Bhosale A, Shah VM, Shah PK. Accuracy of crescent sign on ocular ultrasound in diagnosing papilledema. World J Methodol 2017; 7(3): 108-111 [PMID: 29026691 DOI: 10.5662/wjm.v7.i3.108]
Corresponding Author of This Article
Parag K Shah, DNB, Department of Retina and Vitreous, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Avinashi Road, Coimbatore 641014, Tamil Nadu, India. parag@cbe.aravind.org
Research Domain of This Article
Medical Laboratory Technology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Methodol. Sep 26, 2017; 7(3): 108-111 Published online Sep 26, 2017. doi: 10.5662/wjm.v7.i3.108
Accuracy of crescent sign on ocular ultrasound in diagnosing papilledema
Ananth Bhosale, Virna M Shah, Parag K Shah
Ananth Bhosale, Parag K Shah, Department of Retina and Vitreous, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore 641014, Tamil Nadu, India
Virna M Shah, Department of Neuro Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore 641014, Tamil Nadu, India
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Aravind Eye Hospital.
Informed consent statement: Patients were not required to give informed consent tothe study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Parag K Shah, DNB, Department of Retina and Vitreous, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Avinashi Road, Coimbatore 641014, Tamil Nadu, India. parag@cbe.aravind.org
Telephone: +91-422-4360400 Fax: +91-422-2593030
Received: January 27, 2017 Peer-review started: February 8, 2017 First decision: June 12, 2017 Revised: July 22, 2017 Accepted: August 2, 2017 Article in press: August 2, 2017 Published online: September 26, 2017 Processing time: 240 Days and 15.1 Hours
Abstract
AIM
To study the usefulness of orbital ultrasonography in the diagnosis of papilledema.
METHODS
Fifty patients who were referred to the neurophthalmology clinic and clinically suspected to have papilledema were selected. Thorough, clinical examination with slitlamp biomicroscopy and visual acuity assessment was done. These patients underwent ultrasonography to demonstrate the crescent sign. The patients were further evaluated with the neurologist and magnetic resonance imaging (MRI) thus confirming the diagnosis of papilledema. The results of our ultrasonographic evaluation were correlated with final diagnosis after thorough clinical evaluation, imaging and the neurologist’s opinion.
RESULTS
Out of 50 patients diagnosed having papilledema on MRI, 46 (92%) showed crescent sign on B scan ultrasonography. Headache was most common presenting complaint in 47 (94%) and idiopathic intracranial hypertension was most common underlying cause of papilledema in 30 (60%) cases.
CONCLUSION
“Crescent sign” seen on ultrasonography is a sensitive tool for diagnosis of papilledema. It is cost effective, less cumbersome and effective tool to differentiate between papilledema and pseudo papilledema before subjecting the patients to costly investigations like MRI. A positive crescent sign should always be followed by MRI to find out the cause of papilledema.
Core tip: It is a retrospective study of 50 clinically diagnosed cases of papilledema where 46 cases showed a positive crescent sign on ocular ultrasonography. With an accuracy of 92%, ocular ultrasonography could be a cheaper and useful tool to confirm papilledema before subjecting these patients for MRI scans.
