Linda D'Antona1,2, James A McHugh3, Federico Ricciardi4, Lewis W Thorne1, Manjit S Matharu2,5, Laurence D Watkins1,2, Ahmed K Toma1,2, Fion D Bremner2,3. 1. Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom. 2. UCL Queen Square Institute of Neurology, London, United Kingdom. 3. Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, United Kingdom. 4. Department of Statistical Science, University College London, London, United Kingdom. 5. Headache and Facial Pain Group, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Abstract
Importance: A convenient and reliable method for noninvasive intracranial pressure assessments is desirable to reduce the need for invasive procedures (eg, intracranial pressure monitoring and lumbar punctures) and allow clinicians to identify and treat patients with intracranial hypertension in a timely manner. Objective: To determine whether infrared video assessment of spontaneous retinal venous pulsation is associated with intracranial pressure and is a valid tool to indicate the presence or absence of raised intracranial pressure in patients without papilledema. Design, Setting, and Participants: A single-center prospective study was conducted at a tertiary referral center between January 2017 and May 2018. Patients consecutively admitted for clinically indicated elective 24-hour invasive intracranial pressure monitoring had ophthalmic review including infrared video recording of their spontaneous venous pulsation. Two neuro-ophthalmologists, who were masked to the intracranial pressure monitoring results, independently graded the spontaneous venous pulsation (grade 0 to 3). Analysis began in June 2018. Main Outcomes and Measures: The association between simultaneously recorded intracranial pressure and spontaneous venous pulsation (binary variable: present/absent) assessed through retinal infrared video recordings was evaluated using a multiple linear regression model. Results: Of 105 patients, the mean (SD) age was 39 (14) years, and 79 (75%) were women. The mean (SD) simultaneous intracranial pressure was 1 (5) mm Hg for 91 patients (86.7%) with spontaneous venous pulsations and 13 (14) mm Hg for 14 patients (13.3%) without spontaneous venous pulsations. A multiple linear regression model adjusted for 7 potential confounders confirmed a statistically significant association between intracranial pressure and spontaneous venous pulsation (β = -9.1; 95% CI, -13.7 to -4.6; P < .001; adjusted R2 = 0.42). Conclusions and Relevance: The absence of spontaneous venous pulsation on retinal infrared video recordings is significantly associated with higher levels of intracranial pressure and should raise the suspicion of intracranial hypertension.
Importance: A convenient and reliable method for noninvasive intracranial pressure assessments is desirable to reduce the need for invasive procedures (eg, intracranial pressure monitoring and lumbar punctures) and allow clinicians to identify and treat patients with intracranial hypertension in a timely manner. Objective: To determine whether infrared video assessment of spontaneous retinal venous pulsation is associated with intracranial pressure and is a valid tool to indicate the presence or absence of raised intracranial pressure in patients without papilledema. Design, Setting, and Participants: A single-center prospective study was conducted at a tertiary referral center between January 2017 and May 2018. Patients consecutively admitted for clinically indicated elective 24-hour invasive intracranial pressure monitoring had ophthalmic review including infrared video recording of their spontaneous venous pulsation. Two neuro-ophthalmologists, who were masked to the intracranial pressure monitoring results, independently graded the spontaneous venous pulsation (grade 0 to 3). Analysis began in June 2018. Main Outcomes and Measures: The association between simultaneously recorded intracranial pressure and spontaneous venous pulsation (binary variable: present/absent) assessed through retinal infrared video recordings was evaluated using a multiple linear regression model. Results: Of 105 patients, the mean (SD) age was 39 (14) years, and 79 (75%) were women. The mean (SD) simultaneous intracranial pressure was 1 (5) mm Hg for 91 patients (86.7%) with spontaneous venous pulsations and 13 (14) mm Hg for 14 patients (13.3%) without spontaneous venous pulsations. A multiple linear regression model adjusted for 7 potential confounders confirmed a statistically significant association between intracranial pressure and spontaneous venous pulsation (β = -9.1; 95% CI, -13.7 to -4.6; P < .001; adjusted R2 = 0.42). Conclusions and Relevance: The absence of spontaneous venous pulsation on retinal infrared video recordings is significantly associated with higher levels of intracranial pressure and should raise the suspicion of intracranial hypertension.
Authors: Ivana Labounková; René Labounek; Radim Kolář; Ralf P Tornow; Charles F Babbs; Collin M McClelland; Benjamin R Miller; Igor Nestrašil Journal: Commun Biol Date: 2022-06-14
Authors: Vivek Vijay; Susan P Mollan; James L Mitchell; Edward Bilton; Zerin Alimajstorovic; Keira A Markey; Anthony Fong; Jessica K Walker; Hannah S Lyons; Andreas Yiangou; Georgios Tsermoulas; Kristian Brock; Alexandra J Sinclair Journal: JAMA Ophthalmol Date: 2020-12-01 Impact factor: 7.389
Authors: Linda D'Antona; Hasan Asif; Claudia Louise Craven; James Alexander McHugh; Anna Vassiliou; Lewis Thorne; Manjit Singh Matharu; Laurence Dale Watkins; Fion Bremner; Ahmed Kassem Toma Journal: Neurology Date: 2021-04-13 Impact factor: 11.800