ROLE OF HIGH RESOLUTION ULTRASONOGRAPHY IN THE EVALUATION OF POSTERIOR SEGMENT LESIONS OF THE EYE

Abstract

Rashmi M. Nagaraju1, Ravi Ningappa2, Bhimarao3

BACKGROUND: The superficial location of the eye, its cystic composition, and the advent of high-frequency ultrasound make sonography ideal for imaging the eye. Ultrasonography is a simple, readily available, non-invasive, non-ionizing, highly accurate, real time and cost effective modality

. OBJECTIVES: 1) To evaluate the accuracy of high resolution Bmode ultrasonography in the diagnosis of posterior segment lesions of eye as compared to ophthalmoscopic examination particularly in cases of opaque conducting media. 2) To evaluate sonographic appearances of various posterior segment lesions of the eye.

MATERIALS AND METHODS: 1) A prospective study was carried out on 62 cases with suspected posterior segment lesions of eye. All patients clinically suspected to have posterior segment lesions in the presence of opaque conducting media were included in the study. Cases suspected to have isolated anterior segmental and extra ocular lesions were excluded. 2) HRUS was performed with Philips IU22 using high frequency probe (5 to 17 MHz) utilizing contact method. 3) Sonological diagnosis was made based on sonographic features such as location, morphology, echo pattern, color Doppler characteristics, kinetics of the lesion with eye movements and acoustic characteristics of the lesion. 4) Subsequent clinical, lab investigations, surgical and histopathological examinations were carried out as applicable and final diagnosis was made which was correlated with the sonological diagnosis. Sonological diagnosis was also compared with ophthalmoscopic diagnosis.

STATISTICAL ANALYSES: The validities and diagnostic accuracies of high resolution ultrasound and ophthalmoscopic examinations were calculated and compared.

RESULTS AND CONCLUSIONS: 1) Ultrasound was the initial imaging modality opted in most of the cases as it was readily available, simple and cost effective modality. It establishes the diagnosis in significant number of cases superseding the accuracy of ophthalmoscopic diagnosis with significant difference (p- value < 0.0001). 2) It is particularly well suited in cases of opaque conducting media when direct ophthalmoscopy is not possible. 3) HRUS is a highly sensitive modality and it can reliably differentiate various ocular detachments, vitreoretinal disorders and neoplastic lesions with significant accuracy.

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