Observational studyBMJ paediatrics open2024
Optic nerve sheath diameter as a non-invasive tool to detect clinically relevant raised intracranial pressure in children: an observational analytical study.
Observational study in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Explosive Weapons Trauma Care Collective (EXTRACCT) Clinical Practice Guideline: Resuscitation of Pediatric Blast Injury Patient.World journal of surgery · 2026Guideline
- Paediatric and adult neurological point-of-care ultrasound: Review of the evidence, and the UK accreditation pathway.Journal of the Intensive Care Society · 2026Article
- Orbital Doppler Ultrasonography and Optic Nerve Sheath Diameter in Pediatric Brain Death Evaluation.Journal of clinical medicine · 2026Article
- Ophthalmologic assessment and intracranial pressure in children: diagnostic methods, clinical correlations, and future directions.Frontiers in pediatrics · 2026Review
- Optic nerve sheath diameter trajectories and mortality in children with clinically relevant elevated intracranial pressure.World journal of critical care medicine · 2025Article
- Cervical Oculopathy: The Cervical Spine Etiology of Visual Symptoms and Eye Diseases-A Hypothesis Exploring Mechanisms Linking the Neck and the Eye.Diagnostics (Basel, Switzerland) · 2025Article
- Evaluation of optic nerve sheath diameter in acute stroke: pre- and post-thrombolytic assessment.PeerJ · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRaised intracranial pressure (ICP) contributes to approximately 20% of the admissions in the paediatric intensive care unit (PICU) in our setting. Timely identification and treatment of raised ICP is important to prevent brain herniation and death in such cases. The objective of this study was to examine the role of optic nerve sheath diameter (ONSD) in detecting clinically relevant raised ICP in children.
methodsA hospital-based observational analytical study in a PICU of a tertiary care institute in India on children aged 2-14 years. ONSD was measured in all children on three time points that is, day 1, day 2 and between day 4 and 7 of admission. ONSD values were compared between children with and without clinical signs of raised ICP.
resultsOut of 137 paediatric patients recruited, 34 had signs of raised ICP. Mean ONSD on day 1 was higher in children with signs of raised ICP (4.99±0.57 vs 4.06±0.40; p<0.01). Mean ONSD on day 2 also was higher in raised ICP patients (4.94±0.55 vs 4.04±0.40; p<0.01). The third reading between days 4 and 7 of admission was less than the first 2 values but still higher in raised ICP patients (4.48±1.26 vs 3.99±0.57; p<0.001). The cut-off ONSD value for detecting raised ICP was 4.46 mm on the ROC curve with an area under curve 0.906 (95% CI 0.844 to 0.968), 85.3% sensitivity and 86.4% specificity. There was no difference in ONSD between the right and the left eyes at any time point irrespective of signs of raised ICP.
conclusionWe found that measurement of ONSD by transorbital ultrasound was able to detect clinically relevant raised ICP with an excellent discriminatory performance at the cut-off value of 4.46 mm.
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