Optic nerve sheath diameter in patients with hepatic encephalopathy

Area of Science:

• Neurology
• Hepatology
• Medical Imaging

Background:

• Hepatic encephalopathy (HE) is a complex neurological complication of liver dysfunction.
• The optic nerve sheath diameter (ONSD) is a potential indicator of intracranial pressure.
• Investigating ONSD in HE may offer insights into neurological changes.

Purpose of the Study:

• To determine if ONSD is increased in patients with hepatic encephalopathy.
• To assess the association between ONSD and the prognosis of HE patients, including mortality and disease severity.

Main Methods:

• A retrospective case-control study comparing 74 acute HE patients with 74 age- and gender-matched controls.
• Cranial computerized tomography (CT) was used for ONSD measurements.
• ONSD was compared between groups and correlated with HE grade, Child-Pugh Score, and in-hospital mortality.

Main Results:

• The mean ONSD was significantly higher in HE patients (5.27 mm ± 0.82) compared to controls (4.73 mm ± 0.57, p < 0.001).
• No significant difference in ONSD was observed between survivors (5.30 mm ± 0.87) and non-survivors (5.21 mm ± 0.65, P = 0.670) within the HE group.
• ONSD showed no significant correlation with the West Haven HE grade (P = 0.348) or Child-Pugh Score (P = 0.505).

Conclusions:

• ONSD is elevated in patients with hepatic encephalopathy compared to controls.
• Elevated ONSD in HE patients is not associated with disease severity (HE grade, Child-Pugh Score) or in-hospital mortality.