ArticleEye (London, England)2025
Diagnostic accuracy of optic nerve OCT and ultrasound in a large paediatric cohort referred with suspected papilloedema and very low rates of raised ICP.
Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- A Spectral-Domain-OCT-Guided One-Year Follow-Up of Newly Diagnosed Pediatric Idiopathic Intracranial Hypertension Patients.Diagnostics (Basel, Switzerland) · 2026Article
- Comment on: "Diagnostic accuracy of optic nerve OCT and ultrasound in a large paediatric cohort referred with suspected papilloedema and very low rates of raised ICP".Eye (London, England) · 2025Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesThe Honey Rose trial increased referrals for suspected papilloedema. We audited such referrals from community optometrists and used long-term patient outcomes to investigate the diagnostic accuracy of OCT retinal nerve fibre layer (RNFL) thickness and B scan ultrasound optic nerve sheath diameter (ONSD) for raised intracranial pressure (rICP). SUBJECTS/
methodsAudit of 337 children seen in a 'blurry disc' clinic. Long-term outcomes (6-42 months) were used to classify children as with or without raised ICP. Receiver operating curves investigated diagnostic accuracy of RNFL and ONSD cut-off values. Regression modelling investigated potential predictive variables for rICP.
results310/337 children (92%) were discharged, 75 of whom were reviewed due to some clinical suspicion. 27/337 children (8%) were referred to other specialists, of whom 18 had rICP (16 IIH, one intra-cranial tumour, one arachnoid cyst). RNFL thickness cut-off >144 µm at 95% specificity had 83% sensitivity (95% CI 61-100%) and ONSD cut-off >4.99 mm at 90% specificity had 82% sensitivity (95% CI 50-100%) for rICP. Increased RNFL thickness, increased ONSD and presence of symptoms all contributed to prediction of rICP: acuity, age, sex and all other OCT parameters did not.
conclusions95% (319/337) of children referred with suspected papilloedema did not have raised ICP. Almost three-quarters of children referred (253/337, 70%) would have been more appropriately managed in community optometry. OCT RNFL and ONSD cut-offs show promising diagnostic accuracy for rICP in this study. There is a clear need to support community optometry to resume management of most children with suspected papilloedema.
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