Posterior Globe Depth for Optic Nerve Sheath Diameter Measurement in Ocular Ultrasound in Healthy Volunteers

2021 ◽  
Author(s):  
Stephen Petrou ◽  
Christopher Raio ◽  
Lauren Klein ◽  
Michael Felicetta
Keyword(s):  
Optic Nerve ◽  
Healthy Volunteers ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Diameter Measurement ◽  
Nerve Sheath ◽  
Ocular Ultrasound

Abstract 334: Point-Of-Care Ultrasound in the Assessment of Optic Nerve Sheath Diameter After Out-Of-Hospital Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Pavitra Kotini-Shah ◽  
Sarah E Kim ◽  
Richard Gordon ◽  
Benjamin Karfunkle ◽  
Pratik B Doshi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Optic Nerve ◽  
Neurological Outcome ◽  
Optic Nerve Sheath Diameter ◽  
Small Sample ◽  
Optic Nerve Sheath ◽  
Point Of Care Ultrasound ◽  
Nerve Sheath ◽  
Ocular Ultrasound ◽  
Linear Probe

Introduction: Hypoxic-ischemic injury from cardiac arrest may cause cerebral edema, leading to increased intracranial pressure (ICP) and brain tissue damage. Optic nerve sheath diameter (ONSD) is associated with elevated ICP. Limited clinical studies have reported ONSD changes in the early post-resuscitation time frame. We sought to evaluate the utility of bedside ocular ultrasound measurements in the assessment of post-cardiac arrest brain injury. Methods: We studied adult out-of-hospital cardiac arrests treated at an urban academic ED and achieving return of spontaneous circulation (ROSC) between May 2018 to May 2019. We included witnessed and unwitnessed arrest as well as shockable and non-shockable rhythms. After ROSC, trained emergency physicians performed bedside ultrasonographic assessment of bilateral ONSD at 1, 6, 24, 48, and 72 hours using an ocular preset on a 15MHz linear probe. ONSD measurements at these time frames were compared between groups stratified by rhythm type and neurological outcome. Cerebral performance category (CPC) was measured at 72 hours and at discharge. Results: Out of 48 eligible patients, 15 were excluded from the study due to lack of consent or available ultrasound images. We included 33 patients, of which 11 were female and 22 were male, with a median age of 57 (IQR 20). There were 19 with an initial rhythm of asystole or pulseless electrical activity (PEA), 9 with ventricular fibrillation arrests, and 5 with an unclear rhythm. At 1 hour, patients with CPC 1-2 had smaller ONSD compared to patients with CPC 3-5 (5.5mm vs 6.1mm, p=0.03). At 72 hour, patients with CPC score of 1-2 had an average reduction in ONSD of 1.6mm verses 0.29mm increase in patients with CPC 3-5. Despite small sample size, a trend towards higher ONSD were seen in patients with non-shockable vs shockable rhythm. Females were also consistently found to have smaller ONSD measurements in all time periods compared to males. Conclusions: This is the first study in the USA to perform analysis using ONSD measurements in cardiac arrest patients. Preliminary analysis of this on-going pilot revealed a greater improvement in ONSD diameters in patients with a favorable neurological outcome. OSND may have utility in prognostication of the post-arrest state.

scholarly journals Elevated Intracranial Pressure Diagnosis with Emergency Department Bedside Ocular Ultrasound

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
D. Amin ◽  
T. McCormick ◽  
T. Mailhot
Keyword(s):  
Emergency Department ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Vision Loss ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Elevated Intracranial Pressure ◽  
Nerve Sheath ◽  
Ocular Ultrasound ◽  
Fundoscopic Examination

Bedside sonographic measurement of optic nerve sheath diameter can aid in the diagnosis of elevated intracranial pressure in the emergency department. This case report describes a 21-year-old female presenting with 4 months of mild headache and 2 weeks of recurrent, transient binocular vision loss. Though limited by patient discomfort, fundoscopic examination suggested the presence of blurred optic disc margins. Bedside ocular ultrasound (BOUS) revealed wide optic nerve sheath diameters and bulging optic discs bilaterally. Lumbar puncture demonstrated a cerebrospinal fluid (CSF) opening pressure of 54 cm H2O supporting the suspected diagnosis of idiopathic intracranial hypertension. Accurate fundoscopy can be vital to the appropriate diagnosis and treatment of patients with suspected elevated intracranial pressure, but it is often technically difficult or poorly tolerated by the photophobic patient. BOUS is a quick and easily learned tool to supplement the emergency physician’s fundoscopic examination and help identify patients with elevated intracranial pressure.

scholarly journals Assessment of intra-interobserver reliability of the sonographic optic nerve sheath diameter measurement

2015 ◽  
Vol 31 (8) ◽  
pp. 432-436 ◽  
Author(s):  
Tuba Cimilli Ozturk ◽  
Hasan Demir ◽  
Rasim Yorulmaz ◽  
Serdar Ozdemir ◽  
Gokhan Isat ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Interobserver Reliability ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Diameter Measurement ◽  
Nerve Sheath

scholarly journals Correction: Transorbital Sonographic Evaluation of Normal Optic Nerve Sheath Diameter in Healthy Volunteers in Bangladesh

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Rapeephan R. Maude ◽  
Md Amir Hossain ◽  
Mahtab Uddin Hassan ◽  
Sophie Osbourne ◽  
Katherine Langan ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Healthy Volunteers ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Sonographic Evaluation ◽  
Nerve Sheath
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