Department of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany.
Department of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada.
J Neuroimaging. 2020 Mar;30(2):165-174. doi: 10.1111/jon.12691. Epub 2020 Feb 5.
To date, normal values for optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) for transorbital sonography (TOS) have only been reported by individual small-scale studies, exposing a great variability in the measurement of the OND and ONSD.
We performed a systematic review and metanalysis of available to date studies on TOS evaluation of adults without elevated intracranial pressure to provide an overview of the published literature, measuring methods and further specify normal values for OND and ONSD.
In total, we included 39 studies with 2,927 healthy volunteers (mean age 36.1 years, 44.4% female), so that a total of 5,854 eyes were examined. All pooled analyses were based on random effect models. Mean values for OND were provided in 13 studies. Calculated mean pooled OND value was 3.08 mm (95% confidence interval [CI], 2.9-3.25), with low heterogeneity across studies (I = 12.7%). Thirty-four studies provided mean values for ONSD measurement. The pool of mean ONSD measurements was 4.78 mm (95% CI, 4.63-4.94), with evidence of substantial heterogeneity between estimates ONSD (I = 50.6%). There were no significant differences (P = .139) in the subsequent subgroup analysis for the different geographic continents. Also, no significant differences could be recorded for the effect of age (P = .824) or gender (P = .093).
TOS is a frequently described and widely used method. We provide reference values of OND and ONSD that are based on metanalytical analysis. Different measuring methods of ONSD result in higher heterogeneity. Subgroup analysis revealed no significant correlation between ONSD and age, gender, or geographic origin.
迄今为止，经眶超声(transorbital sonography，TOS)视神经直径(optic nerve diameter，OND)和视神经鞘直径(optic nerve sheath diameter，ONSD)的正常参考值仅由个别小规模研究报道，这导致 OND 和 ONSD 的测量值存在很大差异。
我们对目前尚无颅内压升高的成人 TOS 评估的可用研究进行了系统评价和荟萃分析，以提供该出版物文献的概述，包括测量方法，并进一步明确 OND 和 ONSD 的正常参考值。
共纳入 39 项研究，涉及 2927 名健康志愿者(平均年龄 36.1 岁，44.4%为女性)，共检查了 5854 只眼。所有汇总分析均基于随机效应模型。13 项研究提供了 OND 的平均值。计算得出的平均 pooled OND 值为 3.08mm(95%置信区间[CI]，2.9-3.25)，研究间异质性较低(I = 12.7%)。34 项研究提供了 ONSD 测量的平均值。平均 pooled ONSD 测量值为 4.78mm(95%CI，4.63-4.94)，各估计值间 ONSD 存在显著异质性(I = 50.6%)。不同地理区域的亚组分析差异无统计学意义(P =.139)。年龄(P =.824)或性别(P =.093)对亚组分析的影响也无显著差异。
TOS 是一种被广泛描述和应用的方法。我们提供了基于荟萃分析的 OND 和 ONSD 参考值。不同的 ONSD 测量方法导致更高的异质性。亚组分析显示，ONSD 与年龄、性别或地理来源之间无显著相关性。
