This prospective observational study investigates the potential of point-of-care ultrasonography of the optic nerve sheath diameter (ONSD) to rule out papilledema in patients with suspected hypertensive emergency. The primary focus is on assessing ONSD sensitivity in identifying papilledema (hypertensive retinopathy grade 4), while secondary endpoints include hypertensive retinopathy grade 3, hypertensive encephalopathy, and the need for intravenous rapid-acting medications to lower elevated blood pressure. This study aims to determine the diagnostic characteristics of this procedure for the diagnosis of hypertensive retinopathy, thus assessing its potential as a screening tool to rule out hypertensive retinopathy by the acute internal medicine doctor.
Study Type
OBSERVATIONAL
Enrollment
375
Point of care ultrasonography of the optic nerve sheath diameter
Papilledema
Sensitivity of ONSD \> 5mm for diagnosis of papilledema
Time frame: 2 years
Hypertensive retinopathy grade 3 & 4 combined
Sensitivity/specificity of the ONSD for hypertensive retinopathy grade 3 \& 4 combined
Time frame: 2 years
Hypertensive encephalopathy
Sensitivity/specificity of the ONSD for hypertensive encephalopathy
Time frame: 2 years
Rapid acting medications administered intravenously to lower the elevated blood pressure
Sensitivity/specificity of the ONSD for the need for rapid acting medications administered intravenously to lower the elevated blood pressure
Time frame: 2 years
Presence of a bulging optic nerve disc and/or crescent sign found by ultrasonography of the optic nerve
Diagnostic characteristics for the presence of a bulging optic nerve disc and/or crescent sign for above mentioned diagnoses (papilledema, hypertensive retinopathy grade 3\&4 combined, hypertensive encephalopathy, need for rapid acting intravenous medications to lower elevated bloodpressure).
Time frame: 2 years
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