SVP and ICP Association
Research type
Research Study
Full title
Spontaneous Retinal Venous Pulsation (SVP) and its association with Intracranial Pressure (ICP) in different body positions
IRAS ID
263022
Contact name
Fion Bremner
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Patients who are suspected of having chronic headaches due to abnormal intracranial pressure (ICP) are often admitted for invasive continuous ICP monitoring for 24-48 hours. At the National Hospital for Neurology and Neurosurgery (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. One component of this ophthalmic assessment is to look for spontaneous retinal venous pulsations (SVP) within the eye which are expected to be present in healthy patients but disappear if the ICP is raised. SVP is traditionally assessed using an ophthalmoscope, recently our group has demonstrated that SVP is much more readily visible when assessed using infrared video recordings (IRV) compared with conventional ophthalmoscopy and for this reason IRV is routinely used to assess SVP in our hospital.
In a recent observational study, we have demonstrated that SVP and ICP had a significant correlation in a cohort of 105 patients when simultaneous measurements of ICP and SVP through IRV recordings were performed in sitting position. These results suggest that the absence of SVP assessed with IRV recordings in patients in sitting position should raise the suspicion of intracranial hypertension.
The main limitation of our previous study is the fact that, by only assessing SVP and ICP in sitting position, these results are not applicable to patients who are acutely unwell (e.g. traumatic brain injury, haemorrhagic stroke) and unable to comply to an upright ophthalmic examination.
With this pilot study we propose to investigate the association between ICP and SVP in different body positions by performing IRV recordings of SVP in both supine and upright position for two groups of patients: patients admitted at the NHNN for ICP monitoring and "Healthy Volunteers" undergoing routine ophthalmology follow-up examinations.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
19/SC/0409
Date of REC Opinion
6 Nov 2019
REC opinion
Further Information Favourable Opinion