Real time B-Scan evaluation of Posterior chamber & extraocular pathologies of Eye & Orbit

Satya bhuwan singh Netam, Vishal Jain, Rajesh Singh, Sanjay Kumar, Vishnu Dutt


Objective: Aim of this study is to assess the usefulness and accuracy of high frequency real time ultrasound using non dedicated all purpose scanner to detect and characterise posterior chamber and extraocular pathologies in trauma and non-traumatic eye and to establish etiology of proptosis. Material & Method: A total number of 138 cases (145 eyes) were included in the study. Ultrasound evaluation of eyes with diagnosed or suspected posterior segment pathology, cases of trauma, suspected or diagnosed intraocular tumors / extraocular pathologies and cases presenting with proptosis. Patients lost to follow up and eyes with normal scan were excluded. Supplementary investigation (CT, MRI) done where ever needed. The findings of B-scan then correlated with the ophthalmoscopic/ surgical findings/histology/follow up after treatment. Results: Distinction between intra and extra-ocular pathologies was 100%. The commonest posterior segment pathology in non traumatic eyes was retinal detachment and in traumatic eye was vitreous haemorrhage with diagnostic accuracy of 98.9% and 97.9% respectively. Retinoblastoma and pseudotumor (15%) were the commonest intra and extraocular mass lesions respectively. Accuracy in localization of foreign bodies and dislocated lens, in diagnosing retinoblastoma, in diagnosis and characterization of thyroid orbitopathy, cavernous hemangioma, tumors, cellulitis, dermoids, cysticercosis and intraorbital cysts was excellent. “Triple wall” sign is typical for intraorbital hydatid cyst. Conclusion: B-mode real time ultrasound using non-dedicated all purpose high frequency transducer provides non-ionizing, cost effective, non-invasive technique with excellent image quality and high accuracy for diagnosis and assessment of posterior segment and extraocular pathologies.

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Mundt.G and hughes W. Ultrasound in ocular diagnosis. Am J Ophthalmol, 1956; 41:488198.

BAUM G, GREENWOOD I. The application of ultrasonics locating techniques to ophthalmology; theoretic considerations and acoustic properties of ocular media. I. Reflective properties. Am J Ophthalmol. 1958 Nov;46(5 Pt 2):319-29.

Coleman JD. Ultrasonography of eye and orbit. 2nd ed. Lippincott: Williams and Wilkins; pp. 47–122.

Coleman DJ. Reliability of ocular and orbital diagnosis with B-scan ultrasound. American journal of ophthalmology 1972 April; 73(4):501-16.

Jack RL, Coleman DJ. Detection of retinal detachments secondary to choroidal melanoma with B-scan ultrasound. Am J Ophthalmol. 1972 Dec;74(6):1057-65.

Coleman DJ, Jack RL, Franzen LA. Ultrasonography in ocular trauma. Am J Ophthalmol. 1973 Feb;75(2):279-88.

Sutherland GR, Forrester JV, Railton R. Echography in the diagnosis and management of retinal detachment. Br J Radiol. 1975 Oct;48(574):796-800.

Vashisht S, Berry M. Ultrasound evaluation of the eye. Indian journal of radiology & imaging 1994; 4:195-201.

Ahmed J, Shaikh FF, Rizwan A, Memon MF. Evaluation of vitreo retinal pathologies using B-scan ultrasound. Pak J Ophthalmol 2009; 25(4).

O.P.Sharma. Orbital sonography with its clinic-surgical correlation. Ind J Radiol Imag 2005; 15(4): 537-554.

Lt Col KK Sen, Lt Col JKS Parihar, Maj M Saini, Brig RS Moorthy. Conventional B-mode ultrasonography for evaluation of retinal disorders. Medical Journal Armed Forces India 2003; 59: 310-312.

Azzolini C, Pierro L, Candino M, Brancato R. Reliability of preoperative ultrasonography evaluation for vitreoretinal surgery. Eur J Ophthalmol. 1994 Apr-Jun;4(2):82-90.

McNicholas MM, Brophy DP, Power WJ, Griffin JF. Ocular sonography. AJR Am J Roentgenol. 1994 Oct;163(4):921-6.

McQuown DS. Ocular and orbital echography. Radiol Clin North Am. 1975 Dec;13(3):523-41.

Bedi DG, Gombos DS, Ng CS, Singh S. Sonography of the eye. AJR Am J Roentgenol. 2006 Oct;187(4):1061-72.

Aironi VD, Gandage SG. Pictorial essay: B-scan ultrasonography in ocular abnormalities. Indian J Radiol Imaging. 2009 Apr-Jun;19(2):109-15. doi: 10.4103/0971-3026.50827.

Kwong JS, Munk PL, Lin DT, Vellet AD, Levin M, Buckley AR. Real-time sonography in ocular trauma. AJR Am J Roentgenol. 1992 Jan;158(1):179-82.

Chugh JP, Susheel, Verma M. Role of ultrasound in ocular trauma. Ind J Radiol Imag 2001; 11(2):75-79.

Puodziuvien E, Paunksnis A, Kurapkien S, Imbrasien D. Ultrasound value in diagnosis, management and prognosis of severe eye injuries. ISSN 1392-2114 ULTRAGARSAS, Nr. 3(56).2005.

Bronson NR 2nd. Contact B-scan ultrasonography. Am J Ophthalmol. 1974 Feb;77(2):181-91.

Berrocal T, de Orbe A, Prieto C, al-Assir I, Izquierdo C, Pastor I, Abelairas J. US and color Doppler imaging of ocular and orbital disease in the pediatric age group. Radiographics. 1996 Mar;16(2):251-72.

Dacey MP, Valencia M, Lee MB, Dugel PU, Ober RR, Green RL, Lopez PF. Echographic findings in infectious endophthalmitis. Arch Ophthalmol. 1994 Oct;112(10):1325-33.

Duan Y, Liu X, Zhou X, Cao T, Ruan L, Zhao Y. Diagnosis and follow-up study of carotid cavernous fistulas with color Doppler ultrasonography: analysis of 33 cases. J Ultrasound Med. 2005 Jun;24(6):739-45.

Belden CJ, Abbitt PL, Beadles KA. Color Doppler US of the orbit. Radiographics. 1995 May;15(3):589-608.

Lieb WE. Color Doppler ultrasonography of the eye and orbit. Curr Opin Ophthalmol. 1993 Jun;4(3):68-75.

Kaliaperumal S, Rao VA, Parija SC. Cysticercosis of the eye in South India--a case series. Indian J Med Microbiol. 2005 Oct;23(4):227-30.

Madigubba S, Vishwanath K, Reddy G, Vemuganti GK. Changing trends in ocular cysticercosis over two decades: an analysis of 118 surgically excised cysts. Indian J Med Microbiol. 2007 Jul;25(3):214-9.

Prasad S, Jaiswal AK, Kumar D. Orbital cysticercosis- varied presentation and its management with Albendazole. AIOC 2008 proceedings: 422-23.

Lombardo J. Subretinal cysticercosis.Optom Vis Sci. 2001 Apr;78(4):188-94.

Das et al. Neuro and intraocular cysticercosis: a clinic-pathological case report. Eye and Brain 2010:2, 39-42.

Chaudhry IA, Shamsi FA, Arat YO, Riley FC. Orbital pseudotumor: distinct diagnostic features and management. Middle East Afr J Ophthalmol. 2008 Jan;15(1):17-27. doi: 10.4103/0974-9233.53370.

Dubey RB, Tara N, Sisodiya KN. Computerised Tomographic evaluation of orbital diseases. Ind J Radiol Imag 2003; 13:261-70.

Bianciotto C, Demirci H, Shields CL, Eagle RC Jr, Shields JA. Metastatic tumors to the eyelid: report of 20 cases and review of the literature. Arch Ophthalmol. 2009 Aug;127(8):999-1005. doi: 10.1001/archophthalmol.2009.120.

Betharia SM , Sharma V, Pushker N. Ultrasound findings in orbital hydatid cysts. Am J Ophthalmol. 2003 Apr;135(4):568-70.


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