J.ophthalmol.(Ukraine).2016;4:29-31.

https://doi.org/10.31288/oftalmolzh201642931

Optic nerve ultrasound in idiopathic intracranial hypertension

K.S. Iegorova, MD

L.V. Zadoianyi, Cand Sc (Med)

L.L. Marushchenko, Cand Sc (Med)

Romodanov Neurosurgery Institute

Kyiv, Ukraine

E-mail: iegorova_katya@ukr.net

Backup: Vision loss associated with secondary optic atrophy is the major complication of idiopathic intracranial hypertension (IIH). A potential for the development of severe visual impairment necessitates regular monitoring and determines the importance of ophthalmological examination in patients with this condition. Optic nerve ultrasound (ONUS) enables identification of IIH and monitoring of raised intracranial pressure (ICP) in these patients.

Purpose: To investigate the diagnostic potential of ONUS.

Materials and Methods: Fifty patients (100 eyes) underwent ONUS using general purpose ultrasound system Sonoline Versa Plus with 8-MHz transducer, before and after treatment for IIH. The control group included 15 healthy volunteers (30 eyes). Depending on the ophthalmoscopic changes, patient eyes were divided into four pre-treatment groups (mild papilledema, 26 eyes; moderate papilledema, 25 eyes; marked papilledema, 21 eyes and optic atrophy secondary to papilledema, 28 eyes) and two post-treatment groups (retinal angiopathy, 65 eyes; and secondary optic atrophy, 35 eyes).

Results: The pre-treatment optic nerve diameter in mild, moderate, marked and atrophic papilledema eyes was found to be 5.08 ± 0.18 mm, 5.98 ± 0.45 mm, 6.14 ± 0.37 mm and 5.15 ± 0.72 mm, while that in controls was 4.08 ± 0.25 mm.

Conclusion: ONUS is an accurate, fast, non-invasive and economical diagnostic technique for the detection of raised intracranial pressure in IIH.

Key words: Idiopathic intracranial hypertension, papilledema, optic nerve ultrasound.

 

References 

1.Serova NK. [Clinical neuroophthalmology: Neurosurgical aspects]. Tver’: Triada Publishing House; 2011. 323 p. Russian

2.Monteiro MLR, Moura FC. [Ophthalmic aspects of idiopathic intracranial hypertension syndrome (pseudotumor cerebri)]. Rev Bras Oftalmol. 2008; 67(4):196-203. Portugal 

3.Rosenfeld E, Kesler A. Pseudotumor Cerebri (Idiopathic Intracranial Hypertension) an Update. In: Neuroimaging – Clinical Applications. Bright P, editor. InTech, Rijeka; 2012. p. 373-400
Crossref

4.Mezaal M, Saadah M. Idiopathic intracranial hypertension in Dubai: nature and prognosis. Acta Neurol Scand. 2005 Nov;112(5):298-302.
Crossref   Pubmed

5.Tron EZh. [Visual pathway disorders]. Moscow: Medgiz; 1955. 394 p. Russian 

6.Bruce BB, Preechawat P, Newman NJ, et al. Racial differences in idiopathic intracranial hypertension. Neurology. 2008 Mar 11;70(11):861-7
Crossref   Pubmed

7.Malayeri AA, Bavarian S, Mehdizadeh M. Sonographic evaluation of optic nerve diameter in children with raised intracranial pressure. J Ultrasound Med. 2005 Feb;24(2):143-7.
Crossref   Pubmed

8.Girisgin AS, Kalkan E, Kocak S, et al. The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure. Emerg Med J. 2007 Apr; 24(4): 251-4.
Crossref    Pubmed

9.Glaser JS (Ed.). Neuro-ophthalmology. 3rd ed. Philadelphia etc: Lippincott Williams and Wilkins; 1999

10.Stone MB. Ultrasound diagnosis of papilledema and increased intracranial pressure in pseudotumor cerebri. Am J Emerg Med. 2009 Mar;27(3):376.

11.Karakitsos D., Soldatos T., Gouliamos A., et al. Transorbital sonographic monitoring of optic nerve diameter in patients with severe brain injury. Transplant Proc. 2006 Dec; 38(10):3700-6.

12.Rykun VS. [Additional ultrasonographic criteria in the differential diagnosis of congestive and pseudocongestive optic disks]. Vestn Oftalmol. 2006 Jul-Aug;122(4):9-12. Russian