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Dağdelen K, Dirican E. Optic nerve sheath diameter and axial length in patients with optic disc drusen: a cross-sectional study. Int Ophthalmol 2023; 43:2109-2117. [PMID: 36871114 DOI: 10.1007/s10792-023-02654-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 02/19/2023] [Indexed: 03/06/2023]
Abstract
AIM Measuring the optic nerve sheath diameter (ONSD) and the anteroposterior axial length of the eye in patients with optic disc drusen (ODD). METHODS A total of 43 healthy volunteers and 41 patients with ODD were included in the study. The ONSD and axial length were measured in the posterior position using an ultrasound device (E-Z Scan AB5500 +) probe with a 10 MHz frequency. The ONSD was measured 3 mm behind the globe wall. Receiver operating characteristic (ROC) curve analysis was performed to determine patients with ODD using ONSD. Any p-value of < 0.05 was accepted to demonstrate significance. RESULTS The ONSD was significantly higher (5.2 mm and 4.8 mm, p = 0.006, respectively), and the axial length was shorter (21.82 ± 2.15 mm and 23.27 ± 1.96 mm, p = 0.002, respectively) in the ODD group. The spherical equivalent was more commonly seen as hypermetropic in the ODD group (1.00 [- 0.85 to 1.75]). In the ROC analysis to determine the ONSD value in ODD diagnosis, the area under the curve was 0.6754 (95% confidence interval 0.559-0.788, p = 0.006). ONSD cutoff of 5.70 mm had a sensitivity of 0.366 and a specificity of 0.907 to diagnose ODD. CONCLUSION In this study, the ONSD was significantly higher in the ODD group. The axial length was shorter in the ODD group. This study is the first in the literature to evaluate the ONSD in patients with optic disc drusen. Further studies are needed in this regard.
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Affiliation(s)
- Kenan Dağdelen
- Department of Ophthalmology, Beytepe Şehit Murat Erdi Eker State Hospital, Ahlatlıbel Mh. 1746 Sk., 06800, Beytepe, Çankaya, Ankara, Turkey.
| | - Emrah Dirican
- Department of Ophthalmology, Konya City Hospital, Konya, Turkey
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Tagliani S, Malaventura C, Ceccato C, Parmeggiani F, Suppiej A. Leber Mitochondrial Optic Neuropathy in Pediatric Females With Focus on Very Early Onset Cases. J Child Neurol 2023; 38:5-15. [PMID: 36659874 DOI: 10.1177/08830738221149962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The aim of this study was to describe the phenotype of Leber hereditary optic neuropathy occurring in pediatric females. This disease generally affects young adult males, but it can occur also in females, and research data in this population is lacking. The very early onset can challenge the diagnosis and delay treatment. We searched PubMed through February 2021 and identified 226 pediatric females with genetically confirmed Leber hereditary optic neuropathy and added a new case of a 3-year-old female. The male-female ratio was 1.8:1; the mean onset age in females was 11 years with the onset at 3 years of age occurring in 3 females only. Acute onset with mild visual impairment was the most common presentation, associated with optic disc edema in 16%. Differential diagnoses are pseudotumor cerebri, optic nerve drusen and optic neuritis. The outcome is poor with partial recovery in 50%, despite some receiving Idebenone therapy.
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Affiliation(s)
- Sara Tagliani
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy
| | - Cristina Malaventura
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy
| | | | - Francesco Parmeggiani
- Department of Translational Medicine and for Romagna, 9299University of Ferrara, Ferrara, Italy.,ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, 196013Camposampiero Hospital, Padova, Italy
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University Hospital of Ferrara, Ferrara, Italy.,87812Robert Hollman Foundation, Padova, Italy.,ERN-EYE Network - Center for Retinitis Pigmentosa of Veneto Region, 196013Camposampiero Hospital, Padova, Italy
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Türay S, Kabakuş N, Hancı F, Ulaş F, Dilek M, Cihan B. The role of clinical signs in the diagnosis of papilledema: development of an algorithm. Childs Nerv Syst 2021; 37:599-605. [PMID: 32839852 DOI: 10.1007/s00381-020-04869-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/20/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was not only to emphasize the role of clinical signs as well as ophthalmologic evaluation for accurate and differential diagnosis of papilledema (PE), but also to present an instructive algorithm that would help to eliminate unnecessary examinations and treatments. METHOD The files of 43 patients (ages 0-18) diagnosed with PE were retrospectively reviewed. The study included 25 patients from our pediatric neurology outpatient clinic, who were thought to have PE, and 18 patients, who were referred from the external centers to our hospital with a pre-diagnosis of PE. RESULTS Of the 43 patients, 28 had PE, 8 had pseudopapilledema (PPE), and 7 had optic nerve pathologies (ONP). For patients who applied directly to our pediatric neurology unit, a margin of error of 8% was detected based on only a simple ophthalmologic examination and an evaluation of clinical findings. For the patients who were forwarded to our pediatric neurology unit from the external centers without examining any clinical findings and with no details, the margin of error was 72%. CONCLUSION For patients with suspected PE, advanced ophthalmologic opinion is a necessary requirement before invasive radiological examinations are used. When the ophthalmologic evaluation is properly elaborated, the distinction can be made more clearly by using noninvasive methods. In order to determine the gold standard in terms of the methods used in the evaluation of patients who are not clinically diagnosed, new prospective studies with more patients should be planned.
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Affiliation(s)
- Sevim Türay
- Department of Pediatric Neurology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
| | - Nimet Kabakuş
- Department of Pediatric Neurology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Fatma Hancı
- Department of Pediatric Neurology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Fatih Ulaş
- Department of Ophthalmology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Mustafa Dilek
- Department of Pediatrics, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Büşra Cihan
- Department of Pediatrics, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
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Lecler A, Gillard P. Re: Chang et al.: Accuracy of diagnostic imaging modalities for classifying pediatric eyes as papilledema versus pseudopapilledema ( Ophthalmology . 2017;124:1839-1848). Ophthalmology 2018; 125:e23. [DOI: 10.1016/j.ophtha.2017.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 09/13/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022] Open
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Chang MY, Velez FG, Demer JL, Bonelli L, Quiros PA, Arnold AC, Sadun AA, Pineles SL. Reply. Ophthalmology 2018; 125:e24. [PMID: 29458839 DOI: 10.1016/j.ophtha.2017.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
- Melinda Y Chang
- Department of Ophthalmology, University of California, Los Angeles, California; Stein Eye Institute, University of California, Los Angeles, California; Doheny Eye Institute, University of California, Los Angeles, California
| | - Federico G Velez
- Department of Ophthalmology, University of California, Los Angeles, California; Stein Eye Institute, University of California, Los Angeles, California; Doheny Eye Institute, University of California, Los Angeles, California; Olive View-UCLA Medical Center, University of California, Los Angeles, California
| | - Joseph L Demer
- Department of Ophthalmology, University of California, Los Angeles, California; Stein Eye Institute, University of California, Los Angeles, California; Department of Neurology, University of California, Los Angeles, California; Department of Neuroscience, University of California, Los Angeles, California; Bioengineering Interdepartmental Programs, University of California, Los Angeles, California
| | - Laura Bonelli
- Department of Ophthalmology, University of California, Los Angeles, California; Stein Eye Institute, University of California, Los Angeles, California
| | - Peter A Quiros
- Department of Ophthalmology, University of California, Los Angeles, California; Doheny Eye Institute, University of California, Los Angeles, California
| | - Anthony C Arnold
- Department of Ophthalmology, University of California, Los Angeles, California; Stein Eye Institute, University of California, Los Angeles, California
| | - Alfredo A Sadun
- Department of Ophthalmology, University of California, Los Angeles, California; Doheny Eye Institute, University of California, Los Angeles, California
| | - Stacy L Pineles
- Department of Ophthalmology, University of California, Los Angeles, California; Stein Eye Institute, University of California, Los Angeles, California.
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