Faculty of Medicine, Cairo University, 15, 106 Street, Maadi, Cairo 11431, Egypt.
Faculty of Medicine, Cairo University, 15, 106 Street, Maadi, Cairo 11431, Egypt.
Mult Scler Relat Disord. 2020 May;40:101934. doi: 10.1016/j.msard.2020.101934. Epub 2020 Jan 15.
Optic neuritis (ON) is an inflammatory demyelinating condition that causes acute - usually monocular - visual loss. It is highly associated with multiple sclerosis (MS). In general, ON is a clinical diagnosis based upon the history and examination findings.
The aim was to assess the diagnostic accuracy of measuring optic nerve sheath diameter (ONSD) by ultrasound in acute optic neuritis.
This is a prospective observational study with matched controls carried out on 25 patients and 25 controls. All patients presented with first attack of an acute demyelinating ON. Both patients and controls were submitted to clinical assessment, pattern and flash visual evoked potential and trans-orbital sonography (TOS) to measure the optic nerve sheath diameter (ONSD).
The ONSD was significantly thicker in patients with unilateral (0.6 ± 0.05 cm) and bilateral (0.6 ± 0.1 cm) optic neuritis compared to controls (0.52 ± 0.06 cm). P-value was < 0.001 and 0.04 respectively, with a cutoff value 0.57 cm. A significant negative correlation was found between the thickness of the ONSD and the visual acuity (r= -0.613, P-value <0.05). No correlation was found between the age of the patients and ONSD or between ONSD and latency of P-VEP. TOS showed 68% sensitivity and 88% specificity in diagnosing cases of ON.
ONSD measured by TOS is a noninvasive, inexpensive bed-side test, which represent a supporting tool to confirm the clinical diagnosis of ON. Yet its sensitivity and specificity are lower than P-VEP.
评估超声测量急性视神经炎视神经鞘直径（ONSD）的诊断准确性。
这是一项前瞻性观察研究，对 25 例患者和 25 例对照进行了匹配。所有患者均表现为急性脱髓鞘性视神经炎首次发作。所有患者和对照均进行了临床评估、图形和闪光视觉诱发电位以及眶间超声（TOS）测量视神经鞘直径（ONSD）。
单侧（0.6±0.05cm）和双侧（0.6±0.1cm）视神经炎患者的 ONSD 明显较对照组（0.52±0.06cm）增厚。P 值分别<0.001 和 0.04，截断值为 0.57cm。OSND 的厚度与视力呈显著负相关（r=-0.613，P<0.05）。患者年龄与 ONSD 或 ONSD 与 P-VEP 潜伏期之间无相关性。TOS 在诊断 ON 病例时的敏感性为 68%，特异性为 88%。
TOS 测量的 ONSD 是一种非侵入性、价格低廉的床边检查，可作为辅助工具来确认 ON 的临床诊断。然而，其敏感性和特异性低于 P-VEP。
