Sonographic evaluation of optic nerve diameter in children with raised intracranial pressure

Objective. The optic nerve is part of the central nervous system, and a rise in intracranial pressure (ICP) can directly affect the perioptic nerve space, leading to an increase in nerve diameter. Transorbital sonography is a safe and easy-to-perform method to measure optic nerve diameter for rapid diagnosis of increased ICP. Methods. The optic nerve diameter was measured in 3 individual occasions by transorbital sonography in the transverse view, 3 mm posterior to the papilla in both eyes, and the mean was calculated. Two groups were examined: a control group of children with normal ICP and normal ophthalmologic and optic nerve examination results and a case group with increased ICP as determined by an alternative method. Results. The sample consisted of 156 children, of which 78 (50%) were in the case group and 78 (50%) were in the control group. Eighty-four subjects (53.7%) were male, and 72 (46.1 %) were female. The mean ± SD ages were 6.9 ± 5.6 years in the case group and 6.8 ± 5.5 years in the control group. The mean optic nerve diameters were 5.6 ± 0.6 mm (range, 4.55 ± 0.7 to 7.6 ± 0.6 mm) in the case group and 3.3 ± 0.6 mm (range, 2 ± 0.6 to 4.35 ± 0.6 mm) in the control group. The difference in the means was significant at P < .001. Conclusions. Optic nerve diameter, measured by transorbital sonography, was significantly greater in pediatric patients with increased ICP compared with a control group. Transorbital sonography can be used to identify pediatric patients with raised ICP.