Optic nerve sheath diameter in the prognosis of patients with traumatic optic neuropathy: Evaluation and predictive efficacy.

Journal: World neurosurgery
Published Date:

Abstract

The purpose of this study was to evaluate and predict visual prognosis in patients with traumatic optic neuropathy by measuring the optic nerve sheath diameter (ONSD). This study included patients diagnosed with traumatic optic neuropathy at a single center between September 1, 2023, and October 1, 2024. Data collection and ONSD measurements were performed before starting treatment. ONSD was measured at 3, 5, 10, and 15 mm (ONSD3, 5, 10, and 15, respectively) behind the globe using computed tomography scanning. The t-test, Mann-Whitney U test, and chi-squared test were used to compare the significance of each variable. Receiver operating characteristic curves and decision curve analysis were used to evaluate predictive efficacy. Of the 22 patients included, treatment was effective for 14 and ineffective for 8. ONSD3 (but not the other ONSD distances) was significantly lower in the effective-treatment group than in the ineffective-treatment group (p < 0.05). ONSD3 achieved the highest area under the curve (AUC, 0.893; 95% confidence interval [CI], 0.739-1.000) for predicting prognosis. Good visual recovery was more likely in patients with ONSD3 ≤5.07 mm (sensitivity, 100%; specificity, 85.7%). Initial visual acuity (VA) differed significantly between the two groups (p < 0.05). ONSD3 and initial VA in combination improved predictive efficacy (AUC, 0.929; 95% CI: 0.818-1.000). Based on our decision curve analysis results, considering both these variables could provide benefits to patients with traumatic optic neuropathy. ONSD3 thus represents a potentially important and novel index for evaluating and predicting visual prognosis in traumatic optic neuropathy.

Authors

  • Yuxin Luo
    The Laboratory of Artificial Intelligence and Big Data in Ophthalmology, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
  • Yuxing Jie
    Department of Otolaryngology, Second Affiliated Hospital of Shantou Medical University, Shantou, Guangdong, People's Republic of China.
  • Keying Wu
    Department of Otolaryngology, Second Affiliated Hospital of Shantou Medical University, Shantou, Guangdong, People's Republic of China.
  • Yiyang Tian
    Department of Otolaryngology, Second Affiliated Hospital of Shantou Medical University, Shantou, Guangdong, People's Republic of China.
  • Zehong Cai
    Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Shantou University Medical College, 69 North Dongxia Road, 515041, Shantou, Guangdong, China.
  • Ziping Huang
    Department of Otolaryngology, Second Affiliated Hospital of Shantou Medical University, Shantou, Guangdong, People's Republic of China.
  • Weidong Du
    The First Affiliated Hospital of Zhejiang, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Chinese Medical University, Hangzhou, 310006, China. doctordu20@163.com.
  • Weipiao Kang
    Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Shantou University Medical College, 69 North Dongxia Road, 515041, Shantou, Guangdong, China.
  • Yu Lin
    Research School of Computer Science, Australian National University, Canberra, 2601, ACT, Australia.

Keywords

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