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Review
. 2023 May 25;15(1):26.
doi: 10.1186/s13089-023-00324-7.

Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review

Ghadi Ghanem  1 , David Haase  2 , Agatha Brzezinski  2 , Rikke Ogawa  3 , Parsa Asachi  4 , Alan Chiem  2
Affiliations
Review

Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review

Ghadi Ghanem et al. Ultrasound J. .

Abstract

Background: Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-invasive, bedside tool to measure correlates of eICP. This systematic review seeks to explore the utility of ultrasound detected optic disc elevation (ODE) as an ultrasonographic finding of eICP and to study its sensitivity and specificity as a marker of eICP.

Methods: This systematic review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We systematically searched PubMed, EMBASE, and Cochrane Central for English articles published before April 2023; yielding 1,919 total citations. After eliminating duplicates, and screening the records, we identified 29 articles that addressed ultrasonographically detected ODE.

Results: The 29 articles included a total of 1249 adult and pediatric participants. In patients with papilledema, the mean ODE ranged between 0.6 mm and 1.2 mm. Proposed cutoff values for ODE ranged between 0.3 mm and 1 mm. The majority of studies reported a sensitivity between 70 and 90%, and specificity ranged from 69 to 100%, with a majority of studies reporting a specificity of 100%.

Conclusions: ODE and ultrasonographic characteristics of the optic disc may aid in differentiating papilledema from other conditions. Further research on ODE elevation and its correlation with other ultrasonographic signs is warranted as a means to increase the diagnostic accuracy of ultrasound in the setting of eICP.

Keywords: Elevated intracranial pressure; Intracranial pressure; ODE; Ocular ultrasound; Optic disc; Optic disc elevation; Papilledema; Point of care ultrasound; Pseudopapilledema.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Elevation of the optic disc, marked with a star on B scan ocular ultrasound
Fig. 2
Fig. 2
Flowchart of study selection for systematic review
Fig. 3
Fig. 3
Reported and calculated sensitivity of ultrasound detected optic disc elevation in detecting papilledema
Fig. 4
Fig. 4
Reported and calculated specificity of ultrasound detected optic disc elevation in detecting papilledema
See this image and copyright information in PMC

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