1887
Volume 2021, Issue 3
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

This retrospective study compares point-of-care ocular ultrasound to MRI in order to establish preliminary data for and identify challenges to a multicenter study into the utility of ocular ultrasound for diagnosing optic neuritis. Our ultrasound archive was queried to identify subjects suspected of having optic neuritis who underwent ocular ultrasound and MRI of the brain or orbit. Blinded ultrasounds were reviewed by ultrasound faculty. The presence of optic disc elevation, optic nerve, or sheath dilation, and overall impression were recorded and compared to MRI results. Sensitivity and specificity of each ultrasound finding and the overall impression, as well as agreement between the raters, were calculated. Sensitivity and specificity of ultrasound for MRI confirmed optic neuritis was 100 % (95 % CI 54.1-100) and 58.3 % (95 % CI 27.7-84.8). Optic nerve sheath diameter had nearly perfect agreement (κ = 0.8828), however agreement on optic disc elevation (κ = 0.5641), nerve diameter (κ = 0.2174), and overall agreement (κ = 0.1818) were moderate, fair, and poor, respectively. This preliminary study estimates test characteristics of ocular ultrasound for the diagnosis of optic neuritis for the purposes of power analysis and to identify potential pitfalls in preparation for a larger prospective investigation.

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2021-10-07
2021-10-26
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References

  1. Balcer LJ, . Optic neuritis. N Engl J Med 2006; 354:1273–80.
    [Google Scholar]
  2. Hickman S, Dalton C, Miller D, Plant G, . Management of acute optic neuritis. Lancet 2002; 360:1953–62.
    [Google Scholar]
  3. Milhelm H, Schabet M, . The diagnosis and treatment of optic neuritis. DtschArztebl Int 2015; 112:(37):616–26.
    [Google Scholar]
  4. Pau D, Zubidi N, Yalamanchili S, et al. Optic neuritis. Eye. 2011; 25:833–42.
    [Google Scholar]
  5. Lochner P, Cantello R, Brigo F, et al. Transorbital sonography in acute optic neuritis: a case-control study. Am J Neuroradiol. 2014; 25:2371–5.
    [Google Scholar]
  6. Kwon YJ, Kim YH, Baek SH, et al. Transorbital ultrasonography in acute optic neuritis: can it be a supportive diagnostic tool? Mult Scler Relat Disord. 2019 Jun;31:54–58.
    [Google Scholar]
  7. Smith D, Arthur J, Lewis Z, Snead G, . Ultrasound-assisted diagnosis of optic neuritis in the Emergency Department: a case report. J Emerg Med. 2019; 57:(2):212–5.
    [Google Scholar]
  8. Lochner P, Cantello R, Fassbender K, et al. Longitudinal assessment of transorbital sonography, visual acuity, and biomarkers for inflammation and axonal injury in optic neuritis. Disease Markers. 2017; 2017:1–5.
    [Google Scholar]
  9. Amini H, Vosoughi A, Ranjkesh M, Tarzamni MK, Farhoudi M, . Color doppler imaging evaluation of blood flow parameters in ophthalmic and posterior ciliary arteries and optic nerve diameter in chronic optic neuritis in multiple sclerosis patients. Multiple Sclerosis and Related Disorders. 2019; 27:195–9.
    [Google Scholar]
  10. Gerling J, Janknecht P, Hansen LL, Kommerell G, . Diameter of the optic nerve in idiopathic optic neuritis and in anterior ischemic optic neuropathy. International Ophthalmology. 1997; 21:(3):131–5.
    [Google Scholar]
  11. Elvin A, Andersson T, Söderström M. Optic neuritis. Acta Radiologica. 1998; 39:(3):243248.
    [Google Scholar]
  12. Dehghani A, Akhlaghi M, Salehi F, Giti M, Karami M, . Ultrasonography in distinguishing optic neuritis from nonarteritic anterior ischemic optic neuropathy. Advanced Biomedical Research. 2012; 1:(1):3.
    [Google Scholar]
  13. Karami M, Janghorbani M, Dehghani A, Riahinejad M, . Orbital doppler evaluation of blood flow velocities in optic neuritis. Korean Journal of Ophthalmology. 2012; 26:(2):116.
    [Google Scholar]
  14. Stefanovic I, Jovanovic M, Dacic-Krnjaja B, Veselinovic D, Jovanovic P. Influence of retrobulbar neuritis and papillitis on echographically measured optic nerve diameter. Vojnosanitetskipregled. 2010; 67:(1):32–5.
    [Google Scholar]
  15. Lochner P, Leone MA, Coppo L, et al. B-mode transorbital ultrasononography for the diagnosis of acute optic neuritis. A systematic review. Clinical Neurophysiology. 2016; 127:(1):803–9.
    [Google Scholar]
  16. Lochner P, Leone MA, Fassbender K, et al. Transorbital sonography and visual outcome for the diagnosis and monitoring of optic neuritis. Journal of Neuroimaging. 2016; 27:(1):92–6.
    [Google Scholar]
  17. Saz-Saucedo PD, Redondo-Gonzalez O, Mateu-Mateu A, Huertas-Arroyo R, Garcia-Ruiz R, Botia-Paniagua E. Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension. J Neurol Sci. 2016; 361:122–7.
    [Google Scholar]
  18. Helmke K, Hansen HC, . Fundamental of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension. Pediatr Radiol. 1996; 26:701–5.
    [Google Scholar]
  19. Bauerle J, Schuchardt F, Schroeder L, Egger K, Weigel M, Harloff A, . Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging. BMC Neurol. 2013; 13–187.
    [Google Scholar]
  20. Blaivas M, Theodoro D, Sierzenski PR, . Elevated intracranial pressure detected by bedside ultrasonography of the optic nerve sheath. Acad Emerg Med. 2003;10:376–81.
    [Google Scholar]
  21. Tayal VS, Neulander M, Norton HJ, Foster T, Saunders T, Blaivas M, . Emergency department sonographic measurement of optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann Emerg Med. 2007; 49:508–14.
    [Google Scholar]
  22. Amini A, Kariman H, Dolatabadi AA, et al. Use of the sonographic diameter of optic nerve sheath to estimate intracranial pressure. Am J Emerg Med. 2013; 31:236–9.
    [Google Scholar]
  23. Kimberly H, Shah S, Marill K, Nobel V, . Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med. 2008; 15:201–4.
    [Google Scholar]
  24. Hassen GW, Nazeer O, Manizate F, Patel N, Kalantari H, . The role of bedside ultrasound in pretherapeutic and posttherapeutic lumbar puncture in patients with idiopathic intracranial hypertension. Am J Emerg Med. 2014; 32:1298.
    [Google Scholar]
  25. Bäuerle J, Lochner P, Kaps M, Nedelmann M. Intra- and interobserver reliability of sonographic assessment of the optic nerve sheath diameter in healthy adults. Journal of Neuroimaging. 2010; 22:(1):42–5.
    [Google Scholar]
  26. Hassen GW, Bruck I, Donahue J, et al. Accuracy of optic nerve sheath diameter measurement by emergency physicians using bedside ultrasound. The Journal of Emergency Medicine. 2015; 48:(4):450–7.
    [Google Scholar]
  27. Oberfoell S, Murphy D, French A, Trent S, Richards D, . Inter-rater reliability of sonographic optic nerve sheath diameter measurements by Emergency Medicine Physicians. Journal of Ultrasound in Medicine. 2017; 36:(8):1579–84.
    [Google Scholar]
  28. De Bernardo M, Rosa N. Transbulbar B- mode sonography in multiple sclerosis: Clinical and biological relevance. Ultrasound in Medicine & Biology. 2018; 44:(2):508.
    [Google Scholar]
  29. Baad M, Lu ZF, Reiser I, Paushter D, . Clinical significance of US artifacts. RadioGraphics. 2017; 37:(5):1408–23.
    [Google Scholar]
  30. De Bernardo M, Vitiello L, Cornetta P, Rosa N. Ocular ultrasound evaluation of optic nerve sheath diameter in military environments. Military Medical Research. 2019; 6:(1).
    [Google Scholar]
  31. Terslev L, Diamantopoulos AP, Døhn UM, Schmidt WA, Torp-Pedersen S. Settings and artefacts relevant for doppler ultrasound in large vessel vasculitis. Arthritis Research & Therapy. 2017; 19(1).
    [Google Scholar]
  32. Teismann N, Lenaghan P, Nolan R, Stein J, Green A, . Point-of-care ocular ultrasound to detect optic disc swelling. Academic Emergency Medicine. 2013; 20:(9):920–5.
    [Google Scholar]
  33. Arthur J, Duran-Gehring P, Kumetz C, Chadwick S, Mcintosh M. Cerebral venous thrombosis: An uncommon cause of papilledema on bedside ocular ultrasound. The Journal of Emergency Medicine. 2019; 56:(3):288–93.
    [Google Scholar]
  34. Zhang J, Foroozan R, . Optic disc edema from papilledema. Int Ophthalmol Clin. 2014; 54:13–26.
    [Google Scholar]
  35. Lee M, McCafferty B, McClelland C, . The diagnostic challenge of evaluating papilledema in the pediatric patient. Taiwan J Ophthalmol. 2017;7:15–21.
    [Google Scholar]
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