title: Optic nerve sonography: A noninvasive means of detecting raised intracranial pressure in a resource-limited setting.
abstract: OBJECTIVE
  The aim was to assess the use of optic nerve sonography (ONS) as a quick, noninvasive diagnostic test tool for detecting raised the intracranial pressure (ICP).
  
  
  METHODS
  A prospective blinded observational study was conducted at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. The study population consisted of 160 adult patients referred to the radiology department for cranial computed tomography (CT) scan. There were 80 subjects and 80 controls. Optic nerve sheath diameter (ONSD) was measured by a radiologist using a 7.5 Megahertz ultrasound probe while cranial CT was reviewed by other radiologists blinded to the ONSD.
  
  
  RESULTS
  Sixty-nine subjects (86.3%) had intracranial space occupying lesions (SOL) with cranial CT confirmed features of increased ICP, mean binocular ONSD of 5.7 ± 0.59 mm while 11 (13.7%) had intracranial SOL without any cranial CT evidence of increased ICP, mean binocular ONSD of 4.8 ± 0.39 mm. The difference of mean ONSD of the two groups was statistically significant (P = 0.0001). The controls had a mean binocular ONSD of 4.5 ± 0.22 mm and the difference in mean binocular ONSD for subjects with raised ICP and the controls were also statistically significant (P = 0.0001). A cut-off value of 5.2 mm (sensitivity 81.2% [95% confidence interval (CI): 69.9-89.6], specificity 100% [95% CI: 71.5-100]) was obtained from the receiver operator characteristics curve as the mean binocular ONSD that best predicts raised ICP confirmed by at least a sign on cranial CT.
  
  
  CONCLUSIONS
  Optic nerve sonography can differentiate between normal and elevated ICP and may serve as a useful screening tool in resource-limited practice.
authors.affiliation: Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Olufunso Simisola
authors.initials: OS
authors.lastname: Aduayi
authors.affiliation: Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Christianah Mopelola
authors.initials: CM
authors.lastname: Asaleye
authors.affiliation: Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Victor Adebayo
authors.initials: VA
authors.lastname: Adetiloye
authors.affiliation: Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Edward Oluwole
authors.initials: EO
authors.lastname: Komolafe
authors.affiliation: Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Victor Adovi
authors.initials: VA
authors.lastname: Aduayi
keywords: Optic nerve sheath diameter; raised intracranial pressure; resource-limited settings; ultrasound