Abstract
Background
Ultrasonographic measurements of the diameter of the sheath of the optic nerve can
be used to assess intracranial pressure indirectly. These measurements come with measurement
error.
Objective
Our aim was to estimate observer's measurement error as a determinant of ultrasonographic
measurement variability of the optic nerve sheath diameter.
Methods
A systematic search of the literature was conducted in Embase, Medline, Web of Science,
the Cochrane Central Register of Trials, and the first 200 articles of Google Scholar
up to April 19, 2021. Inclusion criteria were the following: healthy adults, B-mode
ultrasonography, and measurements 3 mm behind the retina. Studies were excluded if
standard error of measurement could not be calculated. Nine studies featuring 389
participants (median 40; range 15–100) and 22 observers (median 2; range 1–4) were
included. Standard error of measurement and minimal detectable differences were calculated
to quantify observer variability. Quality and risk of bias were assessed with the
Guidelines for Reporting Reliability and Agreement Studies.
Results
The standard error of measurement of the intra- and interobserver variability had
a range of 0.10–0.41 mm and 0.14–0.42 mm, respectively. Minimal detectable difference
of a single observer was 0.28–1.1 mm. Minimal detectable difference of multiple observers
(range 2–4) was 0.40–1.1 mm. Quality assessment showed room for methodological improvement
of included studies.
Conclusions
The standard errors of measurement and minimal detectable differences of ultrasonographic
measurements of the optic nerve sheath diameter found in this review with healthy
participants indicate caution should be urged when interpreting results acquired with
this measurement method in clinical context.
Keywords
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Article info
Publication history
Published online: April 29, 2022
Accepted:
April 23,
2022
Received in revised form:
March 13,
2022
Received:
December 1,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc.
