Yang Christopher D, Kim Christine K, Chang Melissa M, Khosravi Pooya, Bhatia Ajeet Pal Bayo, Santos Amanda Dos, Dornhofer Kyle, Guy Megan, Hsu Edmund, Saadat Soheil, Fox John Christian
Department of Emergency Medicine, University of California, Irvine, Orange, CA, USA.
School of Medicine, University of California, Irvine, Orange, CA, USA.
Clin Exp Emerg Med. 2025 Sep;12(3):188-197. doi: 10.15441/ceem.24.249. Epub 2024 Sep 6.
To evaluate the current body of literature pertaining to the use of ocular point-of-care ultrasound (POCUS) in the emergency department (ED).
A comprehensive literature search was conducted on Scopus, Web of Science, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Inclusion criteria were studies written in English and primary clinical studies involving ocular POCUS scans in an ED setting. Exclusion criteria were nonprimary studies (e.g., reviews or case reports), studies written in a non-English language, nonhuman studies, studies performed in a nonemergency setting, studies involving non-POCUS ocular ultrasound modalities, or studies published more than 10 years prior. Data extraction was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations.
The initial search yielded 391 results with 153 duplicates. Of the remaining 238 studies selected for retrieval and screening, 24 met the inclusion criteria. These 24 included studies encompassed 2,448 patients across prospective, retrospective, cross-sectional, and case series study designs. The majority of included studies focused on the use of POCUS in the ED to measure optic nerve sheath diameter as a proxy for papilledema and metabolic aberrations, while a minority of studies used ocular POCUS to assist in the diagnosis of orbital fractures or posterior segment pathology.
The vast majority of studies investigating the use of ocular POCUS in recent years emphasize its utility in measuring optic nerve sheath diameter and fluctuations in intracranial pressure, though additional outcomes of interest include pathology of the posterior segment, orbit, and globe.
评估目前有关急诊科使用眼部即时超声(POCUS)的文献。
在Scopus、科学网、MEDLINE和Cochrane对照试验中央注册库(CENTRAL)数据库中进行了全面的文献检索。纳入标准为用英文撰写的研究以及涉及急诊科眼部POCUS扫描的原发性临床研究。排除标准为非原发性研究(如综述或病例报告)、非英文撰写的研究、非人体研究、在非急诊环境中进行的研究、涉及非POCUS眼部超声模式的研究或发表超过10年的研究。数据提取以PRISMA(系统评价和Meta分析的首选报告项目)建议为指导。
初步检索产生了391条结果,其中153条重复。在其余238项选定进行检索和筛选的研究中,24项符合纳入标准。这24项纳入研究涵盖了前瞻性、回顾性、横断面和病例系列研究设计的2448例患者。大多数纳入研究聚焦于在急诊科使用POCUS测量视神经鞘直径以作为视乳头水肿和代谢异常的替代指标,而少数研究使用眼部POCUS协助诊断眼眶骨折或后段病变。
近年来,绝大多数研究眼部POCUS应用的研究强调了其在测量视神经鞘直径和颅内压波动方面的效用,不过其他感兴趣的结果还包括后段、眼眶和眼球的病变。