Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review
Abstract Background Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-inva...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-05-01
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| Series: | The Ultrasound Journal |
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| Online Access: | https://doi.org/10.1186/s13089-023-00324-7 |
| _version_ | 1797818121542696960 |
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| author | Ghadi Ghanem David Haase Agatha Brzezinski Rikke Ogawa Parsa Asachi Alan Chiem |
| author_facet | Ghadi Ghanem David Haase Agatha Brzezinski Rikke Ogawa Parsa Asachi Alan Chiem |
| author_sort | Ghadi Ghanem |
| collection | DOAJ |
| description | Abstract Background Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-invasive, bedside tool to measure correlates of eICP. This systematic review seeks to explore the utility of ultrasound detected optic disc elevation (ODE) as an ultrasonographic finding of eICP and to study its sensitivity and specificity as a marker of eICP. Methods This systematic review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We systematically searched PubMed, EMBASE, and Cochrane Central for English articles published before April 2023; yielding 1,919 total citations. After eliminating duplicates, and screening the records, we identified 29 articles that addressed ultrasonographically detected ODE. Results The 29 articles included a total of 1249 adult and pediatric participants. In patients with papilledema, the mean ODE ranged between 0.6 mm and 1.2 mm. Proposed cutoff values for ODE ranged between 0.3 mm and 1 mm. The majority of studies reported a sensitivity between 70 and 90%, and specificity ranged from 69 to 100%, with a majority of studies reporting a specificity of 100%. Conclusions ODE and ultrasonographic characteristics of the optic disc may aid in differentiating papilledema from other conditions. Further research on ODE elevation and its correlation with other ultrasonographic signs is warranted as a means to increase the diagnostic accuracy of ultrasound in the setting of eICP. |
| first_indexed | 2024-03-13T09:03:19Z |
| format | Article |
| id | doaj.art-1882e078b07b4c9aa3a6f2e430c2cc7f |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-03-13T09:03:19Z |
| publishDate | 2023-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-1882e078b07b4c9aa3a6f2e430c2cc7f2023-05-28T11:11:34ZengSpringerOpenThe Ultrasound Journal2524-89872023-05-0115111210.1186/s13089-023-00324-7Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic reviewGhadi Ghanem0David Haase1Agatha Brzezinski2Rikke Ogawa3Parsa Asachi4Alan Chiem5David Geffen School of Medicine, University of CaliforniaDepartment of Emergency Medicine, David Geffen School of Medicine UCLA, Olive View UCLA Medical CenterDepartment of Emergency Medicine, David Geffen School of Medicine UCLA, Olive View UCLA Medical CenterUCI Libraries, University of CaliforniaDavid Geffen School of Medicine, University of CaliforniaDepartment of Emergency Medicine, David Geffen School of Medicine UCLA, Olive View UCLA Medical CenterAbstract Background Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-invasive, bedside tool to measure correlates of eICP. This systematic review seeks to explore the utility of ultrasound detected optic disc elevation (ODE) as an ultrasonographic finding of eICP and to study its sensitivity and specificity as a marker of eICP. Methods This systematic review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We systematically searched PubMed, EMBASE, and Cochrane Central for English articles published before April 2023; yielding 1,919 total citations. After eliminating duplicates, and screening the records, we identified 29 articles that addressed ultrasonographically detected ODE. Results The 29 articles included a total of 1249 adult and pediatric participants. In patients with papilledema, the mean ODE ranged between 0.6 mm and 1.2 mm. Proposed cutoff values for ODE ranged between 0.3 mm and 1 mm. The majority of studies reported a sensitivity between 70 and 90%, and specificity ranged from 69 to 100%, with a majority of studies reporting a specificity of 100%. Conclusions ODE and ultrasonographic characteristics of the optic disc may aid in differentiating papilledema from other conditions. Further research on ODE elevation and its correlation with other ultrasonographic signs is warranted as a means to increase the diagnostic accuracy of ultrasound in the setting of eICP.https://doi.org/10.1186/s13089-023-00324-7Optic disc elevationPapilledemaIntracranial pressureODEOptic discPoint of care ultrasound |
| spellingShingle | Ghadi Ghanem David Haase Agatha Brzezinski Rikke Ogawa Parsa Asachi Alan Chiem Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review The Ultrasound Journal Optic disc elevation Papilledema Intracranial pressure ODE Optic disc Point of care ultrasound |
| title | Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review |
| title_full | Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review |
| title_fullStr | Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review |
| title_full_unstemmed | Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review |
| title_short | Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review |
| title_sort | ultrasound detected increase in optic disk height to identify elevated intracranial pressure a systematic review |
| topic | Optic disc elevation Papilledema Intracranial pressure ODE Optic disc Point of care ultrasound |
| url | https://doi.org/10.1186/s13089-023-00324-7 |
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