Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist: An International Consensus Statement on Optic Nerve Sheath Diameter Imaging and Measurement

doi:10.1097/CCM.0000000000006345

. 2024 Oct 1;52(10):1543-1556.

doi: 10.1097/CCM.0000000000006345. Epub 2024 Jun 5.

Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist: An International Consensus Statement on Optic Nerve Sheath Diameter Imaging and Measurement

Mohammad I Hirzallah^{1

2}, Piergiorgio Lochner³, Muhammad Ubaid Hafeez⁴, Andrew G Lee^{5

6}, Christos Krogias⁷, Deepa Dongarwar⁸, Nicholas D Hartman⁹, Michael Ertl¹⁰, Chiara Robba^{11

12}, Branko Malojcic¹³, Jurgita Valaikiene¹⁴, Aarti Sarwal¹⁵, Ryan Hakimi^{16

17}, Felix Schlachetzki¹⁸; Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist (ONSD POCUS QCC) Expert Panelists

Affiliations

¹ Department of Neurology, Section of Neurocritical Care and Vascular Neurology, Baylor College of Medicine, Houston, TX.
² Center for Space Medicine, Baylor College of Medicine, Houston, TX.
³ Department of Neurology Saarland University, Homburg, Germany.
⁴ Department of Neurology, University of Texas Medical Branch at Galveston, Galveston, TX.
⁵ Department of Ophthalmology, Houston Methodist hospital, Houston, TX.
⁶ Department of Ophthalmology, Weill Cornell Medical College, New York, NY.
⁷ Department of Neurology, Evangelisches Krankenhaus Herne, Academic Teaching Hospital of the Ruhr University Bochum, Herne, Germany.
⁸ UT Health McGovern School of Medicine, Houston, TX.
⁹ Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
¹⁰ Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany.
¹¹ Department of Anesthesia and Intensive Care, IRCCS Policlinico San Martino, Genova, Italy.
¹² Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, University of Genoa, Italy.
¹³ Department of Neurology, University Hospital Center Zagreb, Zagreb School of Medicine, Zagreb, Croatia.
¹⁴ Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
¹⁵ Department of Neurology, Atrium Health Wake Forest Baptist, Winston-Salem, NC.
¹⁶ Department of Medicine (Neurology Division), University of South Carolina School of Medicine-Greenville, Greenville, SC.
¹⁷ American Society of Neuroimaging, Kimberly, WI.
¹⁸ Department of Neurology, University of Regensburg, Center for Vascular Neurology and Intensive Care, Regensburg, Germany.

PMID: 38836697
DOI: 10.1097/CCM.0000000000006345

Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist: An International Consensus Statement on Optic Nerve Sheath Diameter Imaging and Measurement

Mohammad I Hirzallah et al. Crit Care Med. 2024.

. 2024 Oct 1;52(10):1543-1556.

doi: 10.1097/CCM.0000000000006345. Epub 2024 Jun 5.

Authors

Affiliations

¹ Department of Neurology, Section of Neurocritical Care and Vascular Neurology, Baylor College of Medicine, Houston, TX.
² Center for Space Medicine, Baylor College of Medicine, Houston, TX.
³ Department of Neurology Saarland University, Homburg, Germany.
⁴ Department of Neurology, University of Texas Medical Branch at Galveston, Galveston, TX.
⁵ Department of Ophthalmology, Houston Methodist hospital, Houston, TX.
⁶ Department of Ophthalmology, Weill Cornell Medical College, New York, NY.
⁷ Department of Neurology, Evangelisches Krankenhaus Herne, Academic Teaching Hospital of the Ruhr University Bochum, Herne, Germany.
⁸ UT Health McGovern School of Medicine, Houston, TX.
⁹ Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
¹⁰ Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany.
¹¹ Department of Anesthesia and Intensive Care, IRCCS Policlinico San Martino, Genova, Italy.
¹² Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, University of Genoa, Italy.
¹³ Department of Neurology, University Hospital Center Zagreb, Zagreb School of Medicine, Zagreb, Croatia.
¹⁴ Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
¹⁵ Department of Neurology, Atrium Health Wake Forest Baptist, Winston-Salem, NC.
¹⁶ Department of Medicine (Neurology Division), University of South Carolina School of Medicine-Greenville, Greenville, SC.
¹⁷ American Society of Neuroimaging, Kimberly, WI.
¹⁸ Department of Neurology, University of Regensburg, Center for Vascular Neurology and Intensive Care, Regensburg, Germany.

PMID: 38836697
DOI: 10.1097/CCM.0000000000006345

Abstract

Objectives: To standardize optic nerve sheath diameter (ONSD) point-of-care ultrasonography (POCUS) and improve its research and clinical utility by developing the ONSD POCUS Quality Criteria Checklist (ONSD POCUS QCC).

Design: Three rounds of modified Delphi consensus process and three rounds of asynchronous discussions.

Setting: Online surveys and anonymous asynchronous discussion.

Subjects: Expert panelists were identified according to their expertise in ONSD research, publication records, education, and clinical use. A total of 52 panelists participated in the Delphi process.

Interventions: None.

Measurements and main results: Three Delphi rounds and three asynchronous discussion rounds generated consensus on quality criteria (QC). This started with 29 QC in addition to other QC proposed by expert panelists. The QC items were categorized into probe selection, safety, body position, imaging, measurement, and research considerations. At the conclusion of the study, 28 QC reached consensus to include in the final ONSD POCUS QCC. These QC were then reorganized, edited, and consolidated into 23 QC that were reviewed and approved by the panelists.

Conclusions: ONSD POCUS QCC standardizes ONSD ultrasound imaging and measurement based on international consensus. This can establish ONSD ultrasound in clinical research and improve its utility in clinical practice.

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Conflict of interest statement

Dr. Sarwal’s institution received a loan device from Butterfly and Image Monitoring (Viasonix); she received funding from Stimdia. Dr. Hakimi received funding from the American Academy of Neurology and the American Society of Neuroimaging; he disclosed that he is President-Elect American Society of Neuroimaging. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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References

1. Liu D, Kahn M: Measurement and relationship of subarachnoid pressure of the optic nerve to intracranial pressures in fresh cadavers. Am J Ophthalmol. 1993; 116:548–556
1. Geeraerts T, Launey Y, Martin L, et al.: Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med. 2007; 33:1704–1711
1. Soliman I, Johnson GGRJ, Gillman LM, et al.: New optic nerve sonography quality criteria in the diagnostic evaluation of traumatic brain injury. Crit Care Res Pract. 2018; 2018:3589762
1. Bhargava V, Tawfik D, Tan YJ, et al.: Ultrasonographic optic nerve sheath diameter measurement to detect intracranial hypertension in children with neurological injury: A systematic review. Pediatr Crit Care Med. 2020; 21:e858–e868
1. Fernando SM, Tran A, Cheng W, et al.: Diagnosis of elevated intracranial pressure in critically ill adults: Systematic review and meta-analysis. BMJ. 2019; 366:l4225

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[1] Liu D, Kahn M: Measurement and relationship of subarachnoid pressure of the optic nerve to intracranial pressures in fresh cadavers. Am J Ophthalmol. 1993; 116:548–556

[2] Liu D, Kahn M: Measurement and relationship of subarachnoid pressure of the optic nerve to intracranial pressures in fresh cadavers. Am J Ophthalmol. 1993; 116:548–556

[3] Geeraerts T, Launey Y, Martin L, et al.: Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med. 2007; 33:1704–1711

[4] Geeraerts T, Launey Y, Martin L, et al.: Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med. 2007; 33:1704–1711

[5] Soliman I, Johnson GGRJ, Gillman LM, et al.: New optic nerve sonography quality criteria in the diagnostic evaluation of traumatic brain injury. Crit Care Res Pract. 2018; 2018:3589762

[6] Soliman I, Johnson GGRJ, Gillman LM, et al.: New optic nerve sonography quality criteria in the diagnostic evaluation of traumatic brain injury. Crit Care Res Pract. 2018; 2018:3589762

[7] Bhargava V, Tawfik D, Tan YJ, et al.: Ultrasonographic optic nerve sheath diameter measurement to detect intracranial hypertension in children with neurological injury: A systematic review. Pediatr Crit Care Med. 2020; 21:e858–e868

[8] Bhargava V, Tawfik D, Tan YJ, et al.: Ultrasonographic optic nerve sheath diameter measurement to detect intracranial hypertension in children with neurological injury: A systematic review. Pediatr Crit Care Med. 2020; 21:e858–e868

[9] Fernando SM, Tran A, Cheng W, et al.: Diagnosis of elevated intracranial pressure in critically ill adults: Systematic review and meta-analysis. BMJ. 2019; 366:l4225

[10] Fernando SM, Tran A, Cheng W, et al.: Diagnosis of elevated intracranial pressure in critically ill adults: Systematic review and meta-analysis. BMJ. 2019; 366:l4225

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Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist: An International Consensus Statement on Optic Nerve Sheath Diameter Imaging and Measurement

Affiliations

Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist: An International Consensus Statement on Optic Nerve Sheath Diameter Imaging and Measurement

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