Early Recognition of Raised Intracranial Pressure in Craniosynostosis Using Optical Coherence Tomography

Methods: We conducted a systematic review of the literature published from inception until 19 August 2019, in the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE and EMBASE. Eligible studies evaluated the role of OCT in detecting raised ICP in children aged 0-16 years with craniosynostosis. Main outcome measures were sensitivity and specificity of OCT parameters for raised ICP. Quality assessment was performed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results: Out of 318 records identified, data meeting the inclusion criteria were obtained from three studies. The quality of two studies was poor whilst one was fair. OCT demonstrated higher sensitivity and specificity for detecting raised ICP compared to fundus examination, clinical history, radiological testing and visual field testing.

Conclusions: This systematic review demonstrated a lack of quality evidence for OCT as a screening tool for children with craniosynostosis.Further research isrequired to clarify the strength of OCT in this role and to determine which OCT parameters are most appropriate