B-Ultrasound Imaging of Optic Nerve Subarachnoid Space: A More Portable Way?

  • Hanruo Liu
  • Diya Yang
  • Teng Ma
  • Wenyuan Shi
  • Zhu Qiang
  • Ningli WangEmail author
Part of the Advances in Visual Science and Eye Diseases book series (AVSED, volume 1)


Glaucoma is an important irreversible blinding eye disease [1]. For primary open-angle glaucoma (POAG), intraocular pressure (IOP) is a known pathogenic factor. Other factors are also associated with morbidity, including low body mass index (BMI), ocular perfusion pressure, migraine, cardiovascular disease, and vasospastic disorders [2–6]. Intracranial pressure (ICP) has been receiving attention in recent years [7], especially in normal pressure glaucoma. At present, it is believed that the trans-lamina cribrosa pressure difference (TLCPD) of normal-tension glaucoma (NTG) is affected by the low cerebrospinal fluid pressure (CSFP) in the subarachnoid space.


  1. 1.
    Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90(3):262–7.CrossRefGoogle Scholar
  2. 2.
    Bonomi L, Babighian S, Bonadimani M, et al. Correlation between glaucoma and vascular factors, and circumstances leading to the diagnosis of glaucoma. Acta Ophthalmol Scand Suppl. 2000;232:34–5.CrossRefGoogle Scholar
  3. 3.
    Leske MC, Wu SY, Hennis A, Honkanen R, Nemesure B, Group BES. Risk factors for incident open-angle glaucoma: the Barbados Eye Studies. Ophthalmology. 2008;115(1):85–93.CrossRefGoogle Scholar
  4. 4.
    Cherecheanu AP, Garhofer G, Schmidl D, Werkmeister R, Schmetterer L. Ocular perfusion pressure and ocular blood flow in glaucoma. Curr Opin Pharmacol. 2013;13(1):36–42.CrossRefGoogle Scholar
  5. 5.
    Ren R, Wang N, Zhang X, Tian G, Jonas JB. Cerebrospinal fluid pressure correlated with body mass index. Graefes Arch Clin Exp Ophthalmol. 2012;250(3):445–6.CrossRefGoogle Scholar
  6. 6.
    Abegao Pinto L, Willekens K, Van Keer K, et al. Ocular blood flow in glaucoma—the Leuven Eye Study. Acta Ophthalmol. 2016;94(6):592–8.CrossRefGoogle Scholar
  7. 7.
    Jonas JB. Role of cerebrospinal fluid pressure in the pathogenesis of glaucoma. Acta Ophthalmol. 2011;89(6):505–14.CrossRefGoogle Scholar
  8. 8.
    Hou R, Zhang Z, Yang D, et al. Intracranial pressure (ICP) and optic nerve subarachnoid space pressure (ONSP) correlation in the optic nerve chamber: the Beijing Intracranial and Intraocular Pressure (iCOP) study. Brain Res. 1635;2016:201–8.Google Scholar
  9. 9.
    Watanabe A, Kinouchi H, Horikoshi T, Uchida M, Ishigame K. Effect of intracranial pressure on the diameter of the optic nerve sheath. J Neurosurg. 2008;109(2):255–8.CrossRefGoogle Scholar
  10. 10.
    Geeraerts T, Newcombe VF, Coles JP, et al. Use of T2-weighted magnetic resonance imaging of the optic nerve sheath to detect raised intracranial pressure. Crit Care. 2008;12(5):R114.CrossRefGoogle Scholar
  11. 11.
    Wang N, Xie X, Yang D, et al. Orbital cerebrospinal fluid space in glaucoma: the Beijing intracranial and intraocular pressure (iCOP) study. Ophthalmology. 2012;119(10):2065–73. e2061CrossRefGoogle Scholar
  12. 12.
    Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods. 2012;9(7):671–5.CrossRefGoogle Scholar
  13. 13.
    Soldatos T, Chatzimichail K, Papathanasiou M, Gouliamos A. Optic nerve sonography: a new window for the non-invasive evaluation of intracranial pressure in brain injury. Emerg Med J. 2009;26(9):630–4.CrossRefGoogle Scholar
  14. 14.
    Moretti R, Pizzi B, Cassini F, Vivaldi N. Reliability of optic nerve ultrasound for the evaluation of patients with spontaneous intracranial hemorrhage. Neurocrit Care. 2009;11(3):406–10.CrossRefGoogle Scholar
  15. 15.
    Jonas JB, Wang N, Yang D, Ritch R, Panda-Jonas S. Facts and myths of cerebrospinal fluid pressure for the physiology of the eye. Prog Retin Eye Res. 2015;46:67–83.CrossRefGoogle Scholar
  16. 16.
    Killer HE, Miller NR, Flammer J, et al. Cerebrospinal fluid exchange in the optic nerve in normal-tension glaucoma. Br J Ophthalmol. 2012;96(4):544–8.CrossRefGoogle Scholar
  17. 17.
    Francois P, Lescanne E, Velut S. The dural sheath of the optic nerve: descriptive anatomy and surgical applications. Adv Tech Stand Neurosurg. 2011;36:187–98.CrossRefGoogle Scholar
  18. 18.
    Helmke K, Hansen HC. Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension I. Experimental study. Pediatr Radiol. 1996;26(10):701–5.CrossRefGoogle Scholar
  19. 19.
    Tayal VS, Neulander M, Norton HJ, Foster T, Saunders T, Blaivas M. Emergency department sonographic measurement of optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann Emerg Med. 2007;49(4):508–14.CrossRefGoogle Scholar
  20. 20.
    Beare NA, Kampondeni S, Glover SJ, et al. Detection of raised intracranial pressure by ultrasound measurement of optic nerve sheath diameter in African children. Trop Med Int Health. 2008;13(11):1400–4.CrossRefGoogle Scholar
  21. 21.
    Berdahl JP, Allingham RR, Johnson DH. Cerebrospinal fluid pressure is decreased in primary open-angle glaucoma. Ophthalmology. 2008;115(5):763–8.CrossRefGoogle Scholar
  22. 22.
    Yablonski E, Rafalski K. Effect of time of administration of food supplement amino acids on protein utilization and the body composition of rats. Vopr Pitan. 1979;5:17–21.Google Scholar
  23. 23.
    Berdahl JP, Fautsch MP, Stinnett SS, Allingham RR. Intracranial pressure in primary open angle glaucoma, normal tension glaucoma, and ocular hypertension: a case-control study. Invest Ophthalmol Vis Sci. 2008;49(12):5412–8.CrossRefGoogle Scholar
  24. 24.
    Ren R, Jonas JB, Tian G, et al. Cerebrospinal fluid pressure in glaucoma: a prospective study. Ophthalmology. 2010;117(2):259–66.CrossRefGoogle Scholar
  25. 25.
    Bauerle J, Schuchardt F, Schroeder L, Egger K, Weigel M, Harloff A. Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging. BMC Neurol. 2013;13:187.CrossRefGoogle Scholar
  26. 26.
    Jaggi GP, Miller NR, Flammer J, Weinreb RN, Remonda L, Killer HE. Optic nerve sheath diameter in normal-tension glaucoma patients. Br J Ophthalmol. 2012;96(1):53–6.CrossRefGoogle Scholar
  27. 27.
    Abegao Pinto L, Vandewalle E, Pronk A, Stalmans I. Intraocular pressure correlates with optic nerve sheath diameter in patients with normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 2012;250(7):1075–80.CrossRefGoogle Scholar
  28. 28.
    Copetti R, Cattarossi L. Optic nerve ultrasound: artifacts and real images. Intensive Care Med. 2009;35(8):1488–9. author reply 1490-1481CrossRefGoogle Scholar
  29. 29.
    Raspanti M, Marchini M, Della Pasqua V, Strocchi R, Ruggeri A. Ultrastructure of the extracellular matrix of bovine dura mater, optic nerve sheath and sclera. J Anat. 1992;181(Pt 2):181–7.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Liu D, Kahn M. Measurement and relationship of subarachnoid pressure of the optic nerve to intracranial pressures in fresh cadavers. Am J Ophthalmol. 1993;116(5):548–56.CrossRefGoogle Scholar
  31. 31.
    Spentzas T, Henricksen J, Patters AB, Chaum E. Correlation of intraocular pressure with intracranial pressure in children with severe head injuries. Pediatr Crit Care Med. 2010;11(5):593–8.CrossRefGoogle Scholar
  32. 32.
    Lirng JF, Fuh JL, Wu ZA, Lu SR, Wang SJ. Diameter of the superior ophthalmic vein in relation to intracranial pressure. AJNR Am J Neuroradiol. 2003;24(4):700–3.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Hanruo Liu
    • 1
  • Diya Yang
    • 1
  • Teng Ma
    • 1
  • Wenyuan Shi
    • 1
  • Zhu Qiang
    • 1
  • Ningli Wang
    • 1
    Email author
  1. 1.Beijing Institute of OphthalmologyBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical UniversityBeijingChina

Personalised recommendations