Volumetric Ophthalmic Ultrasound for Inflight Monitoring of Visual Impairment and Intracranial Pressure

Abstract

Objective: The objective is enhanced ophthalmic ultrasound imaging to monitor ocular structure and intracranial dynamics changes related to visual impairment and intracranial pressure (ICP) induced by microgravity. The goals are to improve the ease of use and reduce operator variability by automatically rendering improved views of the anatomy and deriving new metrics of the morphology and dynamics.

Materials and methods: A prototype three-dimensional (3-D) probe was integrated onto a portable ultrasound scanner. Image analysis algorithms were developed to automatically detect the ocular anatomy and simultaneously render views of the optic nerve with improved sheath definition. Curvature metrics were calculated from 3-D retinal surfaces to quantify posterior globe flattening, and tissue velocity waveforms of the optic nerve were analyzed to assess intracranial dynamics.

Results: New 3-D structural measurements were evaluated in a head-down tilt study. The response of optic nerve sheath and globe flattening metrics were quantified in 11 healthy volunteers from baseline to moderately elevated ICP. The optic nerve measurements showed good correlation with existing two-dimensional (2-D) methods and an acute response to increased ICP, while globe flattening did not show an acute response. The tissue velocities were evaluated in a porcine model from baseline to significantly elevated ICP and correlated with invasive ICP readings in four animals.

Conclusions: Volumetric ophthalmic imaging was demonstrated on a portable ultrasound system and structural measurements validated with existing methods. New 3-D structural measurements and dynamic measurements were evaluation during in vivo studies. Further investigations are needed to evaluate improvements in performance for non-experts and application to clinically relevant conditions.