Assessment of the diagnostic accuracy of optic nerve sheath diameter in Idiopathic Intracranial Hypertension Patients /
Sara Ahmed Rabiea,
Assessment of the diagnostic accuracy of optic nerve sheath diameter in Idiopathic Intracranial Hypertension Patients / تقييم دقة التشخيص لقطرغلاف العصب البصري في مرضى ارتفاع الضغط مجهول السبب داخل الجمجمة by Sara Ahmed Rabiea ; Supervisors Prof. Dr. Maha Mohamed Youssef, Prof. Dr. Shymaa Hassan Salah, Prof. Dr. Nirmeen Adel Kishk, Dr. Ola Zakaria El Sheikha. - 163 pages : illustrations ; 25 cm. + CD.
Thesis (Ph.D)-Cairo University, 2025.
Bibliography: pages 140-163.
Background: The optic nerve is surrounded by the extension of meningeal coverings of the brain. When the pressure in the cerebrospinal fluid increases, it causes a distention of the optic nerve sheath diameter (ONSD) leading to papilledema.
Purpose: Utility of orbital ultrasound (US) versus orbital magnetic resonant imaging (MRI) in diagnosis of patient with idiopathic intracranial hypertension (IIH) with different clinic radiological parameters (Grades of papilledema, Clinical parameters (age, Vision, duration, body mass index (BMI) and symptoms), Visual field changes, Hormonal therapy, Radiological signs of IIH and Optical coherence tomography (OCT) of nerve fiber layer (NFl).
Materials and methods: Observational (analytical cross sectional) study. Patients were subjected to: Magnetic resonance to detect optic nerve sheath diameter (ONSD) 3mm behind the globe, Ocular ultrasound to detect ONSD 3 mm behind the posterior edge of the globe in a horizontal plane, Visual field examinations with a Humphrey automated SITAStandard 30-2, OCT of nerve fiber layer, MRV and lumbar puncture to measure the intracranial pressure.
Results: There was a positive significant correlation between opening pressure and ONSD by US and insignificant correlation with MRI.The ideal cut-off value of ONSD by US that best differentiated IIH patients from controls was 5.65 mm with an area under the curve of 0.784 (95% confidence interval [CI] 0.671-0.896, p = 0.000, 75% sensitivity and 70% specificity).IIH cases had significantly higher RNFL thickness at the superonasal (SN) sector (151.6±53.4 vs 112.9±30.1; P=0.000), inferonasal (IN) sector (152±48.6 vs 118.3±28; P=0.002), as well as significantly higher average RNFL thickness (119.7±33.1vs 99.9±15.2; P=0.000) when compared to controls. They had significantly lower median deviation (MD), and significantly higher pattern standard deviation (PSD), as well as significantly higher incidence of enlargement of blind spot when compared to controls. They had significant higher incidence of scotomas in central, IN, Temporal, ST and SN areas than the control groups. The most affected sector in IIH cases were inferonasal (area 2) with 58.3% then inferotemporal (area 3) and temporal (area 4) with 55.6% then superonasal (area 6) with 52.8% then superotemporal (area 5) with 50.0%. ارتفاع الضغط مجهول السبب داخل الجمجمة هو اضطارب يصيب في المقام الأول الفتيات الصغي ارت اللاتي يعانين من السمنة، وقد هدفت الد ارسة الحالية إلى دارسة العلاقة بين ارتفاع الضغط مجهول السبب داخل الجمجمة مع اختلاف )العمر( و قياس قطرغلاف العصب البصري بواسطة كل من الموجات فو ق الصوتية، والتصوير بالرنين المغناطيسي ،ود ارسة العلاقة بين قطر غلاف العصب البصر ي المقاس بالموجات فو ق الصوتية مع معايير أخرى. لتحقيق هذا الهدف، ضمنت هذه الد ارسة ستة وثلاثون مريضًا ممن يعانون من ارتفاع الضغط مجهول السبب داخل الجمجمة وهؤلاء، هم الذين تم حجزهم في قسم طب العيون وقسم الأعصاب في مستشفيات جامعة القاهرة، وتمت مقارنتهم بـثلاثين فردًا أصحاء مطابقين للعمر والجنس كمجموعة تحكم .
Text in English and abstract in Arabic & English.
Optic Nerve Diseases
أمراض العصب البصري
optic nerve sheath Idiopathic Intracranial Hypertension
617.732
Assessment of the diagnostic accuracy of optic nerve sheath diameter in Idiopathic Intracranial Hypertension Patients / تقييم دقة التشخيص لقطرغلاف العصب البصري في مرضى ارتفاع الضغط مجهول السبب داخل الجمجمة by Sara Ahmed Rabiea ; Supervisors Prof. Dr. Maha Mohamed Youssef, Prof. Dr. Shymaa Hassan Salah, Prof. Dr. Nirmeen Adel Kishk, Dr. Ola Zakaria El Sheikha. - 163 pages : illustrations ; 25 cm. + CD.
Thesis (Ph.D)-Cairo University, 2025.
Bibliography: pages 140-163.
Background: The optic nerve is surrounded by the extension of meningeal coverings of the brain. When the pressure in the cerebrospinal fluid increases, it causes a distention of the optic nerve sheath diameter (ONSD) leading to papilledema.
Purpose: Utility of orbital ultrasound (US) versus orbital magnetic resonant imaging (MRI) in diagnosis of patient with idiopathic intracranial hypertension (IIH) with different clinic radiological parameters (Grades of papilledema, Clinical parameters (age, Vision, duration, body mass index (BMI) and symptoms), Visual field changes, Hormonal therapy, Radiological signs of IIH and Optical coherence tomography (OCT) of nerve fiber layer (NFl).
Materials and methods: Observational (analytical cross sectional) study. Patients were subjected to: Magnetic resonance to detect optic nerve sheath diameter (ONSD) 3mm behind the globe, Ocular ultrasound to detect ONSD 3 mm behind the posterior edge of the globe in a horizontal plane, Visual field examinations with a Humphrey automated SITAStandard 30-2, OCT of nerve fiber layer, MRV and lumbar puncture to measure the intracranial pressure.
Results: There was a positive significant correlation between opening pressure and ONSD by US and insignificant correlation with MRI.The ideal cut-off value of ONSD by US that best differentiated IIH patients from controls was 5.65 mm with an area under the curve of 0.784 (95% confidence interval [CI] 0.671-0.896, p = 0.000, 75% sensitivity and 70% specificity).IIH cases had significantly higher RNFL thickness at the superonasal (SN) sector (151.6±53.4 vs 112.9±30.1; P=0.000), inferonasal (IN) sector (152±48.6 vs 118.3±28; P=0.002), as well as significantly higher average RNFL thickness (119.7±33.1vs 99.9±15.2; P=0.000) when compared to controls. They had significantly lower median deviation (MD), and significantly higher pattern standard deviation (PSD), as well as significantly higher incidence of enlargement of blind spot when compared to controls. They had significant higher incidence of scotomas in central, IN, Temporal, ST and SN areas than the control groups. The most affected sector in IIH cases were inferonasal (area 2) with 58.3% then inferotemporal (area 3) and temporal (area 4) with 55.6% then superonasal (area 6) with 52.8% then superotemporal (area 5) with 50.0%. ارتفاع الضغط مجهول السبب داخل الجمجمة هو اضطارب يصيب في المقام الأول الفتيات الصغي ارت اللاتي يعانين من السمنة، وقد هدفت الد ارسة الحالية إلى دارسة العلاقة بين ارتفاع الضغط مجهول السبب داخل الجمجمة مع اختلاف )العمر( و قياس قطرغلاف العصب البصري بواسطة كل من الموجات فو ق الصوتية، والتصوير بالرنين المغناطيسي ،ود ارسة العلاقة بين قطر غلاف العصب البصر ي المقاس بالموجات فو ق الصوتية مع معايير أخرى. لتحقيق هذا الهدف، ضمنت هذه الد ارسة ستة وثلاثون مريضًا ممن يعانون من ارتفاع الضغط مجهول السبب داخل الجمجمة وهؤلاء، هم الذين تم حجزهم في قسم طب العيون وقسم الأعصاب في مستشفيات جامعة القاهرة، وتمت مقارنتهم بـثلاثين فردًا أصحاء مطابقين للعمر والجنس كمجموعة تحكم .
Text in English and abstract in Arabic & English.
Optic Nerve Diseases
أمراض العصب البصري
optic nerve sheath Idiopathic Intracranial Hypertension
617.732