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Updated: Jun 2, 2026
Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition
Published on: August 18, 2023
Prognostic Value of Computed Tomography-Measured Optic Nerve Sheath Diameter in Cirrhotic Patients with Hepatic
Tugcehan Sezer Akman1,2, Ozkul Yilmaz Colak1,2, Melda Isevi1,2
1Department of Anaesthesiology and Reanimation, Division of Intensive Care, Ondokuz Mayis University, Samsun, Turkiye.
Objective:
To evaluate the correlation of computed tomography (CT)-measured optic nerve sheath diameter (ONSD) with clinical and laboratory parameters in adult cirrhotic patients with hepatic encephalopathy (HE), and to determine its association with in-hospital mortality.
Study Design:
An observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Division of Intensive Care, Ondokuz Mayis University, Samsun, Turkiye, between January and December 2023.
Methodology:
This study included cirrhotic patients with HE identified from the medical records and admitted to the Emergency Department during the study period. Data collected included demographic characteristics, aetiology of cirrhosis, Glasgow Coma Scale (GCS), Child-Pugh and MELD scores, HE grade, prothrombin time (PT), international normalised ratio (INR), blood pH, ammonia and lactate levels, ascites grade, and right eye ONSD measured using cranial CT at admission. Correlation and univariate Cox regression analyses were performed.
Results:
A total of 125 cases were analysed, with a mean age of 66.69 ± 12.36 years and an average hospitalisation period of 8.59 ± 7.8 days. The mean ONSD was 4.43 ± 0.84 mm. ONSD showed significant correlations with Child-Pugh score (r = 0.205, p = 0.022), HE grade (r = 0.261, p = 0.003), ascites grade (r = 0.178, p = 0.046), as well as with PT (r = 0.239, p = 0.007) and INR (r = 0.230, p = 0.010). Significant negative correlations were observed with GCS (r = -0.282, p = 0.001) and blood pH (r = -0.186, p = 0.038). Increased ONSD was associated with in-hospital mortality in univariate analysis (p = 0.048; HR = 1.29).
Conclusion:
Although the mean ONSD values were within the traditionally accepted normal range, relative variations in ONSD were significantly associated with disease severity markers and in-hospital mortality. CT-measured ONSD may therefore serve as an adjunctive parameter in prognostic assessment, warranting further prospective validation.
Key Words:
Hepatic encephalopathy, Cirrhosis, Optic nerve sheath diameter, Intracranial pressure, Prognosis.
