Optic Nerve Sheath Ultrasonography: Should We Be Using It for Bedside Diagnosis of Increased Intracranial Pressure?
Authors: Kathleen Y. Ogle, Resa E. Lewiss
Journal: Annals of Internal Medicine (2019)

Editorials17 December 2019Optic Nerve Sheath Ultrasonography: Should We Be Using It for Bedside Diagnosis of Increased Intracranial Pressure?Kathleen Y. Ogle, MD and Resa E. Lewiss, MDKathleen Y. Ogle, MDGeorge Washington University Hospital Washington, DC (K.Y.O.)Search for more papers by this author and Resa E. Lewiss, MDThomas Jefferson University Hospital Philadelphia, Pennsylvania (R.E.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2928 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their systematic review, Koziarz and colleagues' examined the accuracy of optic nerve ultrasonography for diagnosing increased intracranial pressure in children and adults (1). We commend their careful methods but encourage cautious interpretation of the findings because the measurement of the optic nerve sheath diameter is riddled with greater challenges than other bedside ultrasonography clinical applications.Bedside ultrasonography of the eye has many clinical applications, including the assessment for hemorrhage, foreign body, lens dislocation, retinal detachment, and of course optic nerve sheath diameter (2). In the particular case of optic nerve sheath sonograpaphy, clinicians must integrate the patient history, physical ...References1. Koziarz A, Sne N, Kegel F, et al. Bedside optic nerve ultrasonography for diagnosing increased intracranial pressure. A systematic review and meta-analysis. Ann Intern Med. 2019;171:896-905. doi:10.7326/M19-0812 LinkGoogle Scholar2. Blaivas M. Bedside emergency department ultrasonography in the evaluation of ocular pathology. Acad Emerg Med. 2000;7:947-50. [PMID: 10958141] CrossrefMedlineGoogle Scholar3. Kimberly HH, Shah S, Marill K, et al. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med. 2008;15:201-4. [PMID: 18275454] doi:10.1111/j.1553-2712.2007.00031.x CrossrefMedlineGoogle Scholar4. Zeiler FA, Ziesmann MT, Goeres P, et al. A unique method for estimating the reliability learning curve of optic nerve sheath diameter ultrasound measurement. Crit Ultrasound J. 2016;8:9. [PMID: 27501699] doi:10.1186/s13089-016-0044-x CrossrefMedlineGoogle Scholar5. Li Q, Zhong QH, Luo XQ, et al. Value of transorbital ultrasonography of optic nerve sheath diameter in the diagnosis of intracranial hypertension in patients with hypertensive disorder complication pregnancy. Guangxi Medical Journal. 2017;2:196-9. Google Scholar6. Kishk NA, Ebraheim AM, Ashour AS, et al. Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: the cut-off points. Neuroradiol J. 2018;31:490-5. [PMID: 30024291] doi:10.1177/1971400918789385 CrossrefMedlineGoogle Scholar7. Reeves MJ, Bushnell CD, Howard G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol. 2008;7:915-26. [PMID: 18722812] doi:10.1016/S1474-4422(08)70193-5 CrossrefMedlineGoogle Scholar8. Madsen TE, Howard G, Kleindorfer DO, et al. Sex differences in hypertension and stroke risk in the REGARDS study: a longitudinal cohort study. Hypertension. 2019;74:749-55. [PMID: 31405299] doi:10.1161/HYPERTENSIONAHA.119.12729 CrossrefMedlineGoogle Scholar9. Chiao L, Sharipov S, Sargsyan AE, et al. Ocular examination for trauma; clinical ultrasound aboard the International Space Station. J Trauma. 2005;58:885-9. [PMID: 15920397] CrossrefMedlineGoogle Scholar10. Britton N, Miller MA, Safadi S, et al. Tele-ultrasound in resource-limited settings: a systematic review. Front Public Health. 2019;7:244. [PMID: 31552212] doi:10.3389/fpubh.2019.00244 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: George Washington University Hospital Washington, DC (K.Y.O.)Thomas Jefferson University Hospital Philadelphia, Pennsylvania (R.E.L.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2928.Corresponding Author: Resa E. Lewiss, MD, Thomas Jefferson University Hospital, 1025 Walnut Street, College Building Suite 300, Philadelphia, PA 19107; e-mail, resa.[email protected]edu.Current Author Addresses: Dr. Ogle: George Washington University Hospital, 2150 L Street Northwest, Suite 450, Washington, DC 20037.Dr. Lewiss: Thomas Jefferson University Hospital, 1025 Walnut Street, College Building, Suite 300, Philadelphia, PA 19107.This article was published at Annals.org on 19 November 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBedside Optic Nerve Ultrasonography for Diagnosing Increased Intracranial Pressure Alex Koziarz , Niv Sne , Fraser Kegel , Siddharth Nath , Jetan H. Badhiwala , Farshad Nassiri , Alireza Mansouri , Kaiyun Yang , Qi Zhou , Timothy Rice , Samir Faidi , Edward Passos , Andrew Healey , Laura Banfield , Mark Mensour , Andrew W. Kirkpatrick , Aussama Nassar , Michael G. Fehlings , Gregory W.J. Hawryluk , and Saleh A. Almenawer Metrics 17 December 2019Volume 171, Issue 12Page: 935-936KeywordsChildrenHead injuryLearning curvesNervesOptic nerveProspective studiesRacial and ethnic issuesRetinal detachmentSystematic reviewsUltrasound imaging ePublished: 19 November 2019 Issue Published: 17 December 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...