The ratio of optic nerve sheath diameter to eyeball transverse diameter measured by ultrasound and CT for the diagnosis of increased intracranial pressure:Meta analysis
Zheng Xi
Liu Yichen
Zhang Zhuo
Liu Xiaoyu
Di Baoshan
Abstract：Objective To evaluate the accuracy and optimal threshold of the ratio of optic nerve sheath diameter (ONSD ) to eyeball transverse diameter (ETD ) measured by ultrasound and CT in diagnosing increased intracranial pressure (ICP)by Meta analysis.Methods Literatures on ONSD/ETD for evaluating increased ICP was retrieved from Wanfang Medical Database,VIP databases,CNKI,SinoMed,PubMed,Web of Science and Embase from inception to March 15,2024.Two independent authors extracted relevant data and assessed the bias of literature quality by using the QUADAS-2 tool,and a random effects model was employed to calculate pooled sensitivity,specificity and diagnostic odds ratios.Data analysis was conducted by using Stata 17.0 and Revman 5.4.1 for assessing the accuracy of optimal threshold of the ONSD/ETD in diagnosing increased ICP.Results Eleven studies encompassing 807 patients were included.The pooled sensitivity and specificity of ultrasound ONSD/ETD for diagnosing increased ICP were 0.89 (95％CI 0.85-0.92) and 0.82 (95％CI 0.74-0.87) with positive and negative likelihood ratios of 4.8 (95％CI 3.4-6.8) and 0.14 (95％CI 0.10-0.18),respectively.The diagnostic odds ratio was 35 (95％CI 21-60),and the area under the curve (AUC) for the summary receiver operating characteristic (SROC) was 0.90 (95％CI 0.87-0.93).The optimal threshold was 0.248 mm.For ONSD/ETD by CT measurements,the pooled sensitivity and specificity were 0.77 (95％CI 0.66-0.85) and 0.78 (95％CI 0.66-0.86) with positive and negative likelihood ratios of 3.5 (95％CI 2.1-5.8) and 0.29 (95％CI 0.19-0.46).The diagnostic odds ratio was 12 (95％CI 5-29) and the AUC was 0.84 (95％CI 0.81-0.87) with the optimal threshold of 0.250 mm.Conclusions Ultrasound measurement of the ONSD/ETD ratio is more accurate than CT measurement of the ONSD/ETD ratio for diagnosing increased ICP,offering a safer,more convenient,and bedside-operable option,and the optimal threshold was 0.248 mm.However,due to the relatively small number of included studies and the differences in the causes of increased ICP among the patients in these studies,there may be some impact on the universality and reliability of the research results.
Keywords：Optic nerve sheath diameterEyeball transverse diameterUltrasoundIntracranial pressureMeta analysis
Publication Date：2024-12-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 1047-1055 )