Abstract
IntroductionIntracranial hypertension (ICH) in children can have deleterious effects on the brain and vision. It is notoriously difficult to estimate intracranial pressure (ICP) in children and existing methods deliver suboptimal diagnostic accuracy to be used as screening tools. Optical coherence tomography (OCT) may represent a valuable, non-invasive surrogate measure of ICP, as has been demonstrated in a number of associated conditions affecting adults. More recently, OCT has been employed within the paediatric age group. However, the role of OCT in detecting ICH in children has not been rigorously assessed in a systematic review for all relevant conditions. Here, we propose a systematic review protocol to examine the role of OCT in the detection of ICH in children.Methods and analysisElectronic searches in the Cochrane Central Register of Controlled Trials, Medline, Embase, Web of Science and PubMed will identify studies featuring OCT in detecting ICH in children. Two independent screeners will identify studies for inclusion using a screening questionnaire. The systematic search and screening will take place between 2 April 2020 and 1 June 2020, while we aim to complete data analysis by 1 September 2020. Quality assessment will be performed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The primary outcome measure is the sensitivity and specificity of OCT in detecting ICH in children. Secondary outcomes measures include conditions associated with ICH per study, direct ICP monitoring, sensitivity and specificity of other measures for ICP and OCT parameters used.Ethics and disseminationEthical approval is not required for the proposed systematic review as no primary data will be collected. The findings will be disseminated through presentations at scientific meetings and peer-reviewed journal publication.PROSPERO registration numberCRD42019154254.
Highlights
Intracranial hypertension (ICH) in children can have deleterious effects on the brain and vision
We propose to conduct the first systematic review examining the role of Optical coherence tomography (OCT) in all conditions associated with ICH in children
The secondary research objectives are as follows: ►► To assess which conditions associated with ICH have been successfully studied by OCT. ►► To assess OCT success rate per condition per study. ►► To identify surrogate measures of intracranial pressure (ICP) and their associated sensitivity, specificity and success rates. ►► To assess which ICP range is determined as normal per condition per study
Summary
Intracranial hypertension (ICH) in children can have deleterious effects on the brain and vision. The role of OCT in detecting ICH in children has not been rigorously assessed in a systematic review for all relevant conditions. We propose a systematic review protocol to examine the role of OCT in the detection of ICH in children. Methods and analysis Electronic searches in the Cochrane Central Register of Controlled Trials, Medline, Embase, Web of Science and PubMed will identify studies featuring OCT in detecting ICH in children. The primary outcome measure is the sensitivity and specificity of OCT in detecting ICH in children. Secondary outcomes measures include conditions associated with ICH per study, direct ICP monitoring, sensitivity and specificity of other measures for ICP and OCT parameters used. Ethics and dissemination Ethical approval is not required for the proposed systematic review as no primary data will be collected.
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