Diagnostic and prognostic efficacy of optic nerve sheath diameter in patients with dysnatremia

Berika Kavaz Kuru, Ahmet Baydın, Metin Ocak, İskender Aksoy


Aim: This study aimed to investigate the diagnostic and prognostic value of optic nerve sheath diameter (ONSD) measurement in patients with dysnatremia.

Material and methods: This prospective clinical study included patients aged ≥18 years who were diagnosed with dysnatremia on admission to the emergency department.

Results: The present study included 65 patients (35 with hypernatremia [hypernatremia group] and 30 with hyponatremia [hyponatremia group]) and 14 healthy volunteers (control group). Comparison of these groups in terms of ONSD revealed that the right and left ONSDs were significantly higher in the hypernatremia and hyponatremia groups comparing to the control group (p<0.001). According to the optimal cutoff values determined, the right ONSD detected hypernatremia with 91.4% sensitivity and 92.9% specificity and the left ONSD detected the condition with 88.6% sensitivity and 85.7% specificity. Furthermore, the right ONSD detected hyponatremia with 83.3% sensitivity and 92.9% specificity, and the left ONSD detected it with 93.0% sensitivity and 86.0% specificity. Finally, ONSD was found to be an independent predictor of mortality in patients with hypernatremia.

Conclusion: ONSD is a noninvasive, easy, cheap, and reproducible measurement and can be used as an effective and powerful tool for the diagnosis of patients with dysnatremia and the prognosis of patients with hypernatremia.


hypernatremia; hyponatremia; optic nerve; ultrasound; prognosis

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DOI: http://dx.doi.org/10.11152/mu-4333


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