Evidence map›Paper›PMID 39585390›Full record

ArticleClinical neuroradiology2025

Optic Nerve Sheath Dilation Is a Possible Marker of CSF Dyshomeostasis in Idiopathic Intracranial Hypertension.

Derrek Schartz, Alan J Finkelstein, Emily Schartz, Saanya Lingineni, Matthew Sipple, Zoe Williams, Matthew T Bender, Henry Wang

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Article in Clinical neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Derrek SchartzDepartment of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA. derrek_schartz@urmc.rochester.edu.
Alan J FinkelsteinDepartment of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA.
Emily SchartzDepartment of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA.
Saanya LingineniUniversity of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Matthew SippleDepartment of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA.
Zoe WilliamsDepartment of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA.
Matthew T BenderDepartment of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA.
Henry WangDepartment of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIdiopathic intracranial hypertension (IIH) is a complex neurological disease characterized by symptoms of raised intracranial pressure of unclear etiology. Although optic nerve sheath dilation is a common MR neuroimaging feature of IIH, how and why it occurs remains poorly understood. The purpose of the presented analysis was to investigate if optic nerve sheath dilation might be associated with neuroimaging correlates of cerebrospinal and interstitial fluid homeostasis.

methodsIIH patients were retrospectively identified from 2016-2023 from our tertiary healthcare system. Brain MRIs were computationally segmented using FreeSurfer. Additionally, diffusion tensor imaging along the perivascular space (DTI-ALPS) was employed to assess cerebral glymphatic flow. The mean perioptic subarachnoid space (PSAS) to optic nerve sheath diameter (ONSD) ratio from both eyes was correlated with neuroimaging markers of CSF and interstitial fluid homeostasis (choroid plexus, ventricle, and gray and white matter volume) and glymphatic flow. All volumes of interest were normalized to total intracranial volume. Multiple linear regression was used to evaluate for associations between continuous variables accounting for covariates of patient age, sex, and body mass index.

resultsIn total, 55 IIH patients (89% female; mean age: 30.3 years [SD: 7.6]) were included. Increasing PSAS/ONSD was found to be significantly associated with increasing normalized total choroid plexus volume (p = 0.001, R = 0.48) and total ventricle volume (P = 0.014, R = 0.39). Additionally, increasing PSAS/ONSD was associated with declining/worsening cerebral glymphatic clearance based on DTI-APLS (p = 0.043, R = 0.34). Additionally, there was a significant association between increasing PSAS/ONSD and increasing normalized total gray matter volume (p = 0.025, R = 0.36) and declining normalized total white matter volume (p = 0.012, R = 0.40).

conclusionThese findings suggest that MR optic nerve sheath dilation in IIH might be associated with CSF dyshomeostasis with possible choroid plexus hyperplasia and impaired cerebral glymphatic flow based on DTI-ALPS. These findings encourage future research into the ocular glymphatic system in IIH patients.

Indexed as

Optic NervePseudotumor CerebriAdultCerebrospinal FluidDiffusion Tensor ImagingDilatation, PathologicFemaleGlymphatic SystemHomeostasisHumansMagnetic Resonance ImagingMaleNeuroimagingRetrospective StudiesDiffusion tensor imaging (DTI)Diffusion weighted imaging (DWI)Glymphatic system, cerebrospinal fluidIdiopathic intracranial hypertension (IIH)

Identifiers

PMID39585390

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.