Should we monitor spontaneous retinal venous pulsations in patients with idiopathic intracranial hypertension?
| Sunday, November 3, 2024 |
| 11:30 AM - 11:40 AM |
| Panorama Rooms 2 & 3 |
Overview
Solmaz Bastani Viarsagh
Speaker
Ms Solmaz Bastani Viarsagh
PhD candidate UTS
Should we monitor spontaneous retinal venous pulsations in patients with idiopathic intracranial hypertension?
Abstract
Raised intracranial pressure (ICP) is a clinical manifestation observed in patients with idiopathic intracranial hypertension (IIH) and can lead to optic nerve sheath diameter (ONSD) enlargement and papilledema. Traditionally, lumbar puncture has been the standard diagnostic method for raised ICP, despite its invasiveness and associated risks, including infection and nerve damage.
Recent studies have explored various structural and vascular markers to develop non-invasive detection methods for raised ICP. Among these, changes in spontaneous retinal venous pulsations (SVPs) have shown promise. However, the lack of a standardised objective SVP assessment tool has hindered clinical implementation.
In a pilot study, we aimed to evaluate the efficacy of using SVP properties as a marker of increased ONSD and raised ICP. Using a digital ophthalmoscope (Odocs NUN IR), we obtained 10-second video recordings of the retina centred on the optic nerve head from 26 patients diagnosed with IIH. We then objectively quantified SVPs using custom-written algorithms and examined their correlation with ONSD. This objective method was compared with the subjective technique of clinician observation using a slit lamp.
Preliminary findings indicate that while clinicians could not visually detect SVPs, our objective approach successfully identified them in all patients. Furthermore, a significant correlation was found between SVP absence and increased ONSD measurements (r=-0.35, p<0.005). These results suggest that the lack of SVPs could serve as a potential marker for increased ONSD and raised ICP.
Our study highlights the need for further research to validate SVP assessment tools and their integration into clinical practice.
Recent studies have explored various structural and vascular markers to develop non-invasive detection methods for raised ICP. Among these, changes in spontaneous retinal venous pulsations (SVPs) have shown promise. However, the lack of a standardised objective SVP assessment tool has hindered clinical implementation.
In a pilot study, we aimed to evaluate the efficacy of using SVP properties as a marker of increased ONSD and raised ICP. Using a digital ophthalmoscope (Odocs NUN IR), we obtained 10-second video recordings of the retina centred on the optic nerve head from 26 patients diagnosed with IIH. We then objectively quantified SVPs using custom-written algorithms and examined their correlation with ONSD. This objective method was compared with the subjective technique of clinician observation using a slit lamp.
Preliminary findings indicate that while clinicians could not visually detect SVPs, our objective approach successfully identified them in all patients. Furthermore, a significant correlation was found between SVP absence and increased ONSD measurements (r=-0.35, p<0.005). These results suggest that the lack of SVPs could serve as a potential marker for increased ONSD and raised ICP.
Our study highlights the need for further research to validate SVP assessment tools and their integration into clinical practice.
Biography
Solmaz Bastani Viarsagh was born in Iran, Tehran in 1977. After migrating to Australia in 2005, Solmaz decided to chase her passion which was becoming a scientific researcher in medical field. Solmaz was graduated in Bachelor of Medical Science from Sydney University and then Master of Orthoptics from UTS. Soon after graduation, she was offered PhD degree and awarded UTS scholarship to pursue her research project. Solmaz started her research in the field of neuro ophthalmology investigating the effect of raised intracranial pressure on retinal blood vessels and structure in Idiopathic intracranial hypertension patients in 2022. Aiming to introduce a non-invasive method of detecting elevated ICP through the eyes. So far, Solmaz has presented her research at different conferences such as NOSA confrences in 2022 and 2023 as well as RANZCO NSW branch in 2024 aiming to collabrate with other researchers and learning about others experiences and findings in the same field.
