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Comment & Response
November 2018

Measuring Optic Nerve Sheath Diameter as a Proxy for Intracranial Pressure

Author Affiliations
  • 1Department of Neurosurgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • 2Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan
  • 3Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
  • 4Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
JAMA Ophthalmol. 2018;136(11):1310-1311. doi:10.1001/jamaophthalmol.2018.3435

To the Editor We read with great interest the article by Wang et al, titled “Ultrasonography Assessments of Optic Nerve Sheath Diameter as a Noninvasive and Dynamic Method of Detecting Changes in Intracranial Pressure.”1 The authors proposed an indirect method to assess intracranial pressures (ICPs) by measuring the optic nerve sheath diameter (ONSD) with ultrasonography. They demonstrated that the dilated ONSD was correlated with the elevated opening pressure obtained by lumbar puncture (LP) on admission. During the follow-up period, changes in ONSD were also correlated with the changes in the opening pressure obtained by LP until the pressure dropped to normal levels (defined as less than 200 mm of water). They concluded that ultrasonographic ONSD measurements may be a useful tool for dynamically evaluating ICP.

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