Ocular ultrasound for monitoring pseudotumor cerebri syndrome

The aim of this study was to evaluate the feasibility of ocular ultrasound in the follow-up of pseudotumor cerebri syndrome and to correlate ultrasound with clinical parameters. In a cohort study of 22 consecutive adult patients, ocular ultrasound was performed measuring optic nerve sheath diameter, optic nerve diameter, and optic disc elevation compared with symptoms referred by the patients. The patients showed increased optic nerve sheath diameter [median, 6.51 mm (interquartile range 6.13-7.10)], optic nerve diameter [3.02 mm (2.86-3.27)], and optic disc elevation [0.90 mm (0.64-1.36)] at the time of admission and had ophthalmologically confirmed the presence of papilledema in all 22 patients. After 6 months all parameters decreased significantly for optic nerve sheath diameter [6.08 mm (5.59-6.73), P = 0.002], optic nerve diameter [2.87 mm (2.70-3.15), P = 0.007], and optic disc elevation [0.48 mm (0.30-0.70), P < 0.001]. In addition, a discrete negative correlation between optic nerve sheath diameter and headache change after 6 months was observed with ρ = - 0.477 and P = 0.02. No correlation was found between optic disc elevation and headache. In conclusion, longitudinal follow-up with ocular ultrasound combined with clinical information may provide support for treatment of this condition.