Optic Nerve Sheath Diameter Ultrasound: A Non-Invasive Approach to Evaluate Increased Intracranial Pressure in Critically Ill Pediatric Patients
Abstract
:1. Introduction
2. Pathophysiology of Raised Intracranial Pressure (ICP)
3. Optic Nerve and Its Measurement
3.1. Anatomy and Physiology of Optic Nerve
3.2. Ultrasonographic Technique for Optic Nerve Sheath Diameter (ONSD) Measurement
4. Optic Nerve Sheath Diameter (ONSD) Measurements in Children
5. ONSD Measurements in Neonates
6. Discussion and Future Directions
7. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Population | ICP Reference Values |
---|---|
Adults | <10–15 mm Hg |
Children | 3–7 mm Hg |
Term infants | 1.5–6 mm Hg |
Author | Included Children (n) | Normal Mean ONSD Value (mm) | Cut-Off Value for ONSD (mm) | ||
---|---|---|---|---|---|
Ballantyne et al. [102] | 5 (0–2 months) | 2.57 (SD 0.30) | >4 (<1 year) | ||
9 (2–3 months) | 2.95 (SD 0.35) | >4.5 (1–15 years) | |||
5 (3–12 months) | 3.21 (SD 0.22) | ||||
9 (1–2 years) | 2.99 (SD 0.23) | ||||
17 (2–3 years) | 3.03 (SD 0.20) | ||||
18 (3–4 years) | 3.15 (SD 0.28) | ||||
16 (4–5 years) | 3.23 (SD 0.38) | ||||
10 (5–10 years) | 2.98 (SD 0.16) | ||||
13 (10–15 years) | 3.26 (SD 0.35) | ||||
Rehman Siddiqui et al. [103] | 48 | Patients with signs of raised ICP | Patients with no signs of raised ICP | ||
8 (1 month–1 year) | 4.64 (SD 0.48) n = 3 | 4.32 (SD 0.71) n = 5 | >4 (SE 100% SP 60%) | ||
21 (1–10 years) | 6.44 (SD 0.65) n = 10 | 5.03 (SD 0.82) n = 11 | >4.71 (SE 100% SP 63.6%) | ||
19 (10–16 years) | 6.28 (SD 0.62) n = 13 | 5.46 (SD 0.91) n = 6 | >5.43 (SE 100% SP 66.7%) | ||
Irazuzta et al. [104] | 13 (12–18 years) | Patients with CSF OP greater than 20 cm 2O | Patients with CSF OP less than 20 cm H2O | >4.5 mm (SE 100%) | |
n = 3 | n = 10 | ||||
5.5 ± 1.2 (right eye) | 3.9 ± 0.1 mm (right eye) | ||||
5.4 ± 1 (left eye) | 3.7 ± 0.2 mm (left eye) | ||||
Aslan et al. [105] | 22 (7–17 years) | PTCS group | Control group | Not reported in the article | |
(84–204 months) | |||||
PTCS group | n = 7 | n = 15 | |||
(30–204 months) | 6.7 (SD 0.5) (right eye) | 5.3 (SD 0.2) (right eye) | |||
Control group | 6.7 (SD 0.6) (left eye) | 5.2 (SD 0.3) (left eye) | |||
Padayachy et al. [106] | 174 | Not reported in the article | ICP threshold of 20 mm Hg | ||
Overall | 5.5 | ||||
56 (≤1 year) | 5.16 (SE 80%, SP 76.1%) | ||||
118 (>1 year) | 5.75 (SE 85.9%, SP 70.4%) | ||||
62 (open AF) | 5.16 (SE 85.7%, SP 75%) | ||||
112 (closed AF) | 5.80 (SE 85%, SP 73.1%) | ||||
Kerscher et al. [107] | 72 | Not reported in the article | ICP threshold of 20 mm Hg | ||
Overall | 5.57 (SE 81.3%, SP 62.5) | ||||
21 (≤1 year) | 4.99 (SE 50%, SP 58.8%) | ||||
51 (>1 year) | 5.75 (SE 91.7, SP 66.7) | ||||
ICP threshold of 15 mm Hg | |||||
Overall | 5.28 (SE 90.9%, SP 69.2%) | ||||
21 (≤1 year) | 4.99 (SE 71.4%, SP 71.4%) | ||||
51 (>1 year) | 5.57 (SE 80%, SP 69.2%) | ||||
Robba et al. [108] | 10 (4–14 years) | 3.70 (4.50–3.40) Median (IQR) | ICP threshold of 20 mm Hg | ||
4.75 (SE 0.956, SP 0.938) | |||||
ICP threshold of 15 mm Hg | |||||
3.85 (SE 0.811, SP 0.939) | |||||
Fontanel et al. [109] | 215 (0–18 years) | ||||
≥4.1 (SE 100%, SP 83.9%) | |||||
29 IHT | |||||
0 (<1 year) | |||||
0 (1–4 years) | |||||
29 (>4 years) | IHT | Healthy | ODD | ||
n = 29 | n = 165 | n = 21 | (>4 y) | ||
165 healthy | |||||
21 (<1 year) | 4.9 (4.5–5.1) (>4 y) | 4.0 (3.8–4.1) (>4 y) | 4.0 (3.8–4.0) (>4 y) | ≥4.1 (SE 100%, SP 89.3%) | |
29 (1–4 years) | |||||
115 (>4 years) | |||||
Median (IQR) | Median (IQR) | Median (IQR) | ≥4.4 (SE 100%, SP 98.8%) (11–18 y) | ||
21 optic disc drusen (ODD) | |||||
1 (<1 year) | |||||
1 (1–4 years) | |||||
19 (>4 years) | |||||
Steinborn et al. [110] | 81 (3–17.8 years) | Increased ICP | Normal ICP | >6 (SE 82%, SP 74%) | |
n = 25 | n = 56 | ||||
6.85 (SD 0.81) | 5.77 (SD 0.48) | ||||
Malayeri et al. [42] | 156 | Case group | Control group | Not reported in the article | |
n = 78 | n = 78 | ||||
34 (<4 years) | 5.55 (SD 0.68) (<4 y) | 3.00 (SD 0.67) (<4 y) | |||
44 (>4 years) | 5.68 (SD 0.71) (>4 y) | 3.60 (SD 0.42) (>4 y) | |||
Case group increased ICP | |||||
32 (<4 years) | |||||
46 (>4 years) | |||||
Control group normal ICP | |||||
Aslan et al. [111] | 57 (3–204 months) | Increased ICP | Normal ICP | 5.8 (SE 66%, SP 100%) | |
(suspected clinically or radiologically) | |||||
n = 38 | n = 19 | ||||
5.9 (SD 0.8) | 5.2 (SD 0.3) | ||||
Le et al. [112] | 64 (0–18 years) | Increased ICP | Suspected ICP | >4 (<1 year) | |
Suspected or confirmed increased ICP | (cranial imaging or direct measurement) | >4.5 (>1 year) | |||
n = 24 | n = 40 | (SE 83%, SP 38%) | |||
Not reported in the article | Not reported in the article |
Author | Included Neonates (n) | Normal Mean ONSD Value (mm) | Cut-Off Value for ONSD (mm) | |
---|---|---|---|---|
Ballantyne et al. [102] | 5 (0–2 months) | 2.57 (SD 0.30) | >4 (<1 year) | |
9 (2–3 months) | 2.95 (SD 0.35) | >4.5 (1–15 years) | ||
5 (3–12 months) | 3.21 (SD 0.22) | |||
9 (1–2 years) | 2.99 (SD 0.23) | |||
17 (2–3 years) | 3.03 (SD 0.20) | |||
18 (3–4 years) | 3.15 (SD 0.28) | |||
16 (4–5 years) | 3.23 (SD 0.38) | |||
10 (5–10 years) | 2.98 (SD 0.16) | |||
13 (10–15 years) | 3.26 (SD 0.35) | |||
Gravendeel J et al. [113] | 120 (37–42 weeks of gestation) | Not reported in the article | ||
0–4 days | 3.9 (3.1–4.7) | |||
4 months | 5.5 (4.5–6.5) | |||
8 months | 5.8 (5.0–6.6) | |||
95% reference intervals Males | ||||
0–4 days | 3.7 (2.7–4.7) | |||
4 months | 5.3 (4.3–6.3) | |||
8 months | 5.6 (4.6–6.6) | |||
95% reference intervals Females | ||||
Ardell S et al. [114] | 12 preterm infants (29–36 weeks postconceptional age) | Right eye | Left eye | Not reported in the article |
29 weeks | 2.1 (SD 0.1) | 2.1 (SD 0.2) | ||
30 weeks | 2.2 (SD 0.1) | 2.3 (SD 0.2) | ||
31 weeks | 2.4 (SD 0.1) | 2.4 (SD 0.1) | ||
32 weeks | 2.7 (SD 0.3) | 2.7 (SD 0.4) | ||
33 weeks | 2.7 (SD 0.2) | 2.7 (SD 0.3) | ||
34 weeks | 2.9 (SD 0.2) | 3.0 (SD 0.3) | ||
35 weeks | 3.2 (SD 0.4) | 3.2 (SD 0.3) | ||
36 weeks | 3.1 (SD 0.3) | 3.2 (SD 0.2) | ||
Yapicioglu et al. [115] | 554 | Not reported in the article | ||
22 (23 weeks 0 day–28 weeks 6 days) | 2.6 (SD 0.3)—Distance 2 mm | |||
2.7 (SD 0.3)—Distance 2.5 mm | ||||
64 (29 weeks 0 day–32 weeks 6 days) | 3.0 (SD 0.2)—Distance 2 mm | |||
3.1 (SD 0.2)—Distance 2.5 mm | ||||
167 (33 weeks 0 day–36 weeks 6 days) | 3.3 (SD 0.2)—Distance 2 mm | |||
3.5 (SD 0.2)—Distance 2.5 mm | ||||
3.6 (SD 0.2)—Distance 3 mm | ||||
301 (37 weeks 0 day–41 weeks 6 days) | 4.0 (SD 0.2)—Distance 3 mm |
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Cannata, G.; Pezzato, S.; Esposito, S.; Moscatelli, A. Optic Nerve Sheath Diameter Ultrasound: A Non-Invasive Approach to Evaluate Increased Intracranial Pressure in Critically Ill Pediatric Patients. Diagnostics 2022, 12, 767. https://doi.org/10.3390/diagnostics12030767
Cannata G, Pezzato S, Esposito S, Moscatelli A. Optic Nerve Sheath Diameter Ultrasound: A Non-Invasive Approach to Evaluate Increased Intracranial Pressure in Critically Ill Pediatric Patients. Diagnostics. 2022; 12(3):767. https://doi.org/10.3390/diagnostics12030767
Chicago/Turabian StyleCannata, Giulia, Stefano Pezzato, Susanna Esposito, and Andrea Moscatelli. 2022. "Optic Nerve Sheath Diameter Ultrasound: A Non-Invasive Approach to Evaluate Increased Intracranial Pressure in Critically Ill Pediatric Patients" Diagnostics 12, no. 3: 767. https://doi.org/10.3390/diagnostics12030767