Electrophysiological and fundoscopic detection of intracranial hypertension in craniosynostosis.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
24
02
2021
accepted:
02
11
2021
revised:
08
10
2021
pubmed:
3
1
2022
medline:
12
1
2023
entrez:
2
1
2022
Statut:
ppublish
Résumé
To assess the diagnostic accuracy of fundoscopy and visual evoked potentials (VEPs) in detecting intracranial hypertension (IH) in patients with craniosynostosis undergoing spring-assisted posterior vault expansion (sPVE). Children with craniosynostosis undergoing sPVE and 48-hour intracranial pressure (ICP) monitoring were included in this single-centre, retrospective, diagnostic accuracy study. Data for ICP, fundoscopy and VEPs were analysed. Primary outcome measures were papilloedema on fundoscopy, VEP assessments and IH, defined as mean ICP > 20 mmHg. Diagnostic indices were calculated for fundoscopy and VEPs against IH. Secondary outcome measures included final visual outcomes. Fundoscopic examinations were available for 35 children and isolated VEPs for 30 children, 22 of whom had at least three serial VEPs. Sensitivity was 32.1% for fundoscopy (95% confidence intervals [CI]: 15.9-52.4) and 58.3% for isolated VEPs (95% CI 36.6-77.9). Specificity for IH was 100% for fundoscopy (95% CI: 59.0-100) and 83.3% for isolated VEPs (95% CI: 35.9-99.6). Where longitudinal deterioration was suspected from some prVEPs but not corroborated by all, sensitivity increased to 70.6% (95% CI: 44.0-89.7), while specificity decreased to 60% (95% CI: 14.7-94.7). Where longitudinal deterioration was clinically significant, sensitivity decreased to 47.1% (23.0-72.2) and specificity increased to 100% (47.8-100). Median final BCVA was 0.24 logMAR (n = 36). UK driving standard BCVA was achieved by 26 patients (72.2%), defined as ≥0.30 logMAR in the better eye. Papilloedema present on fundoscopy reliably indicated IH, but its absence did not exclude IH. VEP testing boosted sensitivity at the expense of specificity, depending on method of analysis.
Identifiants
pubmed: 34974540
doi: 10.1038/s41433-021-01839-w
pii: 10.1038/s41433-021-01839-w
pmc: PMC9829653
mid: EMS137959
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
139-145Subventions
Organisme : DH | National Institute for Health Research (NIHR)
ID : NIHR 300155 Doctoral Fellowship Award
Informations de copyright
© 2021. The Author(s).
Références
Renier D, Sainte-Rose C, Marchac D, Hirsch JF. Intracranial pressure in craniostenosis. J Neurosurg. 1982;57:370–7.
doi: 10.3171/jns.1982.57.3.0370
Cornelissen M, Ottelander BD, Rizopoulos D, et al. Increase of prevalence of craniosynostosis. J Craniomaxillofac Surg. 2016;44:1273–9.
doi: 10.1016/j.jcms.2016.07.007
Wilkie AOM, Johnson D, Wall SA. Clinical genetics of craniosynostosis. Curr Opin Pediatr. 2017;29:622–8.
doi: 10.1097/MOP.0000000000000542
Bannink N, Nout E, Wolvius EB, Hoeve HL, Joosten KF, Mathijssen IM. Obstructive sleep apnea in children with syndromic craniosynostosis: long-term respiratory outcome of midface advancement. Int J Oral Maxillofac Surg. 2010;39:115–21.
doi: 10.1016/j.ijom.2009.11.021
Tamburrini G, Caldarelli M, Massimi L, Santini P, Di, Rocco C. Intracranial pressure monitoring in children with single suture and complex craniosynostosis: a review. Childs Nerv Syst. 2005;21:913–21.
doi: 10.1007/s00381-004-1117-x
Taylor WJ, Hayward RD, Lasjaunias P, Britto JA, Thompson DN, Jones BM, et al. Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage. J Neurosurg. 2001;94:377–85.
doi: 10.3171/jns.2001.94.3.0377
Abu-Sittah GS, Jeelani O, Dunaway D, Hayward R. Raised intracranial pressure in Crouzon syndrome: incidence, causes, and management. J Neurosurg Pediatr. 2016;17:469–75.
doi: 10.3171/2015.6.PEDS15177
Thompson DN, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R. Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst. 1995;11:269–75.
doi: 10.1007/BF00301758
Thompson DN, Malcolm GP, Jones BM, Harkness WJ, Hayward RD. Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg. 1995;22:235–40.
doi: 10.1159/000120907
Ramdat Misier KRR, Breakey RWF, Caron CJJM, Schievano S, Dunaway DJ, Koudstaal MJ, et al. Correlation of intracranial volume with head surface volume in patients with multisutural craniosynostosis. J Craniofac Surg. 2020;31:1445–8.
Breakey W, Knoops P, van de Lande LS, Borghi A, Papaionnou A, O’Hara J, et al. S2-05 Session 2: posterior vault distraction volumetric changes of grey matter, white matter and cerebrospinal fluid following 87 posterior vault expansion cases in patients with craniosynostosis. Plastic and Reconstructive Surgery – Global Open; 2019.7.
Tuite GF, Chong WK, Evanson J, Narita A, Taylor D, Harkness WF, et al. The effectiveness of papilledema as an indicator of raised intracranial pressure in children with craniosynostosis. Neurosurgery. 1996;38:272–8.
doi: 10.1097/00006123-199602000-00009
Thompson DA, Liasis A, Hardy S, Hagan R, Hayward RD, Evans RD, et al. Prevalence of abnormal pattern reversal visual evoked potentials in craniosynostosis. Plast Reconstr Surg. 2006;118:184–92.
doi: 10.1097/01.prs.0000220873.72953.3e
Hinds AM, Thompson DA, Rufai SR, Weston K, Schwiebert K, Panteli V, et al. Visual outcomes in children with syndromic craniosynostosis: a review of 165 cases. Eye (Lond). 2021. https://doi.org/10.1038/s41433-021-01458-5 .
doi: 10.1038/s41433-021-01458-5
Tuite GF, Evanson J, Chong WK, Thompson DN, Harkness WF, Jones BM, et al. The beaten copper cranium: a correlation between intracranial pressure, cranial radiographs, and computed tomographic scans in children with craniosynostosis. Neurosurgery. 1996;39:691–9.
doi: 10.1097/00006123-199610000-00007
Hayward R, Britto JA, Dunaway D, Evans R, Jeelani Nu, Thompson D. Raised intracranial press ure and nonsyndromic sagittal craniosynostosis. J Neurosurg Pediatr. 2015;16:346–8.
Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, STARD Group. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ. 2015;351:h5527.
doi: 10.1136/bmj.h5527
Odom JV, Bach M, Brigell M, Holder GE, McCulloch DL, International Society for Clinical Electrophysiology of Vision. ISCEV standard for clinical visual evoked potentials: (2016 update). Doc Ophthalmol. 2016;133:1–9.
doi: 10.1007/s10633-016-9553-y
Hayward R, Britto J, Dunaway D, Jeelani O. Connecting raised intracranial pressure and cognitive delay in craniosynostosis: many assumptions, little evidence. J Neurosurg Pediatr. 2016;18:242–50.
doi: 10.3171/2015.6.PEDS15144
Gov.uk. Driving eyesight rules. https://www.gov.uk/driving-eyesight-rules . Accessed 8 Oct 2021.
Donahue SP, Arnold RW, Ruben JB, AAPOS Vision Screening Committee. Preschool vision screening: what should we be detecting and how should we report it? Uniform guidelines for reporting results of preschool vision screening studies. J AAPOS. 2003;7:314–6.
doi: 10.1016/S1091-8531(03)00182-4
Lange CAK, Feltgen N, Junker B, Schulze-Bonsel K, Bach M. Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg Visual Acuity Test (FrACT). Graefes Arch Clin Exp Ophthalmol. 2009;247:137–42
doi: 10.1007/s00417-008-0926-0
Royal National Institute of Blind People. The criteria for certification. https://www.rnib.org.uk/eye-health/registering-your-sight-loss/criteria-certification . Accessed 21 Jan 2021.
Khan SH, Nischal KK, Dean F, Hayward RD, Walker J. Visual outcomes and amblyogenic risk factors in craniosynostotic syndromes: a review of 141 cases. Br J Ophthalmol. 2003;87:999–1003.
doi: 10.1136/bjo.87.8.999
Thompson DA, Kriss A, Taylor D, Russell-Eggitt I, Hodgkins P, Morgan G, et al. Early VEP and ERG evidence of visual dysfunction in autosomal recessive osteopetrosis. Neuropediatrics. 1998;29:137–44.
doi: 10.1055/s-2007-973550
Haredy MM, Liasis A, Davis A, Koesarie K, Fu V, Losee JE, et al. Serial, visually-evoked potentials for the assessment of visual function in patients with craniosynostosis. J Clin Med. 2019;8:1555.
doi: 10.3390/jcm8101555
Haredy MM, Liasis A, Fu V, Davis A, Pollack IF, Losee JE, et al. Serial visual evoked potentials in patients with craniosynostosis and invasive intracranial pressure monitoring. Plast Reconstr Surg. 2019;144:446e–452e.
doi: 10.1097/PRS.0000000000005935
Judy BF, Swanson JW, Yang W, Storm PB, Bartlett SP, Taylor JA, et al. Intraoperative intracranial pressure monitoring in the pediatric craniosynostosis population. J Neurosurg Pediatr. 2018;22:475–80.
doi: 10.3171/2018.5.PEDS1876
Scott CJ, Kardon RH, Lee AG, Frisén L, Wall M. Diagnosis and grading of papilledema in patients with raised intracranial pressure using optical coherence tomography vs clinical expert assessment using a clinical staging scale. Arch Ophthalmol. 2010;128:705–11.
doi: 10.1001/archophthalmol.2010.94
Rufai SR, Thomas MG, Purohit R, Bunce C, Lee H, Proudlock FA, et al. Can structural grading of foveal hypoplasia predict future vision in infantile nystagmus?: a longitudinal study. Ophthalmology. 2020;127:492–500.
doi: 10.1016/j.ophtha.2019.10.037