Point-of-care ultrasound of optic nerve sheath size in hypertensive emergency

In patients presenting with suspected hypertensive emergency without apparent organ damage that already requires immediate decrease in blood pressure, guidelines recommend funduscopy to rule out hypertensive retinopathy. However, funduscopy requires the presence of an ophthalmologist, leading to delays in diagnosis and adequate treatment. Ultrasonographic measurement of the optical nerve sheath diameter (ONSD) may rule out clinically relevant hypertensive retinopathy if proven effective. This study aims to determine the diagnostic characteristics of this procedure for the diagnosis of hypertensive retinopathy, thus informing the debate as to whether this procedure may replace funduscopy in the management of suspected hypertensive emergency.