Zero retinal vein pulsation amplitude extrapolated model in non-invasive intracranial pressure estimation

W.H. Morgan; A. Vukmirovic; A. Abdul-Rahman; Y.J. Khoo; A.G. Kermode; C.R. Lind; J. Dunuwille; D.Y. Yu

doi:10.1038/s41598-022-09151-7

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Zero retinal vein pulsation amplitude extrapolated model in non-invasive intracranial pressure estimation

Journal article

Open access

Peer reviewed

Zero retinal vein pulsation amplitude extrapolated model in non-invasive intracranial pressure estimation

W.H. Morgan, A. Vukmirovic, A. Abdul-Rahman, Y.J. Khoo, A.G. Kermode, C.R. Lind, J. Dunuwille and D.Y. Yu

Scientific Reports, Vol.12(1), Art. 5190

2022

DOI: https://doi.org/10.1038/s41598-022-09151-7

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Abstract

Intracranial pressure (ICP) includes the brain, optic nerve, and spinal cord pressures; it influences blood flow to those structures. Pathological elevation in ICP results in structural damage through various mechanisms, which adversely affects outcomes in traumatic brain injury and stroke. Currently, invasive procedures which tap directly into the cerebrospinal fluid are required to measure this pressure. Recent fluidic engineering modelling analogous to the ocular vascular flow suggests that retinal venous pulse amplitudes are predictably influenced by downstream pressures, suggesting that ICP could be estimated by analysing this pulse signal. We used this modelling theory and our photoplethysmographic (PPG) retinal venous pulse amplitude measurement system to measure amplitudes in 30 subjects undergoing invasive ICP measurements by lumbar puncture (LP) or external ventricular drain (EVD). We estimated ICP from these amplitudes using this modelling and found it to be accurate with a mean absolute error of 3.0 mmHg and a slope of 1.00 (r = 0.91). Ninety-four percent of differences between the PPG and invasive method were between − 5.5 and + 4.0 mmHg, which compares favourably to comparisons between LP and EVD. This type of modelling may be useful for understanding retinal vessel pulsatile fluid dynamics and may provide a method for non-invasive ICP measurement.

Details

Title: Zero retinal vein pulsation amplitude extrapolated model in non-invasive intracranial pressure estimation
Authors/Creators: W.H. Morgan (Author/Creator) - The University of Western Australia
A. Vukmirovic (Author/Creator) - The University of Western Australia
A. Abdul-Rahman (Author/Creator) - Counties Manukau District Health Board
Y.J. Khoo (Author/Creator) - The University of Western Australia
A.G. Kermode (Author/Creator) - Murdoch University
C.R. Lind (Author/Creator) - Sir Charles Gairdner Hospital
J. Dunuwille (Author/Creator) - Sir Charles Gairdner Hospital
D.Y. Yu (Author/Creator) - The University of Western Australia
Publication Details: Scientific Reports, Vol.12(1), Art. 5190
Publisher: Springer Nature
Identifiers: 991005544793007891
Murdoch Affiliation: Institute for Immunology and Infectious Diseases
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.36 Ophthalmology; 1.36.1932 Idiopathic Intracranial Hypertension
Web Of Science research areas: Clinical Neurology
ESI research areas: Clinical Medicine