Optimal measurement distance for optic nerve sheath diameter in idiopathic intracranial hypertension via magnetic resonance imaging
Fahrettin Ege1
, Oğuzhan Özdemir2, Memet Aslanyavrusu3, Gamze Türk4, Gülhan Sarıçam5
1Department of Neurology, Yüksek İhtisas University, Ankara, Türkiye
2Department of Radiology, Yüksek İhtisas University, Ankara, Türkiye
3Department of Neurology, Kayseri City Hospital, Kayseri, Türkiye
4Department of Radiology, Kayseri City Hospital, Kayseri, Türkiye
5Department of Neurology, Pursaklar State Hospital, Ankara, Türkiye
Keywords: Cerebrospinal fluid opening pressure, idiopathic intracranial hypertension, magnetic resonance imaging, optic nerve sheath diameter, pseudotumor cerebri.
Abstract
Objectives: This study aimed to compare the optic nerve sheath diameter (ONSD) values measured using magnetic resonance imaging (MRI) from 3 mm, 7 mm, and 10 mm behind the orbital globe in patients who met the modified Dandy criteria for idiopathic intracranial hypertension (IIH) with those in a healthy control group.
Patients and methods: This retrospective study examined 88 optic nerves of 44 participants (33 females, 11 males; mean age: 37.3±13.6 years; range, 18 to 67 years) between June 2022 and December 2023. Of these, 21 were patients diagnosed with IIH and 23 were healthy controls. T2-weighted propeller sections were used in the measurements. The ONSD was measured from the optic nerves on both the right and left sides of the globe at 3-, 7-, and 10-mm distances.
Results: Based on receiver operating characteristic analysis findings, ONSD measurements of 3 mm and 7 mm in the right eye were remarkably significant, and 10-mm ONSD measurements were moderately significant in estimating IIH, with area under the curve (AUC) values of 0.889, 0.813 and 0.719, respectively. For the left eye, the 3-mm ONSD measurements displayed substantial results at a high level. In comparison, the 7- and 10-mm ONSD measurements yielded significant results at a moderate level when predicting IIH, with AUC values of 0.816, 0.794, and 0.738, respectively).
Conclusion: Optic nerve sheath diameter measurements were more sensitive to the disease in proximal segments. In the MRI assessment of IIH patients, measurements should predominantly be taken from proximal segments.
Cite this article as: Ege F, Özdemir O, Aslanyavrusu M, Türk G, Sarıçam G. Optimal measurement distance for optic nerve sheath diameter in idiopathic intracranial hypertension via magnetic resonance imaging. Turk J Neurol 2025;31(2):133-141. doi: 10.55697/tnd.2025.266.