Authors: Hadi Khazaei, Danesh Khazaei, John Lipor, Faryar Etesami, Sung Yi
The aim of this review is to provide a wide overview of optic nerve ultrasound normal values assessment using eye phantom imaging techniques using POCUS. We examine the suitability of commercially available, low-cost, portable ultrasound devices that can be combined with artificial intelligence algorithms to reduce the training required for and cost of in-field optic nerve sheath diameter measurement. Several disorders can affect the optic nerve and their differential diagnosis can be challenging, requiring expensive or uncomfortable tests. Elucidation of its underlying disease and follow up may require expensive or uncomfortable tests or even invasive procedures like lumbar puncture. Ultrasound has been widely used for this purpose, but it requires knowledge and skill to give reliable results.
Methods: Transorbital sonographic measurement of optic nerve sheath diameter (ONSD) was measured by pointof-care ultrasound machines on phantom ONS model. Measurements were analyzed for mean error and variance and tested for significance using regression analyses. We developed a low cost, easily made phantom model that may assist with training and improve the quality of sonographic measurements of the ONSD. This study aims to: (1) provide a step-by-step description of producing a sonographic phantom of the posterior chamber of the eye; and (2) validate the model as a realistic educational tool utilizing in vivo and phantom ONS images obtained by ultrasound.
Outcome: Accurate ONSD measurement is possible utilizing POCUS. Measurement of the optic nerve sheath diameter (ONSD) via ultrasonography has been proposed as a non-invasive metric of intracranial pressure that may be employed during in-field patient triage. However, first responders are not typically trained to conduct sonographic exams and/or do not have access to an expensive ultrasound device. Therefore, for successful deployment of ONSD measurement in-field, we believe that first responders must have access to low-cost, portable ultrasound and be assisted by artificial intelligence (AI) systems that can automatically interpret the optic nerve sheath ultrasound scan.
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