Point-of-care Ultrasound of Optic Nerve Sheath Diameter in Suspected Hypertensive Emergency
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hypertensive Emergency
- Sponsor
- Leiden University Medical Center
- Enrollment
- 375
- Primary Endpoint
- Papilledema
- Status
- Not yet recruiting
- Last Updated
- last year
Overview
Brief Summary
This prospective observational study investigates the potential of point-of-care ultrasonography of the optic nerve sheath diameter (ONSD) to rule out papilledema in patients with suspected hypertensive emergency. The primary focus is on assessing ONSD sensitivity in identifying papilledema (hypertensive retinopathy grade 4), while secondary endpoints include hypertensive retinopathy grade 3, hypertensive encephalopathy, and the need for intravenous rapid-acting medications to lower elevated blood pressure. This study aims to determine the diagnostic characteristics of this procedure for the diagnosis of hypertensive retinopathy, thus assessing its potential as a screening tool to rule out hypertensive retinopathy by the acute internal medicine doctor.
Investigators
Tessa Mulder
Principal Investigator
Leiden University Medical Center
Eligibility Criteria
Inclusion Criteria
- •≥ 18 years old
- •Any patient presenting to the emergency department (ED) with suspected hypertensive emergency i.e.: blood pressure of \> 200 millimetres of mercury (mmHg) systolic and/or \> 120 mmHg diastolic
Exclusion Criteria
- •Patients with preexisting optic nerve head changes such as glaucoma, pre-existing retinal artery/vein occlusions or any other condition that makes assessment of the fundi impossible.
- •Primary neurological cause of hypertension: ischemic cerebrovascular incident
Outcomes
Primary Outcomes
Papilledema
Time Frame: 2 years
Sensitivity of ONSD \> 5mm for diagnosis of papilledema
Secondary Outcomes
- Hypertensive encephalopathy(2 years)
- Hypertensive retinopathy grade 3 & 4 combined(2 years)
- Presence of a bulging optic nerve disc and/or crescent sign found by ultrasonography of the optic nerve(2 years)
- Rapid acting medications administered intravenously to lower the elevated blood pressure(2 years)