Title: Role of B-scan ultrasonography in Evaluating Posterior segment of the eye in the event of non visualization of Fundus

Authors: Dr Ridham Nanda, Dr Dinesh Gupta, Dr Priyanka Sodani

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.124

Abstract

Background: Evaluation of posterior segment of eye in hazy ocular media is difficult ophthalmoscopically. B-scan ultrasonography is an important tool in such cases.

Purpose: To evaluate the status of the posterior segment of eyes in patients with opaque ocular media due to any reason.

Materials and Methods: This prospective study was conducted in the Ophthalmology department of a tertiary care hospital over a period of one year from November 2015 to October 2016, on two hundred patients presenting with opaque ocular media. After detailed history and clinical examination, B-scan ocular examination was done using ultrasound machine - Nidek US-4000 (Echoscan) with the contact method. Data was entered in Microsoft excel and Chi Square test was used for statistical analysis.

Results: Out of 200 patients, 141 (70.5%) were males and 59 (29.5%) -females. The patients had an age range between 6 months to 90 years. The mean age was 47.845 ± 22.95 years. Majority of patients (34%) were in the age group ≥61 years. The most common indication of ocular sonography in our study was opaque media due to lenticular opacity (48.5%). One hundred eight patients (54%) did not demonstrate any posterior segment pathology on B-scan echography. Two most common posterior segment lesions found in our study were vitreous haemorrhage (VH) - 18.50% and retinal detachment (RD) combined with vitreous disorders- 8%, respectively. Other B-scan findings were isolated retinal detachment group which comprised 7%, retinoblastoma - 1.5% patients, total choroidal detachment (1.5%), endophthalmitis (1%), dislocated PCIOL in vitreous (1%) and phthisis bulbi -0.5%.

Conclusion: B scan ultrasonography is an indispensible tool in examination of posterior segment in patients with opaque ocular media, where a preoperative fundoscopic evaluation is virtually impossible.

Keywords: B scan, posterior segment, opaque ocular media

References

1.   1.      Weiss RA, Haik BG, Smith ME. Introduction to diagnostic imaging techniques in ophthalmology. Int Ophthalmol Clin 1986; 26(3):1-24

2.      Anteby II, Blumenthal EZ, Zamir E, Waindim P. The role of preoperative ultrasonography for patients with dense cataract: a retrospective study of 509 cases. Ophthalmic surg lasers 1998; 29(2):114-8

3.      Verbeek AM. Differential diagnosis of intraocular neoplasms with ultrasonography. Ultrasound Med Biol 1985; 11(1):163-70

4.      McNicholas MM, Brophy DP, Power WJ, Griffin JF. Ocular trauma: evaluation with US. Radiol 1995; 195(2):423-7

5.      Fisher YL, Slakter JS, Friedman RA, Yannuzzi LA. Kinetic ultrasound evaluation of the posterior vitreoretinal interface. Ophthalmol 1991; 98(7):1135-8

6.      Aironi VP, Gandage SG. Pictorial essay: B-scan ultrasonography in ocular abnormalities. Ind J Radiol Imaging 2009; 19 (2):109-15

7.      Dawood Z, Mirza SA, Qadeer A. Role of B-scan ultrasonography for posterior segment lesions. Pak J LUMHS 2008; 07(1):7-12

8.      Qureshi MA, Laghari K. Role of B-scan ultrasonography in preoperative cataract patients. Int J Health Sci 2010; 4(1):31-37

9.      Rabinowitz R, Yagev R, Shoham A, Lifshitz T. Comparison between clinical and ultrasound findings in patients with vitreous hemorrhage. Eye 2004; 18(3):253-6   

10.  Sen KK, Parihar JKS, Saini M Moorthy RS. Conventional B-mode ultrasonography for the evaluation of retinal disorders. MJAFI 2003; 59:310-12

11.  Sharma OP. Orbital sonography with its clinico-surgical correlation.  Ind J Radiol Imag 2005; 15(4):537-54

12.  Javed EA, Chaudhry AA, Ahmad I, Hussain M. Diagnostic applications of “B-Scan”.  Pak J Ophthalmol 2007; 23(2):80-83

13.  Maresova K, Kalitova J, Simicak J,  Rehak J. The ultrasound findings in post-traumatic endophthalmitis. Cesk Slov Oftalmol 2006; 62(2):125-32

14.  Maneschg O, Csakany B, Nemeth J. Ultrasonographic findings in endophthalmitis following cataract surgery: a review of 81 cases. Ophthalmologe 2009; 106(11):1012-15

Corresponding Author

Dr Ridham Nanda

House No. 49, Denis Gate, Near Mansar Hotel, Jammu - 180001, J&K, India

Mob: 9419617971, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.