ABSTRACT

Background: The measurement of the optic nerve sheath diameter (ONSD) has been suggested to be used in the evaluation of intracranial pressure of several etiologies. However, its potential utility in the clinical evaluation of patients with idiopathic intracranial hypertension (IIH) needs to be clarified.

Methods: We recruited all the IIH patients who had been admitted to our neurology clinics and had a cranial MRI before lumbar puncture investigation. A control group of patients with migraine was also included. Studies were reviewed blindly by a radiologist, and ONSD and ONSD/ eyeball transverse diameter (ETD) for both eyes were measured.

Results: Ultimately, we have enrolled 50 patients with IIH and 53 migraineurs. The right ONSD values were higher in the IIH group (p = 0.024) whereas the values of ONSD/ETD were found to be both higher in the IIH group (right: p = 0.006, left: p = 0.043). The ROC curve demonstrated an area under the curve of 0.620 (95% CI = 0.508 to 0.731) for ONSD, and it was 0.642 for ONSD/ETD. Using a cut-off of 6.3 mm, ONSD had the following performance characteristics: sensitivity 18%, specificity 81%.

Conclusions: The ONSD and ONSD/ETD values may be utilizable in the evaluation processes of IIH patients; however, they do not solely reach sufficient discriminative accuracy. The potential significance of these parameters in rather monitoring the IIH patients may constitute a strictly crucial topic of interest for future research.

摘要

背景：已建议将视神经鞘直径 (ONSD) 的测量用于评估几种病因的颅内压。然而，它在特发性颅内高压（IIH）患者临床评估中的潜在效用需要澄清。

方法：我们招募了所有在我们的神经科门诊就诊并在腰椎穿刺检查前进行了头颅 MRI 的 IIH 患者。还包括一组偏头痛患者。放射科医生对研究进行了盲审，并测量了双眼的 ONSD 和 ONSD/眼球横向直径 (ETD)。

结果：最终，我们招募了 50 名 IIH 患者和 53 名偏头痛患者。IIH 组的右侧 ONSD 值较高（p = 0.024），而 IIH 组的 ONSD/ETD 值均较高（右：p = 0.006，左：p = 0.043）。ROC 曲线显示 ONSD 的曲线下面积为 0.620（95% CI = 0.508 至 0.731），ONSD/ETD 为 0.642。使用 6.3 mm 的截止值，ONSD 具有以下性能特征：灵敏度 18%，特异性 81%。

结论： ONSD和ONSD/ETD值可用于IIH患者的评估过程；然而，它们并不能仅仅达到足够的判别精度。这些参数在监测 IIH 患者中的潜在意义可能构成未来研究的一个严格关键的主题。