Search

10.3390/jcm12175607 2 Rosa N., De Bernardo M., Abbinante G., Vecchio G., Cione F., Capasso L. Optic Nerve Drusen Evaluation: A Comparison between Ultrasound and OCT. J. Clin. Optic Nerve Drusen Evaluation: A Comparison between Ultrasound and OCT. J. Clin. Graph: Figure 1 Optical coherence tomography (OCT): optic disc drusen (ODD), visible as hypo-reflective structures with a total or partial hyperreflective margin, as described by the ODD studies consortium. [Extracted from the article]

Ultrasonographic appraisal of the optic nerve sheath diameter has become popular in recent years as a useful diagnostic tool to detect intracranial pressure variations. Intracranial hypertension is a life-threatening disease with possible poor clinical outcomes and can be caused by a variety of neurological and non-neurological conditions. Considering the latter, increases in intracranial pressure have also been described during several surgical procedures. Ocular ultrasonography might be utilized to identify intracranial pressure increases by evaluating optic nerve sheath diameter variations. The aim of this review is to provide a wide overview on the use of the optic nerve ultrasound evaluation to detect intracranial pressure changes during surgical procedures, also discussing the pitfalls of the B-scan technique, the most widely used for such a purpose. PubMed medical database, Web of Science and Scopus were used to carry out this review. The present review showed that ocular ultrasonography could be considered a valuable diagnostic tool in the surgical setting to indirectly assess intracranial pressure. However, the use of the B-scan ultrasound should always be coupled with the standardized A-scan technique for a more accurate, precise and trustworthy ultrasound assessment. [ABSTRACT FROM AUTHOR]

This observational study compared optic coherence tomography (OCT) and B-scan in the detection of optic disc drusen. In total, 86 eyes of 50 patients with optic disc drusen (ODD) (36 bilateral) with a mean age of 34.68 ± 23.81 years, and 54 eyes of 27 patients with papilledema, with a mean age of 35.42 years ± 17.47, were examined. Patients with ODD, diagnosed with ultrasound, underwent spectral-domain OCT evaluation. With US, 28 ODD cases were classified as large (4 buried and 24 superficial), 58 were classified as point-like (6 buried, 49 superficial and 3 mixed). Then, all patients underwent OCT. OCT was able to detect the presence of ODD and/or peripapillary hyperreflective ovoid mass structure (PHOMS) in 69 eyes (p < 0.001). In particular, 7 eyes (8.14%) showed the presence of ODD alone, 25 eyes (29.07%) showed only PHOMS and 37 eyes (43.02%) showed ODD and PHOMS. In 17 eyes (19.77%) no ODD or PHOMS were detected. In the papilledema group, no ODD were observed with both US and OCT. OCT showed the presence of drusen or similar lesions in only 80.23% of the cases highlighted by the US scan, so it does not allow for certain ODD diagnoses, especially in the case of buried ODD. [ABSTRACT FROM AUTHOR]

Migration of intraocular silicone oil, used in the treatment of complicated retinal detachment, has been rarely described, but when it happens it can arise with a differential diagnosis with scleral buckling extrusion, tumor, dermoid, ocular cysticercosis, and abscess. The presence of silicone oil in the eye gives very ugly echographic pictures, but these kinds of pictures can be very useful in making a differential diagnosis in the above-mentioned cases. A 39-year-old white female complained of the presence of conjunctival hyperemia and tearing in the right eye (RE); her visual acuity was hand motion, and the intraocular pressure was 14 mmHg. In the upper nasal quadrant a dome shaped lesion was detected. Due to the lens opacities, the patient underwent an echographic examination, which revealed the presence of silicon oil both in the vitreous chamber and in a large subconjunctival space, corresponding to the lesion. This article in addition provides a possible explanation of such cystic formation and discusses the risk factors and the role of the echographic examination in such cases. [ABSTRACT FROM AUTHOR]

They compared the ONSD measurements provided by magnetic resonance imaging (MRI) with the ultrasound findings, also analyzing the relationship between these ultrasound measurements and intracranial pressure values directly measured through external ventricular drainage [[1]]. In conclusion, the authors' statement that ultrasound ONSD measurements "cannot be presumed to be related to simultaneous ICP values" [[1]] could be explained by the above-discussed B-scan limitations. [Extracted from the article]

1 Du J, Deng Y, Li H. Ratio of optic nerve sheath diameter to eyeball transverse diameter by ultrasound can predict intracranial hypertension in traumatic brain injury patients: a prospective study. 5 De Bernardo M, Vitiello L, Rosa N. Ocular ultrasound assessment to estimate the risk of increased intracranial pressure after traumatic brain injury in prehospital setting. [Extracted from the article]

We read with great interest the article published in a recent issue of I Critical Care Medicine i by Agrawal et al ([1]) that compared two ultrasound techniques to measure optic nerve sheath diameter (ONSD) in patients at risk for increased intracranial pressure. To the best of our knowledge, in case of intracranial hypertension, the ONSD increase is due to the increased presence of subarachnoidal fluid between the arachnoid and pia that surrounds the optic nerve. 5 De Bernardo M Rosa N. Transorbital sonography to evaluate optic nerve in hypertensive encephalopathy. [Extracted from the article]

In this Letter to the Editor we would like to comment the article by Das and colleagues, concerning the optic nerve sheath diameter evaluation with ultrasonography in children with acute liver failure. In particular, this letter highlights several limitations in the use of B scan for such a purpose and suggests a more precise assessment with the standardized A scan technique. [ABSTRACT FROM AUTHOR]

For their evaluation, the authors used the ultrasound B-scan technique, which has been employed for more than 50 years to diagnose several ocular and orbital diseases. 2 De Bernardo M, Rosa N. transorbital sonography to evaluate optic nerve in hypertensive encephalopathy. [Extracted from the article]

A review of the article "Sonography of the Optic Nerve Sheath Diameter" which speaks about raised intracranial pressure being detected by sonography and computed tomography.

We read with great interest the article published in a recent issue of I Critical Care Medicine i by Agrawal et al ([1]) dealing with the comparison of two ultrasound techniques to measure optic nerve sheath diameter (ONSD) in patients at risk for increased intracranial pressure. In their study, the authors used two different B scan measurement techniques, namely axial and coronal, to measure ONSD. For this reason, to overcome the aforementioned drawbacks, we would like to suggest to use Standardized A Scan technique, a blooming effect-free ultrasound method that displays easily noticeable high spikes from the interface between arachnoid and subarachnoidal fluid, making these measurements objective and exacter, giving more accurate and universal reference range values ([3]). [Extracted from the article]