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Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice
Background Consistently raised intracranial pressure (ICP) is a common final pathway to morbidity/mortality in many neurosurgical conditions. This underscores the need for early diagnosis and prompt management of raised ICP. This study aims to determine whether smartphone fundal photography features...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226839/ https://www.ncbi.nlm.nih.gov/pubmed/37261138 http://dx.doi.org/10.7759/cureus.38246 |
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author | Mbanugo, Tochukwu H Mezue, Wilfred C Emejulu, Jude-Kennedy C Uche, Enoch O Chikani, Mark O Iloabachie, Izuchukwu Onyia, Ephraim Okpalauwaekwe, Udoka |
author_facet | Mbanugo, Tochukwu H Mezue, Wilfred C Emejulu, Jude-Kennedy C Uche, Enoch O Chikani, Mark O Iloabachie, Izuchukwu Onyia, Ephraim Okpalauwaekwe, Udoka |
author_sort | Mbanugo, Tochukwu H |
collection | PubMed |
description | Background Consistently raised intracranial pressure (ICP) is a common final pathway to morbidity/mortality in many neurosurgical conditions. This underscores the need for early diagnosis and prompt management of raised ICP. This study aims to determine whether smartphone fundal photography features of raised ICP can accurately predict the computed tomography (CT) findings suggestive of elevated ICP in neurosurgery patients. Methods Dilated ocular fundal photography examinations using an ophthalmoscope adapter mounted on a smartphone were done on 82 patients with clinical suspicion of raised ICP. Fundal photography findings were recorded as pictures/videos for disc analysis. Patients subsequently had neuroimaging with results analyzed for radiological features of raised ICP. These were correlated with fundal photography findings. Results A total of 82 adult patients participated in this study. Chi-square analysis showed a relationship between radiological signs of raised ICP and the absence of spontaneous retinal venous pulsation (SRVP) (p=0.001). There was no relationship observed between papilledema and radiological signs of raised ICP. However, when the fundal photography signs were aggregated, there was a significant relationship between the fundal signs of raised ICP and radiological signs of raised ICP (p=0.004). The sensitivity and specificity of smartphone-fundoscopy-detected papilledema in predicting radiological signs of raised ICP were 43.2% and 100%, respectively, while those of absent SRVP were 100% and 92.6%, respectively. Conclusion Smartphone ophthalmoscopy is a reliable screening tool for evaluating ICP in neurosurgical patients. It should be introduced into the neurosurgeon's tools for prompt evaluation of raised ICP, especially in developing/resource-poor settings where CT or magnetic resonance imaging is not readily available. |
format | Online Article Text |
id | pubmed-10226839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-102268392023-05-31 Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice Mbanugo, Tochukwu H Mezue, Wilfred C Emejulu, Jude-Kennedy C Uche, Enoch O Chikani, Mark O Iloabachie, Izuchukwu Onyia, Ephraim Okpalauwaekwe, Udoka Cureus Neurology Background Consistently raised intracranial pressure (ICP) is a common final pathway to morbidity/mortality in many neurosurgical conditions. This underscores the need for early diagnosis and prompt management of raised ICP. This study aims to determine whether smartphone fundal photography features of raised ICP can accurately predict the computed tomography (CT) findings suggestive of elevated ICP in neurosurgery patients. Methods Dilated ocular fundal photography examinations using an ophthalmoscope adapter mounted on a smartphone were done on 82 patients with clinical suspicion of raised ICP. Fundal photography findings were recorded as pictures/videos for disc analysis. Patients subsequently had neuroimaging with results analyzed for radiological features of raised ICP. These were correlated with fundal photography findings. Results A total of 82 adult patients participated in this study. Chi-square analysis showed a relationship between radiological signs of raised ICP and the absence of spontaneous retinal venous pulsation (SRVP) (p=0.001). There was no relationship observed between papilledema and radiological signs of raised ICP. However, when the fundal photography signs were aggregated, there was a significant relationship between the fundal signs of raised ICP and radiological signs of raised ICP (p=0.004). The sensitivity and specificity of smartphone-fundoscopy-detected papilledema in predicting radiological signs of raised ICP were 43.2% and 100%, respectively, while those of absent SRVP were 100% and 92.6%, respectively. Conclusion Smartphone ophthalmoscopy is a reliable screening tool for evaluating ICP in neurosurgical patients. It should be introduced into the neurosurgeon's tools for prompt evaluation of raised ICP, especially in developing/resource-poor settings where CT or magnetic resonance imaging is not readily available. Cureus 2023-04-28 /pmc/articles/PMC10226839/ /pubmed/37261138 http://dx.doi.org/10.7759/cureus.38246 Text en Copyright © 2023, Mbanugo et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Neurology Mbanugo, Tochukwu H Mezue, Wilfred C Emejulu, Jude-Kennedy C Uche, Enoch O Chikani, Mark O Iloabachie, Izuchukwu Onyia, Ephraim Okpalauwaekwe, Udoka Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice |
title | Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice |
title_full | Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice |
title_fullStr | Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice |
title_full_unstemmed | Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice |
title_short | Smartphone Ocular Fundal Photography in the Diagnosis of Raised Intracranial Pressure: A Novel Adaptation to Neurosurgical Practice |
title_sort | smartphone ocular fundal photography in the diagnosis of raised intracranial pressure: a novel adaptation to neurosurgical practice |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226839/ https://www.ncbi.nlm.nih.gov/pubmed/37261138 http://dx.doi.org/10.7759/cureus.38246 |
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