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. 2024 Mar-Apr;27(2):146-151.
doi: 10.4103/aian.aian_1057_23. Epub 2024 Apr 27.

Characterization of Ocular Sonography Findings and their Relationship to Clinical Features from a South Indian Cohort of Idiopathic Intracranial Hypertension

K V Kishore  1 , Ameya Patwardhan  1 , H R Aravinda  2 , Veerendrakumar Mustare  1 , Subasree Ramakrishnan  1
Affiliations

Characterization of Ocular Sonography Findings and their Relationship to Clinical Features from a South Indian Cohort of Idiopathic Intracranial Hypertension

K V Kishore et al. Ann Indian Acad Neurol. 2024 Mar-Apr.

Abstract

Background: Idiopathic intracranial hypertension (IIH) typically manifests with headache, accompanied by papilledema and visual loss, and has a higher prevalence in females. In recent years, ocular sonography, particularly, measurement of optic nerve sheath diameter (ONSD), is being investigated for diagnosis of IIH.

Methods: A total of 35 patients over the age of 18 years, fulfilling the modified Dandy's criteria for diagnosis of IIH were included. Patients underwent assessment with magnetic resonance imaging, lumbar puncture, and ocular sonography to measure ONSD and ocular arterial indices.

Results: The mean ONSD values (in centimeters) in the right eye of patients with IIH was 0.57 ± 0.13, while it was 0.48 ± 0.03 in controls. In the left eye, the mean ONSD value (cm) was 0.59 ± 0.13 in patients with IIH and 0.48 ± 0.03 in controls. ONSD was significantly higher in cases compared to controls (P < 0.001, Welch test). Pulsatility index of the central retinal artery was significantly higher in cases compared to controls (P < 0.001, Welch test). Resistance index of the ophthalmic artery was statistically significant (P < 0.005, Welch test). Receiver operating characteristic curve analysis revealed a cutoff value of 5.1 mm on the right side and 5 mm on the left side had a sensitivity and specificity of more than 80% for IIH diagnosis.

Conclusion: Our study provides insights into the utility of optic nerve sheath measurements and arterial indices in the diagnosis of IIH in a South Indian cohort. Further research is needed to fully understand the longitudinal relationship of these parameters and treatment outcomes in IIH.

Keywords: Idiopathic intracranial hypertension; ONSD; ocular ultrasound.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
ONSD cut-off for IIH diagnosis. ONSD = optic nerve sheath diameter
Figure 2
Figure 2
ONSD values in cases and controls. ONSD = optic nerve sheath diameter, ROC = receiver operating characteristic
See this image and copyright information in PMC

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