Observational studyJournal of neuroimaging : official journal of the American Society of Neuroimaging2023
Optic nerve sheath diameter in intracranial hypertension: Measurement external or internal of the dura mater?
Observational study in Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- B-mode transorbital ultrasonography for the diagnosis of idiopathic intracranial hypertension: an updated systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Pooled it
- Intraindividual Optic Nerve Sheath Variation and Intracranial Pressure Changes: A Systematic Review and Meta-Analysis.Journal of neuroimaging : official journal of the American Society of NeuroimagingPooled it
- 3D Imaging and Measurement of Optic Nerve Sheath Diameter.Translational vision science & technology · 2026Article
- Dynamic Changes in Optic Nerve Sheath Diameter on Computed Tomography Predict Decompressive Efficacy and Outcomes in Severe Traumatic Brain Injury.Life (Basel, Switzerland) · 2026Article
- Paediatric and adult neurological point-of-care ultrasound: Review of the evidence, and the UK accreditation pathway.Journal of the Intensive Care Society · 2026Article
- A prospective study of transorbital ultrasound multimodal imaging in the detection and evaluation of increased intracranial pressure.BMC medical imaging · 2025Article
- Accuracy of intracranial pressure assessment with a non-invasive transcranial doppler and arterial blood pressure method in patients with suspected idiopathic intracranial hypertension.The ultrasound journal · 2025Article
- Intracranial pressure estimated non-invasively and postoperative outcomes in surgery in the Trendelenburg position with pneumoperitoneum.Journal of anesthesia, analgesia and critical care · 2025Review
- The impact of demographics and positioning on the imaging features of the optic nerve sheath and ophthalmic vessels.The ultrasound journal · 2025Article
- The optic nerve sheath in hypertensive disorders of pregnancy and perinatal outcomes: a cohort study.BMC pregnancy and childbirth · 2024Article
- Sex differences in the diagnostic value of optic nerve sheath diameter for assessing intracranial pressure.Scientific reports · 2024Observational
- Optic nerve sheath diameter in intracranial hypertension: Measurement external or internal of the dura mater?Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2023Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeOptic nerve sheath diameter (ONSD) is a promising metric to estimate intracranial pressure (ICP). There is no consensus whether ONSD should be measured external (ONSDext) or internal (ONSDint) of the dura mater. Expert opinion favors ONSDint, though without clear evidence to support this. Adjustments of ONSD for eye diameter (ED) and optic nerve diameter (OND) have been suggested to improve precision. We examined the diagnostic accuracy of ONSDext and ONSDint for estimating ICP, unadjusted as well as adjusted for ED and OND.
methodsWe performed an observational cohort study, measuring ONSDext and ONSDint in patients with invasive ICP monitoring at Karolinska University Hospital in Stockholm, Sweden. We used ONSDext and ONSDint unadjusted as well as adjusted for ED and for OND. We compared the area under the receiver operator characteristics curve (AUROC) for these methods. Thresholds for elevated ICP were set at ≥20 and ≥22 mmHg, respectively.
resultsWe included 220 measurements from 100 patients. Median ONSDext and ONSDint were significantly different at 6.7 and 5.2 mm (p = .00). There was no significant difference in AUROC for predicting elevated ICP between ONSDext and ONSDint (.67 vs. .64, p = .31). Adjustment for ED yielded better diagnostic accuracy (AUROC, cutoff, sensitivity, specificity) for ONSDext/ED (.76, .29, .81, .62) and ONSDint/ED (.71, .24, .5, .89).
conclusionsONSDext and ONSDint differ significantly and are not interchangeable. However, there were no significant differences in diagnostic accuracy between ONSDext and ONSDint. Adjustment for ED may improve diagnostic accuracy of ONSD.
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