scholarly journals Measurement of corneal thickness, optic nerve sheath diameter and retinal nerve fiber layer as potential new non-invasive methods in assessing a risk of cerebral edema in type 1 diabetes in children

2018 ◽  
Vol 55 (12) ◽  
pp. 1295-1301 ◽  
Author(s):  
Krzysztof Jeziorny ◽  
Anna Niwald ◽  
Agnieszka Moll ◽  
Katarzyna Piasecka ◽  
Aleksandra Pyziak-Skupien ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Optic Nerve ◽  
Corneal Thickness ◽  
Optic Nerve Sheath Diameter ◽  
Study Group ◽  
Newly Diagnosed ◽  
Fiber Layer ◽  
Non Invasive ◽  
Nerve Sheath

Abstract Aims Some patients with diabetic ketoacidosis develop cerebral edema (CE) in the course of type 1 diabetes mellitus (T1D), which may result in central nervous system disorders and high mortality. The imperfection of existing neuroimaging techniques for early recognition of CE forces us to search for the new and non-invasive methods. The aim of the study was to assess the usefulness of new methods (pachymetry, transorbital ultrasonography—USG, optical coherence tomography—OCT study) in the assessment of the risk of CE occurrence in children with newly diagnosed T1D. Methods The study group included 50 children with newly diagnosed T1D, 54 patients with long-term T1D as a reference group and 40 children without glucose tolerance disorders as controls. In all subjects, a corneal thickness (CCT) index with pachymeter, optic nerve sheath diameter (ONSD) using transorbital USG and retinal nerve fiber layer (RNFL) during OCT study were measured and compared with selected clinical parameters of T1D. Results In patients from a study group at onset of T1D, the higher CCT (p < 0.001) and ONSD (p < 0.001) values were observed as compared to the results obtained after 48 h of metabolic compensation. The ONSD correlated negatively with pH value (r = − 0.64; p < 0.001), BE (r = − 0.54, p < 0.001) and HCO3− (r = − 0.50; p < 0.001). A positive correlation between RNFL and Na+ levels (r = 0.47; p < 0.005) was also observed. Conclusions Transorbital USG and pachymetry may serve as the potential promising methods for the non-invasive assessment of the increased risk of development of CE in patients with T1D.

Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? – case report and literature review

2020 ◽  
Vol 33 (2) ◽  
pp. 319-322
Author(s):  
Krzysztof Jeziorny ◽  
Arleta Waszczykowska ◽  
Dobromiła Barańska ◽  
Agnieszka Szadkowska ◽  
Wojciech Młynarski ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cerebral Edema ◽  
Diagnostic Methods ◽  
Newly Diagnosed ◽  
Cns Disorders ◽  
Case Presentation ◽  
Non Invasive ◽  
Appropriate Treatment ◽  
Life Threatening

AbstractBackgroundCerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient.Case presentationWe present the case of a 11-year-old boy with severe DKA in the course of newly diagnosed type 1 diabetes (T1D). The delay in the diagnosis of DKA and some therapeutic problems contributed to the development of CE and direct life-threatening conditions. Early diagnosis of CE development in the course of DKA using non-invasive methods such as pachymetry or transorbital ultrasound seems to be a very important prognostic factor.ConclusionsThis case highlights the importance of appropriate treatment according to the newest recommendations and presents the usefulness of new diagnostic methods to assess the risk of CE in children with newly diagnosed T1D.

scholarly journals Study of Optic Nerve Sheath Diameter in Normal Nepalese Adults Using Ultrasound

2018 ◽  
Vol 3 (1) ◽  
pp. 357-360 ◽  
Author(s):  
Bidur KC ◽  
Amit Thapa
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Cross Sectional Study ◽  
Optic Nerve Sheath ◽  
P Value ◽  
Cross Sectional ◽  
Non Invasive ◽  
Normal Limits ◽  
Nerve Sheath ◽  
Significant Difference

Introduction: Though invasive intracranial devices are gold standard to calculate intracranial pressure (ICP); these are not without any complications. Non-invasive measurement of ICP by Ultrasonography could be a safe and portable technique.Objectives: The objective of the study was to measure and compare values of optic nerve sheath diameter of both eyes in healthy Nepalese adults.Methodology: A prospective cross-sectional study of healthy adult Nepalese volunteers was performed using a 7.5 MHz linear Ultrasound probe on the closed eyelids; optic nerve sheath diameter (ONSD) was measured 3 mm behind the globe in each eye.Results: Optic nerve sheath diameter (ONSD) of both eyes was measured in 100 healthy volunteers of age ranged from 15 to 75 years with a mean of 30.21 ± 14.05 years. There were 18 (18%) male and 82 (82%) female. ONSD for right eye ranged from 3.20 to 4.90 mm with mean of 4.10 ± 0.50 mm and left eye from 3.20 to 4.80 mm with mean of 4.22 ± 0.49 mm. P value for right and left eye ONSD (P = 0.06) and male and female (P = 0.12 and 0.85 for right and left ONSD respectively) were within normal limits. ONSD has no correlation with age (P = 0.27 and 0.27 for right and left ONSD respectively).Conclusion Mean of optic nerve sheath diameter (ONSD) is 4.10mm and 4.22 mm for right and left eye respectively. There is no statistical significant difference in mean of ONSD between right and left eye. BJHS 2018;3(1)5 : 357-360

scholarly journals The HD-OCT Study May Be Useful in Searching for Markers of Preclinical Stage of Diabetic Retinopathy in Patients with Type 1 Diabetes

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 105 ◽  
Author(s):  
Magdalena Kołodziej ◽  
Arleta Waszczykowska ◽  
Irmina Korzeniewska-Dyl ◽  
Aleksandra Pyziak-Skupien ◽  
Konrad Walczak ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Ganglion Cells ◽  
Control Group ◽  
Study Group ◽  
Fiber Layer ◽  
Preclinical Phase ◽  
Gender And Age ◽  
Disc Area ◽  
Lower Disc

The aim of the study was to analyze the thickness of individual retinal layers in patients with type 1 diabetes (T1D) in comparison to the control group and in relation to markers of diabetes metabolic control. The study group consisted of 111 patients with an average of 6-years of T1D duration. The control group included 36 gender- and age-matched individuals. In all patients optical coherence tomography (OCT) study was performed using HD-OCT Cirrus 5000 with evaluation of optic nerve head (ONH) parameters, thickness of retinal nerve fiber layer (RNFL) with its quadrants, macular full-thickness parameters, ganglion cells with inner plexus layer (GCIPL) and choroidal thickness (CT). Lower disc area value was observed in the study group as compared to controls (p = 0.0215). Negative correlations were found both between age at examination and rim area (R = −0.28, p = 0.0007) and between superior RNFL thickness and duration of diabetes (R = −0.20, p = 0.0336). Positive correlation between center thickness and SD for average glycemia (R = 0.30, p = 0.0071) was noted. Temporal CT correlated positively with age at examination (R = 0.21, p = 0.0127). The selected parameters the HD-OCT study may in the future serve as potential markers of preclinical phase of DR in patients with T1D.

scholarly journals Optic Nerve Sheath Diameter Assessment Used As a Non-Invasive Tool To Dynamically Monitor Intracranial Pressure

2021 ◽  
Author(s):  
Guo-Biao Wu ◽  
Jun Tian ◽  
Xiao-Bing Liu ◽  
Zhi-Yong Wang ◽  
Jian-Ying Guo
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Supine Position ◽  
Dynamic Test ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Strongly Correlated ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Good Agreement

Abstract Objective: This study aimed to detect whether optic nerve sheath diameter (ONSD) can be used to dynamically monitor intracranial pressure (ICP). Methods: Adult patients being monitored for invasive ICP on day one after hospital admission were included. For each patient, ONSD was first measured in the supine position, then at the 30° head-up position. The dynamic test was conducted in 16 patients. The ONSD was measured in the supine position once a day for three continuous days (day one to day three after admission).Results: The ONSD and ICP values obtained in the supine position on admission were strongly correlated (r of 0.799). When patients changed their position from supine to the 30° head-up position, the ICP and ONSD values decreased correspondingly. However, the change in ICP did not correlate well with the change in ONSD (r of 0.358). In the dynamic test, a good agreement between ICP and ONSD only existed in three (18.75%) patients. In addition, three patients had completely different profiles for ICP and ONSD.Conclusions: The results suggest that the changes in ONSD and ICP values were not correlated well after dynamic observation. Measurement of ONSD may not be a suitable tool to dynamically monitor ICP.

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