Email this article 
Hide
Show all
Original Research
How accurate is ultrasound of the optic nerve sheath diameter performed by inexperienced operators to exclude raised intracranial pressure?
Submitted: 14 October 2014 | Published: 07 August 2015
About the author(s)
G. J. du Toit, Department of Clinical Imaging Sciences, University of the Free State, South AfricaD. Hurter, Department of Radiology, Kimberley Hospital Complex, Kimberley, South Africa, South Africa
M. Nel, Department of Biostatistics, University of the Free State, South Africa
Abstract
Method: A prospective analytical cross-sectional study was conducted. All patients ≥18 years of age who presented at our medical casualty and emergency departments with suspected meningitis were enrolled in the study. All patients were evaluated with the use of optic nerve sheath diameter ultrasound with or without computed tomography brain scan prior to lumbar puncture. Lumbar puncture opening pressure measurements were compared with the ultrasound measurements.
Results: A total of 73 patients were enrolled in the study, of whom 14 had raised intracranial pressure. The study had a sensitivity of 50% (95% confidence interval (CI) 26.8%–73.2%) and specificity of 89.8% (95% CI 79.5%–95.3%) with a positive predictive value of 54.8% (95% CI 29.1%–76.8%) and negative predictive value of 88.3% (95% CI 77.8%–94.2%). The likelihood ratio of a positive test was 4.92 (95% CI 1.95–11.89) and that of a negative test 0.56 (95% CI 0.29–0.83). Cohen’s kappa value was 0.41 which indicates a moderate agreement. The receiver operating characteristic (ROC) curve had an area under the curve (AUC) of 0.73 (95% CI 0.51–0.95).
Conclusion: Ultrasound measurement of the optic nerve sheath diameter can be used to exclude raised intracranial pressure, even in the hands of inexperienced operators.
Keywords
Metrics
Total abstract views: 5872Total article views: 9434
Crossref Citations
1. Optic nerve sheath diameters in nontraumatic brain injury: A scoping review and role in the intensive care unit
Madhura Bhide, Deven Juneja, Omender Singh, Shakya Mohanty
World Journal of Critical Care Medicine vol: 13 issue: 3 year: 2024
doi: 10.5492/wjccm.v13.i3.97205
2. Optic nerve sheath diameter and severity of central nervous infection
Anggun Puspita Dewi, Dzulfikar Djalil Lukmanul Hakim, Sri Endah Rahayuningsih, Nelly Amalia Risan, Reni Ghrahani, Riyadi Adrizain
Paediatrica Indonesiana vol: 63 issue: 5 first page: 411 year: 2023
doi: 10.14238/pi63.5.2023.411-7
3. Noninvasive intracranial pressure monitoring in central nervous system infections
Signe A. WOLTHERS, Cecilie P. ENGELHOLM, Bülent USLU, Christian T. BRANDT
Minerva Anestesiologica vol: 89 issue: 3 year: 2023
doi: 10.23736/S0375-9393.22.16863-X
4. Bedside Optic Nerve Ultrasonography for Diagnosing Increased Intracranial Pressure
Alex Koziarz, Niv Sne, Fraser Kegel, Siddharth Nath, Jetan H. Badhiwala, Farshad Nassiri, Alireza Mansouri, Kaiyun Yang, Qi Zhou, Timothy Rice, Samir Faidi, Edward Passos, Andrew Healey, Laura Banfield, Mark Mensour, Andrew W. Kirkpatrick, Aussama Nassar, Michael G. Fehlings, Gregory W.J. Hawryluk, Saleh A. Almenawer
Annals of Internal Medicine vol: 171 issue: 12 first page: 896 year: 2019
doi: 10.7326/M19-0812
5. The role of ultrasound methods in the assessment of biometric characteristics of the optic nerve
T. N. Kiseleva, A. V. Baeva, E. K. Eliseeva, V. V. Makukhina
Russian Ophthalmological Journal vol: 13 issue: 3 first page: 97 year: 2020
doi: 10.21516/2072-0076-2020-13-3-97-102
6. The relationship between computed tomography measurement of the optic nerve sheath diameter and elevated intracranial pressure in non-trauma patients
Daniël Luyt, Delmé Hurter, Gina Joubert
South African Journal of Radiology vol: 20 issue: 1 year: 2016
doi: 10.4102/sajr.v20i1.1060