Optic Nerve Sheath Diameter in Pediatric Populations: Establishing Reference Intervals and Anthropometric...

Area of Science:

• Pediatric Neurology
• Medical Imaging
• Ophthalmology

Background:

• Optic nerve sheath diameter (ONSD) ultrasonography is a promising noninvasive tool for estimating intracranial pressure (ICP) in children.
• Current clinical use is hindered by a lack of established age-specific normative data for healthy pediatric populations.

Purpose of the Study:

• To determine age-specific reference ranges for ONSD in healthy children aged 4 to 18 years.
• To investigate the influence of anthropometric factors, including BMI, height, and weight, on ONSD measurements in this age group.

Main Methods:

• A cross-sectional study involving 150 healthy children (ages 4-18) without suspected increased ICP or chronic conditions.
• Standardized transorbital ultrasonography was used for bilateral ONSD measurements.
• Anthropometric z-scores were calculated, and correlations and percentile-based reference intervals were established.

Main Results:

• The mean ONSD was 3.67±0.50 mm, with significantly higher values in older children (11-18 years) compared to younger ones (4-10 years).
• ONSD demonstrated positive correlations with age, height, weight, and BMI across the entire cohort.
• BMI was a significant predictor of ONSD specifically in the adolescent group (11-18 years).
• Age-specific 97th percentile upper limits for ONSD were determined as 4.33 mm (4-10 years) and 4.40 mm (11-18 years).

Conclusions:

• This research provides crucial age-specific normative reference intervals for ONSD in healthy children.
• The study highlights the significant impact of BMI on ONSD measurements in adolescents, essential for accurate ICP assessment.
• These findings support the integration of ONSD ultrasonography into pediatric noninvasive ICP monitoring protocols, though further multicenter validation is recommended.