) is highly correlated with changes in ICP. Normal ultrasonographic ONSD values for preterm infants have been published. This study sought to compare these data with MRI measured OSND and to propose suggested ultrasonographic ONSD values.
Methods:
The ONSD in preterm MRIs were retrospectively measured and related to pre-existing ultrasonographic ONSD. Data were stratified for corrected gestational age. Simple linear regression between ONSD mean values and age was modeled for both eyes, and R2 was calculated. Suggested values for ultrasonographic ONSD were ascertained through linear regression and calculated prediction intervals.
Results:
ONSD measurements demonstrated R2 values of 0.95 (right ONSD MRI), 0.95 (left ONSD MRI), 0.96 (right ONSD ultrasound), and 0.93 (left ONSD ultrasound). Suggested ONSD values were incremental with corrected gestational age.
Conclusion:
ONSD measurements with MRI and ultrasound are similar. The proposed suggested ONSD values may be helpful in clinical situations where ICPs are suspected or known.
