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Optic nerve sonographic parameters in idiopathic intracranial hypertension, case-control study
Islam El Malky1, Wael Elshazly Aita2, Alaa Elkordy3
1Department of Neurology, Director of Interventional Neurovascular Unit, South Valley University, Qena, Egypt. islam.elmalky@yahoo.com.
Scientific Reports
|January 13, 2025
Summary
Transorbital sonography can identify increased intracranial pressure (ICP) in idiopathic intracranial hypertension (IIH). Optic nerve sheath diameter (ONSD) is a key predictor of elevated ICP, offering a non-invasive diagnostic tool.
Area of Science:
- Ophthalmology
- Neurology
- Radiology
Background:
- Idiopathic intracranial hypertension (IIH) diagnosis often relies on funduscopic examination, which can be prone to errors.
- IIH can be diagnosed even in the absence of papilledema, highlighting the need for alternative diagnostic methods.
- Transorbital sonography presents a non-invasive and cost-effective approach for detecting increased intracranial pressure (ICP).
Purpose of the Study:
- To investigate changes in ultrasonographic indices in patients with IIH.
- To identify which ultrasonographic indices can effectively predict increased ICP in IIH patients.
- To evaluate the diagnostic performance of optic nerve sheath diameter (ONSD) in predicting elevated ICP.
Main Methods:
- A case-control study involving 68 definite IIH patients and 68 age- and sex-matched healthy controls.
- Transorbital color Doppler ultrasonography was used to measure optic nerve sheath diameter (ONSD), peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI).
- Multivariate linear regression and ROC curve analysis were employed to identify predictors of increased ICP and determine optimal cut-off values.
Main Results:
- Statistically significant differences were observed between IIH patients and controls in ONSD, EDV, and RI.
- Multivariate analysis identified ONSD as the sole significant predictor of increased ICP.
- Optimal cut-off values for ONSD were determined as 5.7 mm for both the right and left eyes, demonstrating high sensitivity and specificity (AUC > 0.90).
Conclusions:
- Transorbital sonography, particularly ONSD measurement, is a valuable non-invasive tool for diagnosing increased ICP in IIH.
- ONSD measurement can aid in the early and accurate diagnosis of IIH, potentially reducing diagnostic errors associated with funduscopy.
- The established cut-off values for ONSD provide reliable criteria for identifying elevated ICP in the context of IIH.
