Background

To assess the validity of neurosonological parameters (transorbital sonography (TOS)) for detection and monitoring of patients with idiopathic intracranial hypertension (IIH).

Methods

Prospective, single-center, case-controlled study in 25 patients with IIH and 19 controls. Visual parameters of papilledema, visual acuity, computerized static threshold perimetry, fundus examination, and neurosonological parameters of papilledema/optic disc elevation (ODE), optic nerve sheath diameter (ONSD) and optic nerve diameter (OND) were recorded at baseline and only for patients with IIH again within 6 months.

Results

ONSD was significantly enlarged among individuals with IIH (6.2 ± 0.73 mm) compared to controls (4.99 ± 0.54 mm; p < 0.001). Bilateral ODE was found in 36/50 eyes in patients at their initial visit and in none of the controls. Re-evaluation 6 months later showed a significant reduction of ONSD (6.0 ± 0.7 mm; p = 0.024) and ODE (0.2 (0–1) mm; p ≤0.001). Best corrected visual acuity (BCVA) and square root of lost variance (sLV) remained stable. Headache intensity (Numeric rating scale, NRS) improved significantly p < 0.001. When compared to patients with first diagnosed IIH (n = 18), the subset of patients with preexisting IIH with acute relapse (n = 7) showed persistent but reduced levels of ICP increase. They also presented significant decrease of BVCA (p = 0.01) and mean defect (MD) (p = 0.012). Re-evaluation 6 months later showed significant change in ODE in both groups.

Conclusions

Our study confirmed that TOS and ophthalmological parameters are a valuable and non-invasive method to detect and monitor elevated ICP in IIH.

中文翻译：

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特发性颅内高压患者视神经的超声和眼科评估：一项纵向研究

背景

评估神经超声参数（经吸收超声（TOS））对特发性颅内高压（IIH）患者的检测和监测的有效性。

方法

在 25 名 IIH 患者和 19 名对照者中进行的前瞻性、单中心、病例对照研究。视乳头水肿的视觉参数、视力、计算机静态阈值视野、眼底检查和视神经乳头水肿/视盘抬高 (ODE)、视神经鞘直径 (ONSD) 和视神经直径 (OND) 的神经声学参数在基线时记录，仅用于6 个月内再次发生 IIH 的患者。

结果

与对照组 (4.99 ± 0.54 mm; p  < 0.001)相比，IIH (6.2 ± 0.73 mm) 个体的 ONSD 显着扩大。初次就诊时，患者 36/50 眼中发现双侧 ODE，对照组中均未发现。6 个月后的重新评估显示 ONSD (6.0 ± 0.7 mm; p  = 0.024) 和 ODE (0.2 (0–1) mm; p  ≤0.001)显着降低。最佳矫正视力 (BCVA) 和损失方差的平方根 (sLV) 保持稳定。头痛强度（数值评定量表，NRS）显着改善，p  < 0.001。与首次诊断为 IIH 的患者 ( n  = 18) 相比，预先存在的 IIH 急性复发患者 ( n = 7) 显示持续但降低的 ICP 增加水平。他们还表现出 BVCA ( p  = 0.01) 和平均缺陷 (MD) ( p  = 0.012) 的显着降低。6 个月后的重新评估显示两组的 ODE 发生显着变化。

结论

我们的研究证实，TOS 和眼科参数是检测和监测 IIH 中升高的 ICP 的一种有价值的非侵入性方法。