Optic nerve sheath diameter in severe preeclampsia with neurologic features versus controls

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Ophthalmology

Background:

• Optic nerve sheath diameters (ONSD) are validated for detecting elevated intracranial pressure in hypertensive encephalopathy.
• Neurologic symptoms of preeclampsia and eclampsia resemble hypertensive encephalopathy.
• This study investigated ONSD in severe preeclampsia with neurologic criteria versus non-preeclamptic patients.

Purpose of the Study:

• To assess the incidence of elevated ONSD in severe preeclampsia with neurologic criteria compared to non-preeclamptic controls.
• To determine baseline ONSD in severe preeclampsia without neurologic criteria and non-severe preeclampsia.
• To evaluate ONSD as a potential biomarker for neurologic involvement in preeclampsia.

Main Methods:

• A single-site cohort study included 62 pregnant women (≥18 years, ≥20 weeks gestation).
• Participants were categorized into: preeclampsia without severe features, severe preeclampsia (non-neurologic criteria), severe preeclampsia (neurologic criteria), and controls.
• Optic nerve sheath diameters were measured by a blinded reviewer; statistical analyses included chi-square, Kruskal-Wallis, and regression models.

Main Results:

• The incidence of ONSD > 5.8 mm was 43.8% in severe preeclampsia with neurologic features and 42.1% in controls (relative risk 1.04).
• Mean ONSD was 5.75 ± 1.09 mm in severe preeclampsia without neurologic features and 5.54 ± 1.26 mm in non-severe preeclampsia.
• No significant difference in ONSD was observed between severe preeclampsia with neurologic features and the control group.

Conclusions:

• No significant elevated ONSD relative risk was found between severe preeclampsia patients with neurologic features and non-preeclampsia controls.
• This study is the first to examine ONSD in a North American population using ACOG criteria for preeclampsia severity, stratified by neurologic criteria.
• Findings suggest ONSD may not be a reliable indicator for neurologic involvement in severe preeclampsia.