The early diagnosis of increased intracranial pressure is of great value for the prognosis of neurological diseases. Non-invasive ocular multimodal imaging methods for intracranial pressure monitoring include optic nerve sheath diameter measurement and optical coherence tomography (OCT). Optic nerve sheath diameter measurement is the most convenient and efficient, and OCT has also been proven applicable for the early differentiation of papilledema associated with increased intracranial pressure. This editorial aims to detail the clinical value, diagnostic efficacy, and application scenarios of three imaging methods for optic nerve sheath diameter measurement and OCT in predicting increased intracranial pressure, clarifying that multimodal imaging methods help improve the monitoring system for increased intracranial pressure and provide guidance for early screening of intracranial pressure elevation. Given the promising application prospects of multimodal imaging in ophthalmology, it is suggested that ophthalmologists pay more attention to optic nerve sheath diameter and OCT results when facing patients suspected of having increased intracranial pressure, and conduct relevant basic and clinical research to further explore the application value of multimodal imaging in different age and disease conditions.
Radiation-induced optic neuropathy (RION) is a severe complication of radiotherapy for head and neck tumors, characterized by painless, often irreversible visual decline after a long and highly variable latent period. Its incidence correlates with radiotherapy techniques and tumor types, with radiation dose constituting the principal risk factor. Advanced age and pre-existing vascular conditions can further elevate the risk of RION. The underlying pathology is thought to involve vascular injury, dysregulated molecular signaling, and impaired axoplasmic transport, although these mechanisms are not fully understood. Diagnosis in clinical practice remains largely exclusionary, based on patient history, imaging, and visual function testing. No specific cure exists, so management focuses on symptomatic relief and vision stabilization. Adherence to established safe radiation dose thresholds is the most effective strategy for reducing RION incidence. This review synthesizes clinical insights to summarize the epidemiology, risk factors, pathophysiology, diagnosis, and management of RION, discusses ongoing challenges in its prevention and treatment, and aims to inform more precise prevention and personalized therapeutic strategies.