Background/Aims Papilloedema is an important sign of serious neurological disease, but it can be difficult to detect on funduscopy. The purpose of this study was to determine the diagnostic accuracy of point-of-care ultrasound (POCUS) and optical coherence tomography (OCT) for detecting papilloedema in children. Methods This was a prospective observational study at a tertiary care paediatric hospital. Patients were eligible for the study if they underwent a lumbar puncture with opening pressure and had high-quality POCUS and OCT imaging. Results A total of 63 eyes from 32 patients were included in the study, 41 (65%) with papilloedema and 22 (35%) without. There were statistically significant differences between the groups in the optic disc elevation (ODE) (p<0.001) and optic nerve sheath diameter (ONSD) (p<0.001) on POCUS, and in the average retinal nerve fibre layer (rNFL) thickness on OCT (p<0.001). Average rNFL thickness had the highest diagnostic accuracy with an area under the curve (AUC) of 0.999 and a 100% sensitivity and 95% specificity for papilloedema (threshold value of ≥108 µm). ODE had an AUC of 0.866 and a 93% sensitivity and 55% specificity (threshold value of ≥0.5 mm). ONSD had an AUC of 0.786 and a 93% sensitivity and 45% specificity (threshold value of ≥5.5 mm). Conclusion Both OCT and POCUS are potentially useful tools to help diagnose papilloedema in children. Larger studies are needed to further define the role and accuracy of POCUS and OCT in assessing papilloedema in children. Data are available upon reasonable request. Data available upon request.

中文翻译：

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床旁超声和光学相干断层扫描对儿童视乳头水肿的诊断效用：一项前瞻性试点研究


背景/目的 乳头水肿是严重神经系统疾病的重要体征，但通过眼底镜检查很难发现。本研究的目的是确定床旁超声 (POCUS) 和光学相干断层扫描 (OCT) 用于检测儿童视乳头水肿的诊断准确性。方法 这是在一家三级儿科医院进行的一项前瞻性观察研究。如果患者接受开放压腰椎穿刺并且具有高质量的 POCUS 和 OCT 成像，则他们有资格参加该研究。结果 该研究共纳入 32 名患者的 63 只眼睛，其中 41 名（65%）患有视乳头水肿，22 名（35%）没有视乳头水肿。 POCUS 上的视盘抬高 (ODE) (p<0.001) 和视神经鞘直径 (ONSD) (p<0.001) 以及平均视网膜神经纤维层 (rNFL) 厚度方面，各组之间存在统计学显着差异。 OCT（p<0.001）。平均 rNFL 厚度具有最高的诊断准确性，曲线下面积 (AUC) 为 0.999，对视乳头水肿的敏感性为 100%，特异性为 95%（阈值≥108 µm）。 ODE 的 AUC 为 0.866，敏感性为 93%，特异性为 55%（阈值≥0.5 mm）。 ONSD 的 AUC 为 0.786，敏感性为 93%，特异性为 45%（阈值≥5.5 mm）。结论 OCT 和 POCUS 都是帮助诊断儿童视乳头水肿的潜在有用工具。需要更大规模的研究来进一步明确 POCUS 和 OCT 在评估儿童视乳头水肿方面的作用和准确性。数据可根据合理要求提供。可根据要求提供数据。