Determination of Normal Values of Optic Nerve Sheath Diameter in Turkish Adult Population Using Magnetic Resonance Imaging

Abstract

Abstract Title: Determination of Normal Values of Optic Nerve Sheath Diameter in Turkish Adult Population Using Magnetic Resonance Imaging Introduction: The measurement of optic nerve sheath diameter (ONSD) is a reliable tool for the estimation of increased intracranial pressure (ICP). However, it is known that racial changes can occur in human anatomy. In the present study we aimed to determine the normal values of ONSD in Turkish adult population. Methods: This retrospective study involved the collection of data between June 1, 2015 and May 31, 2019, and was conducted on 291 adults known to have no increased cranial/intraocular pressure. The ONSD was measured at 3 mm posterior to the globe on MR images. Results: 291 subjects were enrolled, 63.6% of whom were female. The total median ONSD was 4.40mm (4.20 - 4.70). The median ONSD of the male participants was 4.50mm (4.25-4.75), of the female participants was 4.35mm (4.15-4.50) and the difference was statistically significant (p = 0.001). According to statistical analysis, it was found that only the presence of chronic renal failure altered the median of ONSD among the comorbid diseases (p = 0.042). Conclusions: Monitoring and treating increased ICP is crucial. Thanks to an ONSD with a known normal value, recognition and emergency management of this pathology would be easier. We think our study is noteworthy because it is the first study investigating the normal ONSD value in Turkish adult population. Keywords: Optic nerve sheath diameter; Normal value; MRI; Turkish adult population.

Keywords

• Optic nerve sheath diameter
• Normal value
• MRI
• Turkish adult population

References

1. 1. Newman WD, Hollman AS, Dutton GN, Carachi R. Measurement of optic nerve sheath diameter by ultrasound: a means of detecting acute raised intracranial pressure in hydrocephalus. Br J Ophthalmol 2002; 86: 1109–13. DOI: 10.1136/bjo.86.10.1109.
2. 2. Dubourg J, Messerer M, Karakitsos D, Rajajee V, Antonsen E, Javouhey E, et al. Individual patient data systematic review and meta-analysis of optic nerve sheath diameter ultrasonography for detecting raised intracranial pressure: protocol of the ONSD research group. Syst Rev. 2013; 2: 62. DOI: 10.1186/2046-4053-2-62. PMID: 23919384; PMCID: PMC3751128.
3. 3. Fontanel L, Pensiero S, Ronfani L, Rosolen V, Barbi E. Optic Nerve Sheath Diameter Ultrasound: Optic Nerve Growth Curve and Its Application to Detect Intracranial Hypertension in Children. Am J Ophthalmol. 2019; 208: 421-8. DOI: 10.1016/j.ajo.2019.07.014. Epub 2019 Aug 1. PMID: 31377281.
4. 4. Maude RR, Hossain MA, Hassan MU, Osbourne S, Sayeed KL, Karim MR, et al. Transorbital sonographic evaluation of normal optic nerve sheath diameter in healthy volunteers in Bangladesh. PLoS One. 2013; 8(12): e81013. DOI: 10.1371/journal.pone.0081013. Erratum in: PLoS One. 2014; 9(1). DOI:10.1371/annotation/4e2f88bd-e836-4e0c-a3e0-f6062331702b. PMID: 24312515; PMCID: PMC3846670.
5. 5. Varma R, Tielsch JM, Quigley HA, Hilton SC, Katz J, Spaeth GL, Sommer A. Race, age, gender, and refractive error-related differences in the normal optic disc. Arch Ophthalmol. 1994; 112(8): 1068-76. DOI: 10.1001/archopht.1994.01090200074026.
6. 6. Dajiang Wang, Behzad Amoozgar, Travis Porco, Zhen Wang, Shan C. Lin. Ethnic differences in lens parameters measured by ocular biometry in a cataract surgery population. PLoS ONE 2017; 12(6): e0179836. DOI: 10.1371/journal.pone.0179836.
7. 7. Samarawickrama C, Wang JJ, Huynh SC, et al Ethnic differences in optic nerve head and retinal nerve fibre layer thickness parameters in children British Journal of Ophthalmology 2010;94: 871-6. DOI: 10.1136/bjo.2009.158279
8. 8. Roy Beck W, Messner DK, Musch DC, Martonyi CL, Lichter PR. Is There a Racial Difference in Physiologic Cup Size? 1985; 92(7): 873-6. DOI: 10.1016/S0161-6420(85)33942-8.

9. 9. Fansi AAK, Papamatheakis DG, Harasymowycz PJ. Racial variability of glaucoma risk factors between African Caribbeans and Caucasians in a Canadian urban screening population. Can J Ophthalmol. 2009 Oct;44(5):576-81. DOI: 10.3129/i09-130.
10. 10. Zangwill LM, Weinreb RN, Berry CC, Smith AR, Dirkes KA, Coleman AL, et al. Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study. Racial differences in optic disc topography: baseline results from the confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study. Arch Ophthalmol. 2004; 122(1): 22-8. DOI: 10.1001/archopht.122.1.22. PMID: 14718290.
11. 11. Girkin CA, McGwin G Jr, McNeal SF, DeLeon-Ortega J. Racial differences in the association between optic disc topography and early glaucoma. Invest Ophthalmol Vis Sci. 2003 Aug;44(8):3382-7. DOI: 10.1167/iovs.02-0792. PMID: 12882785.
12. 12. El-Dairi M, Holgado S, Asrani S, Freedman SF. Optical coherence tomography (OCT) measurements in black and white children with large cup-to-disc ratios. Experimental Eye Research 2011; 93(3): 299-307. DOI: 10.1016/j.exer.2011.05.004.
13. 13. Girkin CA, McGwin G Jr, Sinai MJ, Sekhar GC, Fingeret M, Wollstein G, Varma R, Greenfield D, Liebmann J, Araie M, Tomita G, Maeda N, Garway-Heath DF. Variation in optic nerve and macular structure with age and race with spectral-domain optical coherence tomography. Ophthalmology. 2011; 118(12): 2403-8. DOI: 10.1016/j.ophtha.2011.06.013. Epub 2011 Sep 9. PMID: 21907415.
14. 14. Wang LJ, Yao Y, Feng LS, Wang YZ, Zheng NN, Feng JC, et al. Noninvasive and quantitative intracranial pressure estimation using ultrasonographic measurement of optic nerve sheath diameter. Sci Rep. 2017; 7: 42063. DOI:10.1038/srep42063
15. 15. Raboel PH, Bartek J Jr, Andresen M, Bellander BM, Romner B. Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods-A Review. Crit Care Res Pract. 2012;2012:950393. DOI: 10.1155/2012/950393. Epub 2012 Jun 8. PMID: 22720148; PMCID: PMC3376474.
16. 16. Rajajee V, Vanaman M, Fletcher JJ, Jacobs TL. Optic nerve ultrasound for the detection of raised intracranial pressure. Neurocrit Care. 2011; 15(3): 506-15. DOI: 10.1007/s12028-011-9606-8. PMID: 21769456.
17. 17. Park JS, Cho Y, You Y, Min JH, Jeong W, Ahn HJ, et al. Optimal timing to measure optic nerve sheath diameter as a prognostic predictor in post-cardiac arrest patients treated with targeted temperature management. Resuscitation. 2019; 143: 173-9. DOI: 10.1016/j.resuscitation.2019.07.004. Epub 2019 Jul 12. PMID: 31306717.
18. 18. Patterson DF, Ho ML, Leavitt JA, Smischney NJ, Hocker SE, Wijdicks EF, et al. Comparison of Ocular Ultrasonography and Magnetic Resonance Imaging for Detection of Increased Intracranial Pressure. Front Neurol. 2018; 9: 278. DOI: 10.3389/fneur.2018.00278.