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The efficacy of optic nerve ultrasonography for differentiating papilloedema from pseudopapilloedema in eyes with swollen optic discs.
MedLine Citation:
PMID:  21951833     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose:  To evaluate the diagnostic yield of optic nerve ultrasonography (US) in distinguishing between papilloedema (swollen discs owing to raised intracranial pressure) and pseudopapilloedema. Methods:  We prospectively evaluated all patients with bilateral optic disc swelling who underwent a complete neuro-ophthalmological examination. Suitable patients were referred for neuroimaging (computerized tomography or magnetic resonance imaging) and lumbar puncture. They underwent optic nerve US (A-mode and B-mode), and the findings were compared with the final clinical assessment. Sensitivity, specificity and predictive values for US distinction between true papilloedema and pseudopapilloedema were calculated and compared with those of the other imaging tests. Results:  Forty-four patients were enrolled. Ultrasonography detected papilloedema with a high degree of sensitivity (85%) when the normal optic nerve width (ONW) was set at ≤3.3 mm, and with an even higher degree of sensitivity (95%) when the normal ONW was set at ≤3.0 mm. Ultrasonography had a high negative predictive value for detecting papilloedema: 83% when the normal ONW was set at ≤3.3 mm and 93% when it was set at ≤3.0 mm. There was a significant correlation between the US findings and the final diagnosis (p < 0.001) when the upper limit of the normal ONW was set at 3.0 mm. Conclusions:  Ultrasonography findings of the ONW correlated well with the final diagnosis of papilloedema or pseudopapilloedema, especially when the upper limit of the normal ONW was set at 3.0 mm. Ultrasonography could be a useful non-invasive technique for differentiating papilloedema from other causes for swollen discs, such as pseudopapilloedema.
Authors:
Meira Neudorfer; Maytal S Ben-Haim; Igal Leibovitch; Anat Kesler
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-22
Journal Detail:
Title:  Acta ophthalmologica     Volume:  -     ISSN:  1755-3768     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468102     Medline TA:  Acta Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.
Affiliation:
Department of Ophthalmology, Tel Aviv-Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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