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Intraindividual optic nerve sheath variation and intracranial pressure changes: a systematic review and meta-analysis

2025-09-01Review article Open access
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dc.contributor.authorAzevedo, Henrique
dc.contributor.authorNeto, Lia Lucas
dc.contributor.authorBerhanu, David
dc.date.accessioned2025-09-22T09:41:47Z
dc.date.available2025-09-22T09:41:47Z
dc.date.issued2025-09-01
dc.description.abstractBackground and Purpose: To review the existing evidence on multiple timepoint assessments of optic nerve sheath diameter (ONSD) as an indicator of intraindividual variation of intracranial pressure (ICP). Methods: A systematic search identified studies assessing intraindividual variation in ICP through multiple timepoint measurements of ONSD using ultrasonography. Meta-analysis of studies assessing intraindividual correlation coefficients between ONSD and ICP was performed using a random effects model, and we calculated the weighted correlation coefficient for the expected change in ICP associated with variations in ONSD. Results: A total of five studies, comprising 157 patients, were included in the review. ONSD was compared with invasive ICP measurement methods at multiple timepoints. Meta-analysis of intraindividual ONSD–ICP correlation demonstrated a correlation coefficient of 0.62 (CI: 0.50–0.71). Individual linear correlation analyses were performed in two of the studies, yielding correlation coefficients ranging from 0.79 to 1.00; however, widely variable individual slopes were found (1.51–41.43 mm/mmHg). ONSD variations ranged from 0.12 to 3.30 mm per 5 mmHg change in ICP, with a variation of 0.55 mm in adults with hypoxic brain injury and 0.77 mm in children with idiopathic intracranial hypertension. Conclusions: Our findings indicate that ONSD significantly correlates with ICP, and longitudinal intraindividual assessment shows a predominantly linear correlation between both variables. A personalized ONSD–ICP correlation equation may enable accurate ICP prediction, making ONSD a useful tool for follow-up in patients with previous invasive ICP measurements, when adjusted to each patient's characteristics and pathologies.eng
dc.identifier.citationAzevedo, H., Neto, L. L., & Berhanu, D. (2025). Intraindividual optic nerve sheath variation and intracranial pressure changes: a systematic review and meta-analysis. Journal of Neuroimaging, 35(5), Article e70083. https://doi.org/10.1111/jon.70083
dc.identifier.doi10.1111/jon.70083
dc.identifier.eid105015054178
dc.identifier.issn1051-2284
dc.identifier.other2ecf6b37-263f-4449-8cfa-ed0ae281003c
dc.identifier.pmid40916062
dc.identifier.urihttp://hdl.handle.net/10400.14/55053
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectIntracranial pressure
dc.subjectOptic nerve sheath
dc.subjectOptic nerve sheath diameter
dc.subjectUltrasonography
dc.titleIntraindividual optic nerve sheath variation and intracranial pressure changes: a systematic review and meta-analysiseng
dc.typereview article
dspace.entity.typePublication
oaire.citation.issue5
oaire.citation.titleJournal of Neuroimaging
oaire.citation.volume35
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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