The effectiveness of optic nerve sheath diameter in predicting large vessel occlusion in ischemic stroke patients.

Aim: This study assessed the effectiveness of ultrasonography-measured optic nerve sheath diameter (ONSD) in predicting large vessel occlusion (LVO) in ischemic stroke patients.

Materials and methods: This single-center, prospective observational study involved patients presenting to the emergency department within 24 hours of symptom onset with moderate to severe stroke, and healthy volunteers.

Results: The study included 133 ischemic stroke patients and 63 healthy volunteers. The patient group had significantly higher right [5.8 (0.9)] and left [5.9 (0.8)] ONSD values compared to controls (right [5.7 (0.6)], left [5.7 (0.8)], p<0.001 for both). LVO was present in 58.6% (n = 78) of patients. Median right ONSD was 6.1 mm (0.8) in LVO patients vs. 5.7 mm (0.65) in non-LVO patients (p=0.002). Median left ONSD was 5.9 mm (0.9) in LVO patients vs. 5.7 mm (0.7) in non-LVO patients (p=0.002). A right ONSD ≥6 mm had 51.28% sensitivity and 78.18% specificity for LVO. A left ONSD ≥5.5 mm had 83.33% sensitivity and 40% specificity for LVO.

Conclusion: Elevated ONSD values measured by ultrasonography can effectively indicate LVO in stroke patients.