超声监测视神经鞘减压术后视神经鞘直径变化与视野恢复的相关性研究OA

Objective:To investigate the association with temporal sequence between the changes of optic nerve sheath diameter(ONSD)and the recovery of visual field after optic nerve sheath fenestration(ONSF),so as to provide a quantifiable biomarker for clinical practice.Methods:Eighty-six patients who underwent ONSF at Xuanwu Hospital between 2022 and 2024 were selected.The ONSD of sagittal position at 3mm behind eyeball was measured by ultrasound,and papilledema was assessed according to the internationally standardized Frisén scale for papilledema grading(Frisén).The variation of mean damage(MD)value(ΔMD)of visual field was compared.The time points of measures included before surgery(T0),at the 1st week after surgery(T1),at the 1st month after surgery(T2)and at the 3rd month after surgery(T3).The difference of baseline was analyzed,and the time effects were assessed by using repeated measures one-way analysis of variance(ANOVA).Pearson correlation coefficients(r)were used to analyze the correlation of various indicators.Results:The postoperative ONSD of patients continuously decreased,and the difference of that between before and after surgery was significant(F=265.730,P<0.001).With the change of time,Frisnuous grading improved,and the improvement rate reached to 70.09%.The correlation analysis indicated that there were significant correlations among different variables at before surgery,at the 1st week,1st month and 3rd month after surgery,there was significant change between before and after surgery.There were significantly positive correlations between ONSD and Frisérisnts grading at different time points included before surgery,at the 1st week,1st month and 3rd month after surgery(r=0.843,0.782,0.711,0.623,P<0.05).ONSD appeared significantly negative correlation with ΔMD values before surgery(r=-0.763,P<0.05),but it appeared significantly positive correlation with that at the 1st week,1st month and 3rd month after surgery(r=0.695,0.772,0.824,P<0.05).In addition,the Frisérisnts grading appeared significantly negative correlation with ΔMD values before surgery(r=-0.684,P<0.05),but it appeared significantly positive correlation with that at the 1st week,1st month and 3rd month after surgery(r=0.732,0.753,0.795,P<0.05).Conclusion:Standardized ultrasonographic monitoring can dynamically quantify the reduction of ONSD after ONSF,which appears significantly positive association with temporal sequence to visual field.It can provide reliable non-invasive biomarker for evaluation of therapeutic efficacy.The individualized follow-up strategy can be formulated according to this research in clinical practice.