Learning objectives
Reviewing the normal ultrasonographic anatomy of the eye and briefly listing its indications,
the purpose of this exhibit is to describe the US technique and its rolein the radiological evaluation of ophthalmological emergencies.
Clinical scenarios and most frequent pathologies will be explained.
Background
Ultrasonography (US) is an important and reliable diagnostic tool for the complete and adequate evaluation of the vitreous chamber,
allowing radiologists to identifythe mostcommon pathologies in ophthalmologic emergency scenarios when clinical ophthalmoscopy is not diagnostic,
mainly due toopacification of the light-conductingtransparent media.
The echo-structure of the eye and its superficiallocation allowsits assesment through B-mode US combined with Color Doppler,
being able to rule out various conditions that would otherwise bedifficult to differentiate in thesescenarios,
such as retinal,
vitreous,
choroidal detachment,tumours,
and otherpathological conditions that affect...
Findings and procedure details
Technique
Conventional B Mode US technique requires a high frequency (10-15 MHz) linear transducer,
preferably a small one,
as it will match with the eye socket size.Fig 3
Ocular sonography in the emergency departament is performed with the patient in supine position with his eyelids gently closed.
The sonographer should hold the probe using the thumb and index finger while the remaining fingers stabilize the arm by resting on the maxilla,
supraorbital ridge,
or other bony structures.Fig 4
Careful technique is essential in order to...
Conclusion
Proper ophthalmoscopic assessment of the vitreous chamber can not be performed or isnot conclusive in many situations.
In such cases,
ocular ultrasonography is an accessible,
highly valuable,
and efficient diagnostic modality to confirm pathology,
especially in emergency scenarios.
Adequate knowledge of the ocular anatomy,
the ultrasound technique and its indications is essential in order to recognize common and relevant pathology in emergency cases,
such as detachments and tumours.
References
1.
Sung E,
Nadgir R,
Fujita A,
Siegel C,
Ghafouri R,
Traband A et al.
Injuries of the Globe: What Can the Radiologist Offer?.
RadioGraphics.
2014;34(3):764-776.
2.
De La Hoz Polo M,
Torramilans Lluís A,
Pozuelo Segura O,
Anguera Bosque A,
Esmerado Appiani C,
Caminal Mitjana J.
Ocular ultrasonography focused on the posterior eye segment: what radiologists should know.
Insights into Imaging.
2016;7(3):351-364.
3.
Berrocal T,
de Orbe A,
Prieto C,
al-Assir I,
Izquierdo C,
Pastor I et al.
US and color Doppler imaging of...