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水肿的诊断效用：一项前瞻性试点研究


背景/目标 视水肿是严重神经系统疾病的重要体征，但可能难以通过眼底镜检查发现。本研究的目的是确定床旁超声 （POCUS） 和光学相干断层扫描 （OCT） 检测儿童视水肿的诊断准确性。方法 这是一项在三级儿科医院进行的前瞻性观察研究。如果患者接受了具有开放压力的腰椎穿刺并具有高质量的 POCUS 和 OCT 成像，则他们有资格参加该研究。结果 研究共纳入 32 例患者的 63 只眼，其中 41 例 （65%） 有视水肿，22 例 （35%） 没有。POCUS 上椎间盘抬高 （ODE） （p<0.001） 和视神经鞘直径 （ONSD） （p<0.001） 和 OCT 平均视网膜神经纤维层 （rNFL） 厚度 （p<0.001） 差异有统计学意义。平均 rNFL 厚度具有最高的诊断准确性，曲线下面积 （AUC） 为 0.999，对视水肿的敏感性为 100%，特异性为 95% （阈值为 ≥108 μm）。ODE 的 AUC 为 0.866，敏感性为 93%，特异性为 55% （阈值为 ≥0.5 mm）。ONSD 的 AUC 为 0.786，敏感性为 93%，特异性为 45% （阈值为 ≥5.5 mm）。结论 OCT 和 POCUS 都是帮助诊断儿童视水肿的潜在有用工具。需要更大规模的研究来进一步确定 POCUS 和 OCT 在评估儿童视水肿中的作用和准确性。数据可根据合理要求提供。可根据要求提供数据。