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Rivista di Oftalmologia
Minerva Oftalmologica 2017 March;59(1):1-6
Copyright © 2017 EDIZIONI MINERVA MEDICA
Diagnostic performance of ocular ultrasonography compared to fundoscopy to predict papilledema
Peyman NAMDAR 1 ✉, Shiva YOUSEFIAN 1, Zahra FARZANEH KHANSHIR 2, Mohammad A. ZOHAL 3, Amir M. KAZEMIFAR 3, Zahra TORABI GOODARZI 4
1 Department of Emergency Medicine, Metabolic Disease Research Center, Qazvin University of Medical Science, Booali Hospital, Qazvin, Iran; 2 Department of Psychiatry, Qazvin University of Medical Science, Qazvin, Iran; 3 Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; 4 Department of Clinical and Personality Psychology, Rasoul-e- Akram Hospital Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
BACKGROUND: The aim of this study was to determine the association between the diameters of optic nerve sheath assessed by ultrasonography, grading of papilledema in fundoscopy among patients suspected to raising intracranial pressure and determining the sensitivity and specificity of ultrasonography to detect optic nerve sheath dilatation.
METHODS: This prospective blinded cohort study was performed on 223 consecutive patients with clinical suspicion to optic papilledema. The patients were assessed using direct fundoscopy. The diameter of the optic nerve sheath was determined by ocular ultrasonography.
RESULTS: In fundoscopy, 46 patients were revealed to have papilledema in at least one of the two eyes. A significant correlation was found between diameter of optic nerve sheath and age in total population as well as in those without papilledema, but not in the group with papilledema. The mean diameter of optic nerve sheath in bilateral assessment was significantly higher in the group with papilledema. The association between the mean diameter of optic nerve sheath and grade of papilledema was strongly significant. The assessment of the area under ROC analysis showed that measuring diameter of optic nerve sheath could effectively discriminate papilledema from normal condition.
CONCLUSIONS: Ultrasonography can effectively discriminate papilledema from normal condition by measuring diameter of optic nerve sheath.
KEY WORDS: Ultrasonography - Papilledema - Intracranial hypertension - Optic nerve