Spontaneous Retinal Venous Pulsation and its correlation with ICP
Research type
Research Study
Full title
Spontaneous retinal venous pulsation and its correlation with intracranial pressure in patients with cerebrospinal fluid dynamics disturbances
IRAS ID
230308
Contact name
Fion Bremner
Contact email
Sponsor organisation
University College London Hospitals
Duration of Study in the UK
1 years, 10 months, 3 days
Research summary
The purpose of this study is to evaluate the correlation between raised intracranial pressure (ICP) and absence of spontaneous retinal venous pulsation (SVP).\nPatients who are suspected of having chronic headaches due to abnormal intracranial pressure (ICP) are often admitted to neurosurgical units for assessment. This usually involves continuous monitoring of the ICP over 24 or 48 hours, data that currently can only be collected invasively by means of surgical implantation of a bolt. At NHNN we routinely perform ophthalmic assessment in all patients undergoing ICP monitoring because the presence of ophthalmic symptoms and signs related to abnormal ICP may help subsequent neurosurgical decision-making. This ophthalmic assessment includes SVP evaluation within the eye which is expected to be present in healthy patients but disappears if the ICP is raised. \nAlthough not yet reported in the literature, many ophthalmologists have noticed that SVP is much more readily visible when assessed using infrared videography (IRV) compared with conventional ophthalmoscopy. Several UK neuro-ophthalmic units, including NHNN, have therefore started routinely recording SVP using IRV, but to date there has been no validation study to relate these infrared video SVP assessments to ICP measurements.\nWe propose to retrospectively identify all patients who have had ICP monitoring at NHNN in the last 2 years, and examine the IRV recordings of SVP made in these patients during their admission. By using the date and time stamp for these two sources of data it should then be possible to determine the ICP at precisely the same time as the SVP recording and thereby assess their degree of correlation.\nA clarification of the correlation between ICP and SVP might allow decisions on neurosurgical intervention to be made without overnight admission for invasive ICP recording in a higher proportion of cases than is currently possible. \n\n
REC name
South West - Central Bristol Research Ethics Committee
REC reference
18/SW/0208
Date of REC Opinion
6 Sep 2018
REC opinion
Favourable Opinion