Transorbital sonography in idiopathic intracranial hypertension: Single-center study, systematic review and meta-analysis.
idiopathic intracranial hypertension
optic disc elevation
optic nerve sheath diameter
sonography
transorbital sonography
Journal
Journal of neuroimaging : official journal of the American Society of Neuroimaging
ISSN: 1552-6569
Titre abrégé: J Neuroimaging
Pays: United States
ID NLM: 9102705
Informations de publication
Date de publication:
11 Oct 2023
11 Oct 2023
Historique:
revised:
29
09
2023
received:
23
07
2023
accepted:
01
10
2023
medline:
12
10
2023
pubmed:
12
10
2023
entrez:
12
10
2023
Statut:
aheadofprint
Résumé
Transorbital sonography (TOS) provides a noninvasive tool to detect intracranial pressure by assessing optic nerve sheath diameter (ONSD) and optic disc elevation (ODE). The utility of TOS in the diagnosis of idiopathic intracranial hypertension (IIH) has been increasingly recognized. A single-center case-control study sought to compare TOS-acquired ONSD and ODE among IIH-cases versus patients with other neurological diseases (controls). Furthermore, a systematic review and meta-analysis was conducted to present pooled mean differences and diagnostic measures of ONSD and ODE between IIH-cases and controls. In the single-center study, consisting of 31 IIH-cases and 34 sex- and age-matched controls, ONSD values were higher among IIH-cases than controls (p<.001), while ODE was more prevalent in cases (65% vs. 15%; p<.001). The receiver-operating characteristic (ROC)-curve analysis revealed that the optimal cutoff value of ONSD for predicting IIH was 5.15 mm, with an area under the curve (AUC) of 0.914 (95% confidence interval [CI]: 0.861-0.967) and sensitivity and specificity values of 85% and 90%, respectively. In a meta-analysis of 14 included studies with 415 IIH-cases, ONSD and ODE values were higher in IIH-cases than controls (mean difference in ONSD 1.20 mm; 95% CI: 0.96-1.44 mm and in ODE 0.3 mm; 95% CI: 0.33-0.67 mm). With regard to ONSD, pooled sensitivity, specificity, and diagnostic odds ratio were calculated at 85.5% (95% CI: 77.9-90.8%), 90.7% (95% CI: 84.6-94.5%), and 57.394 (95% CI: 24.597-133.924), respectively. The AUC in summary ROC-curve analysis was 0.878 (95% CI: 0.858-0.899) with an optimal cutoff point of 5.0 mm. TOS has a high diagnostic utility for the noninvasive diagnosis of IIH and may deserve wider implementation in everyday clinical practice.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Transorbital sonography (TOS) provides a noninvasive tool to detect intracranial pressure by assessing optic nerve sheath diameter (ONSD) and optic disc elevation (ODE). The utility of TOS in the diagnosis of idiopathic intracranial hypertension (IIH) has been increasingly recognized.
METHODS
METHODS
A single-center case-control study sought to compare TOS-acquired ONSD and ODE among IIH-cases versus patients with other neurological diseases (controls). Furthermore, a systematic review and meta-analysis was conducted to present pooled mean differences and diagnostic measures of ONSD and ODE between IIH-cases and controls.
RESULTS
RESULTS
In the single-center study, consisting of 31 IIH-cases and 34 sex- and age-matched controls, ONSD values were higher among IIH-cases than controls (p<.001), while ODE was more prevalent in cases (65% vs. 15%; p<.001). The receiver-operating characteristic (ROC)-curve analysis revealed that the optimal cutoff value of ONSD for predicting IIH was 5.15 mm, with an area under the curve (AUC) of 0.914 (95% confidence interval [CI]: 0.861-0.967) and sensitivity and specificity values of 85% and 90%, respectively. In a meta-analysis of 14 included studies with 415 IIH-cases, ONSD and ODE values were higher in IIH-cases than controls (mean difference in ONSD 1.20 mm; 95% CI: 0.96-1.44 mm and in ODE 0.3 mm; 95% CI: 0.33-0.67 mm). With regard to ONSD, pooled sensitivity, specificity, and diagnostic odds ratio were calculated at 85.5% (95% CI: 77.9-90.8%), 90.7% (95% CI: 84.6-94.5%), and 57.394 (95% CI: 24.597-133.924), respectively. The AUC in summary ROC-curve analysis was 0.878 (95% CI: 0.858-0.899) with an optimal cutoff point of 5.0 mm.
CONCLUSIONS
CONCLUSIONS
TOS has a high diagnostic utility for the noninvasive diagnosis of IIH and may deserve wider implementation in everyday clinical practice.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The Authors. Journal of Neuroimaging published by Wiley Periodicals LLC on behalf of American Society of Neuroimaging.
Références
Thurtell MJ. Idiopathic intracranial hypertension. Continuum (N Y). 2019;25:1289-1309.
Ball AK, Clarke CE. Idiopathic intracranial hypertension. Lancet Neurol. 2006;5:433-442.
Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81:1159-1165.
Bäuerle J, Nedelmann M. Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension. J Neurol. 2011;258:2014-2219.
del Saz-Saucedo P, Redondo-González O, Mateu-Mateu Á, Huertas-Arroyo R, García-Ruiz R, Botia-Paniagua E. Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension. J Neurol Sci. 2016;361:122-127.
Lochner P, Brio F, Zedde ML, et al. Feasibility and usefulness of ultrasonography in idiopathic intracranial hypertension or secondary intracranial hypertension. BMC Neurol. 2016;16:85.
Rehman H, Khan MS, Nafees M, Rehman AU, Habib A. Optic nerve sheath diameter on sonography in idiopathic intracranial hypertension versus normal. J Coll Physicians Surg Pak. 2016;26:758-760.
Soliman H, Gad A, Kishk NA, Shalaby N, Badr el Dine N, El-Sayed M. Diagnostic value of orbital ultrasound and orbital magnetic resonance imaging in idiopathic intracranial hypertension. Med J Cairo Univ. 2014;82:145-150.
Foska A, Palaiodimou L, Stefanou MI, et al. Telltale signs of idiopathic intracranial hypertension with normal opening cerebrospinal fluid pressure. Neurohospitalist. 2023;13:103-106.
Bakola E, Alonistiotis D, Arvaniti C, et al. Optic disc drusen mimicking idiopathic intracranial hypertension: rely on ultrasound. Neurol Res Pract. 2021;3:33.
Schroeder C, Katsanos AH, Richter D, Tsivgoulis G, Gold R, Krogias C. Quantification of optic nerve and sheath diameter by transorbital sonography: a systematic review and metanalysis. J Neuroimaging. 2020;30:165-174.
Schroeder C, Katsanos AH, Ayzenberg I, et al. Atrophy of optic nerve detected by transorbital sonography in patients with demyelinating diseases of the central nervous system. Eur J Neurol. 2020;27:626-632.
Wang LJ, Chen LM, Chen Y, et al. Ultrasonography assessments of optic nerve sheath diameter as a noninvasive and dynamic method of detecting changes in intracranial pressure. JAMA Ophthalmol. 2018;136:250-256.
Teismann N, Lenaghan P, Nolan R, Stein J, Green A. Point-of-care ocular ultrasound to detect optic disc swelling. Acad Emerg Med. 2013;20:920-925.
Page MJ, McKenzie JE, Bossuyt PM, et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol. 2021;134:103-112.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008-2012.
Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.
Ruopp MD, Perkins NJ, Whitcomb BW, Schisterman EF. Youden index and optimal cut-point estimated from observations affected by a lower limit of detection. Biom J. 2008;50:419-430.
DerSimonian R, Laird N. Meta-analysis in clinical trials revisited. Contemp Clin Trials. 2015;45:139-145.
McGrath S, Zhao X, Steele R, Thombs BD, Benedetti A. Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis. Stat Methods Med Res. 2020;29:2520-2537.
Katsanos AH, Psaltopoulou T, Sergentanis TN, et al. Transcranial Doppler versus transthoracic echocardiography for the detection of patent foramen ovale in patients with cryptogenic cerebral ischemia: a systematic review and diagnostic test accuracy meta-analysis. Ann Neurol. 2016;79:625-635.
Steinhauser S, Schumacher M, Rücker G. Modelling multiple thresholds in meta-analysis of diagnostic test accuracy studies. BMC Med Res Methodol. 2016;16:97.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-634.
Deeks JJ, Higgins JP, Altman DG. Chapter 10: Analysing data and undertaking meta-analyses. In: Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Accessed September 26, 2022. https://training.Cochrane.Org/handbook/current/chapter-10
Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36:1-48.
mada: meta-analysis of diagnostic accuracy. Accessed September 26, 2022 https://cran.R-project.Org/web/packages/mada/index.Html
Rücker G, Steinhauser S, Kolampally S, Schwarzer G. Meta-analysis of diagnostic accuracy studies with several cutpoints. 2022. Accessed September 26, 2022 https://cran.R-project.Org/web/packages/diagmeta/diagmeta.Pdf
Patel A, Cooper N, Freeman S, Sutton A. Graphical enhancements to summary receiver operating characteristic plots to facilitate the analysis and reporting of meta-analysis of diagnostic test accuracy data. Res Synth Methods. 2021;12:34-44.
Dağdelen K, Ekici M. Measuring optic nerve sheath diameter using ultrasonography in patients with idiopathic intracranial hypertension. Arq Neuropsiquiatr. 2022;80:580-585.
Ebraheim AM, Mourad HS, Kishk NA, Badr Eldin N, Saad AA. Sonographic assessment of optic nerve and ophthalmic vessels in patients with idiopathic intracranial hypertension. Neurol Res. 2018;40:728-735.
Jeub M, Schlapakow E, Ratz M, et al. Sonographic assessment of the optic nerve and the central retinal artery in idiopathic intracranial hypertension. J Clin Neurosci. 2020;72:292-297.
Kishk NA, Ebraheim AM, Ashour AS, Badr NM, Eshra MA. Optic nerve sonographic examination to predict raised intracranial pressure in idiopathic intracranial hypertension: the cut-off points. Neuroradiol J. 2018;31:490-495.
Knodel S, Roemer SN, Moslemani K, et al. Sonographic and ophthalmic assessment of optic nerve in patients with idiopathic intracranial hypertension: a longitudinal study. J Neurol Sci. 2021;430:118069.
Korsbaek JJ, Hagen SM, Schytz HW, et al. Transorbital sonography: a non-invasive bedside screening tool for detection of pseudotumor cerebri syndrome. Cephalalgia. 2022;42:1116-1123.
Patterson DF, Ho ML, Leavitt JA, et al. Comparison of ocular ultrasonography and magnetic resonance imaging for detection of increased intracranial pressure. Front Neurol. 2018;9:278.
Razek A, Elsaid N, Belal T, Batouty N, Azab A. Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension. Ultrasonography. 2022;41:106-113.
Lochner P, Fassbender K, Knodel S, et al. B-mode transorbital ultrasonography for the diagnosis of idiopathic intracranial hypertension: a systematic review and meta-analysis. Ultraschall Med. 2019;40:247-252.
Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2011;37:1059-1068.
Robba C, Santori G, Czosnyka M, et al. Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2018;44:1284-1294.
Koziarz A, Sne N, Kegel F, et al. Bedside optic nerve ultrasonography for diagnosing increased intracranial pressure: a systematic review and meta-analysis. Ann Intern Med. 2019;171:896-905.
Aletreby W, Alharthy A, Brindley PG, et al. Optic nerve sheath diameter ultrasound for raised intracranial pressure: a literature review and meta-analysis of its diagnostic accuracy. J Ultrasound Med. 2022;41:585-595.
Pansell J, Bell M, Rudberg P, Friman O, Cooray C. Optic nerve sheath diameter measurement by ultrasound: evaluation of a standardized protocol. J Neuroimaging. 2022;32:104-110.
Bloria SD, Bloria P, Luthra A. Is it the time to standardize the procedure of ultrasound guided optic nerve sheath diameter measurement? Saudi J Anaesth. 2019;13:255-256.
Chen H, Ding GS, Zhao YC, Yu RG, Zhou JX. Ultrasound measurement of optic nerve diameter and optic nerve sheath diameter in healthy Chinese adults. BMC Neurol. 2015;15:106.
Moss HE, Margolin EA, Lee AG, Van Stavern GP. Should lumbar puncture be required to diagnose every patient with idiopathic intracranial hypertension? J Neuroophthalmol. 2021;41:379-384.
Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology. 2002;59:1492-1495.