Non-Invasive Ocular Biomarkers for Intracranial Pressure
Deepta Ghate Collaboration: Non-Invasive Ocular Biomarkers for Intracranial Pressure 

Head wounds causing traumatic brain injury (TBI) are a major cause of death and disability in the military and in civilian life in the United States. Intracranial pressure (ICP) is the pressure within the brain. An ICP increase after TBI indicates the need for immediate medical assistance to prevent death or severe brain damage. Detecting this increased ICP is challenging because current methods of measuring ICP need surgeons to drill holes into either the brain or the spine and directly measure pressure. Our previous work in animals and humans has shown that eye measurements, namely the intraocular pressure (IOP- pressure in the eye), episcleral venous pressure (EVP-pressure in the veins on the eye surface), and retinal vein diameter (RVD- thickness of the veins inside the eye) increase with increasing ICP. These eye measurements are obtained easily and quickly at the surface of the eye. 

We propose to study these eye measurements in humans, specifically in 2 groups of patients in the hospital whose ICP is already being measured as part of their clinical care. These will include patients in the intensive care unit who have an ICP pressure monitor in their brain and patients undergoing lumbar puncture procedure to remove cerebrospinal fluid (fluid around brain) from the spine, as part of standard medical care. Our expectation is that these eye measurements (EVP, IOP and RVD) will increase with increasing ICP. We will analyze the data and develop a mathematical formula to estimate ICP using these 3 measurements. In this study, we also propose to further develop our portable device for EVP measurement to make it suitable for military use. Our study can fill the scientific and societal need for a cost-efficient, rugged, portable method for estimating ICP without inserting needles into the fluid around the brain.
UNMC: Deepta Ghate, MD (PI), Sachin Kedar, MD, Vikas Gulati, MD, William Thorell, MD, Jason Helvey, MD, Gleb Haynatzki, PhD; UNO: Deepak Khazanchi, PhD; UNL: Carl Nelson, PhD; Stanford University: Heather Moss, MD, PhD
Application for Funding:
Defense Medical Research and Development Program (DMRDP) Joint Program Committee-6 (JPC-6)/CCCRP, Multi-Domain Lifesaving Trauma Innovations (MuLTI) Award
Funding Source:
Nebraska Research Initiative System Science Team Forming Grant