Sharanaprasad, Hosapeti (2012) B mode ultrasound: its diagnostic role in the evaluation of ocular and orbital diseases. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Ocular ultrasound takes a weekend to learn and a life time to master! B Scan ultrasonography is an important adjuvant for clinical assessment of various ocular and orbital diseases. With proper use one can gather vast amount of information not possible with clinical examination alone. In the past two decades, clinical use of ophthalmic ultrasound has come of age. The equipment has grown in sophistication and our understanding of its merits and scope of clinical application has been steadily increasing. This has increased the ability to detect and differentiate a wide variety of ocular and orbital disorders using ultrasound. Today, ultrasonography (USG) is an indispensable tool in the preoperative evaluation of the posterior segment behind an opaque ocular media (which prevents the examination by other methods) to obtain good surgical results and to avoid inadvertent complications during surgery in the differentiation of intraocular tumours and in the accurate calculation of intraocular lens power. The recent development of ultrasound biomicroscopy (UBM) has provided us with the magnified in vivo images of the anterior segment structures. The availability of high resolution scanners, combined with colour Doppler has permitted us to venture into the orbit. Ultrasound is a safe, non invasive procedure which can be performed in the outpatient department, without any sedation and radiation exposure. The relative low cost and less time consumption of ultrasound in comparison to CT and MRI gives it a distinct and practical advantage that will maintain its value along with other imaging modalities for the foreseeable future. Hence, the study to determine the role of ultrasound in the evaluation of ocular and orbital diseases assumes importance especially in a developing country like India. AIMS AND OBJECTIVES: 1. To evaluate the role of B-mode ultrasound as a diagnostic tool and prognostic indicator for posterior segment examination in eyes with opaque media (due to any cause) where other methods of examination fail to visualize the posterior segment. 2. To assess the usefulness of B-mode ultrasound in the detection and for topographic evaluation of intraocular tumours. 3. To assess the role of B-mode ultrasound in the evaluation of orbital lesions. MATERIALS AND METHODS: This study was conducted in the Department of Ophthalmology, Government Rajaji Hospital, Madurai during the period July 2010 to June 2011. The subjects for the study were selected from the following sources, 1. Out-patients attending the Department of Ophthalmology, Government Rajaji Hospital, Madurai. 2. In-patients of Department of Ophthalmology, Government Rajaji Hospital, Madurai. 3. Out-patients and in-patients of various other departments of Government Rajaji Hospital who were referred to the Department of Ophthalmology. SUMMARY: In the present study, 206 eyes of 164 patients were included. Of these, 176 eyes of 144 patients had opaque media and 30 eyes of 20 patients had orbital diseases. A provisional clinical diagnosis was made initially and then ultrasound examination was carried out. 16 patients were lost for follow up. In the remaining patients a final diagnosis was established either by other ancillary investigations or following surgery. This was then compared with the echographic diagnosis already made. CONCLUSION: B mode ultrasound not only diagnosed intraocular pathologies with high sensitivity and specificity but also helped in planning management of traumatic eyes. Thus B mode ultrasound is an ideal diagnostic tool and useful prognostic indicator in the evaluation of eyes with opaque media where other methods of examination fail to visualise the posterior segment. B mode ultrasound is extremely useful and accurate in the detection, differentiation and staging of intraocular tumours. Though ultrasound has an important role in the evaluation of orbital lesions, it should be combined with other imaging modalities like CT Scan and MRI. CT scan and MRI are definitely better for orbital apex lesions. Thus owing to its accuracy, cost effectiveness, safety, repeatability, absence of radiation exposure, excellent tissue differentiation and noninvasive nature, ultrasound is an indispensable tool in the evaluation of ocular and orbital diseases. This is more so in a developing country like India where other imaging modalities are neither widely available nor affordable.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | B mode ultrasound ; ocular ; orbital diseases ; evaluation |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 05 Oct 2017 11:51 |
| Last Modified: | 06 Oct 2017 03:33 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3615 |
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