Médecine

Paramédical

Autres domaines


Suscribirse

Effect of changes in optic nerve elasticity on central retinal artery blood flow in patients with idiopathic intracranial hypertension - 11/06/21

Doi : 10.1016/j.neurad.2021.06.001 
Nada Elsaid a, , Tamer Belal a, Nihal Batouty b, Ahmed Abdel Khalek Abdel Razek b, Ahmed Azab a
a Department of Neurology, Faculty of Medicine, Mansoura University, Egypt 
b Department of Radiology, Faculty of Medicine, Mansoura University, Egypt 

Corresponding author at: Lecturer of Neurology, Department of Neurology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.Lecturer of NeurologyDepartment of NeurologyFaculty of MedicineMansoura UniversityMansouraEgypt
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Friday 11 June 2021

Graphical abstract




El texto completo de este artículo está disponible en PDF.

Highlights

Optic nerve and disc edema are the hallmark of idiopathic intracranial hypertension.
Optic nerve ischemia is a common consequence.
The associated reduced optic nerve elasticity leads to further decrease in the blood flow.
Orbital color Doppler and shear wave elastography can serve as possible biomarkers.

El texto completo de este artículo está disponible en PDF.

Abstract

Purpose

To assess changes in central retinal artery (CRA) blood flow by orbital color-coded Doppler ultrasonography in patients with idiopathic intracranial hypertension (IIH) and their relation with optic nerve (ON) elasticity assessed by shear wave elastography (SWE).

Methods

This study was carried out on 68 eyes of patients diagnosed with IIH and 32 eyes of healthy controls. The severity of papilledema in IIH patients was sub-classified into mild and moderate/severe groups. Color-coded Doppler was used to measure peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (Vmean) and pulsatility index (PI) of the CRA.

Results

PSV, Vmean, and SWE were significantly higher in patients with IIH than in controls (p = 0.001). The optimal cut-off values of PSV and Vmean for differentiating IIH patients from controls were 11.25 and 6.75 cm/s with AUC 0.81 and 0.785 respectively. AUC was 0.92 and accuracy 91% for combined PSV, Vmean and SWE differentiation between IIH patients and controls. PSV, Vmean and SWE were significantly different between mild versus moderate/severe papilledema (p = 0.001). PSV and Vmean were correlated with papilledema (r = 0.790 and 0.722 respectively) and SWE (r = 0.818 and 0.761 respectively).

Conclusion

IIH is associated with decreased ON elasticity and reduced CRA blood flow. Individual and combined color-coded Doppler of the CRA and SWE help in diagnosis of IIH. CRA hemodynamic changes are correlated with papilledema severity and with the extent of biomechanical changes in the ON represented by SWE.

El texto completo de este artículo está disponible en PDF.

Abbreviations : CRA, CSF, EDV, IIH, ON, ONSD, OP, PI, PSV, ROI, SE, SWE, US, Vmean

Keywords : Ultrasound elastography, Idiopathic intracranial hypertension, Color-coded Doppler, Central retinal artery


Esquema


© 2021  Elsevier Masson SAS. Reservados todos los derechos.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

  • Contenido

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.

¿Ya suscrito a @@106933@@ revista ?

Mi cuenta


Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.