Role Of B–Mode Ultrasound In The Evaluation Of Orbital Masses.

Introduction: Blindness and Vision impairment cause significant morbidity amongst Indian population. According to WHO estimates, about 20.5 % people in India are categorized as blind while 22.2 % people have low vision. The orbital masses owing to the small anatomical volume of orbit can cause devastating consequences. Ultrasound and colour doppler are useful in analysis of orbital masses with real time evaluation, excellent soft tissue resolution, localisation, and benign or malignant nature of masses. This study evaluates the role of ultrasound in orbital masses.Aim: To study the role of ultrasound in evaluation and identification of orbital masses.Study design & settings: Prospective observational study in ultrasound unit of a rural hospital in central India.Materials and methods: Atotal of 316 consenting patients were studied for 1 year using high frequency linear and curved probes. Statistical analysis was done using SPSS software (IBM Inc.)Results:Out of the 316 patients, total 15 cases were identified to have orbital masses. Most common orbital mass lesions observed were lacrimal gland tumours. Most of the masses were extraconal in location and most common ultrasound appearance of the lesions was solid with most of the malignant masses showing vascularity on colour doppler imaging.Conclusion:Ultrasound can identify and characterize orbital masses based on appearance and echotexture with accurate localisation. It is cheap and easily available with no radiation hazards Pre-operative ultrasound and Colour Doppler evaluation of orbit can help in predicting prognosis of the disease.

Elderly male with blurry vision / 世界急诊医学杂志（英文）

@#We present a case of an elderly gentleman who was punched in the face and subsequently diagnosed by an emergency physician with acute angle closure glaucoma secondary to a posterior lens dislocation. Slit lamp evaluation, ocular ultrasound, and computed tomography (CT) imaging, can identify a dislocated lens. A rare complication of a lens dislocation includes secondary acute angle closure glaucoma. Treatment of lens dislocation includes prosthetic lens placement or reattachment in cases of a partial lens dislocation.

Observer variation in quantitative assessment of retinal shortening with ultrasound in patients of total rhegmatogenous retinal detachment

Purpose: To evaluate the interobserver variation in the assessment of retinal length to choroidal length ratio (RCR) as a marker for proliferative vitreoretinopathy (PVR) in cases of rhegmatogenous retinal detachment (RRD). Methods: This was a double-masked, prospective study at a tertiary center. Ultrasound was used to calculate RCR in 50 eyes with total RRD by two observers. Both observers were trained after the first round of calculations, and all the calculations were repeated as before. Difference between the RCR values was stratified into four categories (<0.01, 0.01�05, 0.06�1, and >0.1) for descriptive analysis. A difference of 0.05 was set as the maximal limit for defining interobserver agreement. Correlation between RCR and interobserver difference was assessed. Results: The mean interobserver difference in RCR values was found to be 0.06 � 0.0 (P = 0.41) and was reduced to 0.04 � 0.02 (P = 0.81) following training. The interobserver difference was <0.1 in 82% of the cases before training and in 98% of cases after training. The worst interobserver agreement was noted in cases with RCR < 0.8, and there was a good negative correlation between RCR and interobserver difference (r = ?0.6, P ? 0.001). Conclusion: There is good interobserver agreement in assessing RCR with ultrasound in eyes with RRD, which improves further with training. RCR needs careful assessment in eyes with very low RCR. This technique may be useful in prognostication of surgical outcomes in cases with advanced PVR.

Exploración ecográfica ocular básica en perros (modo B tiempo real) / Basic ocular ultrasound examination in dogs (real-time B-mode) / Exploração por meio de ultrassonografia ocular básica em cachorros (modo B tempo real)

Resumen: En las últimas décadas, la ecografía veterinaria ha vivido un gran avance tecnológico y técnico. Los médicos veterinarios no solo la utilizan para las valoraciones comunes de abdomen, o incluso corazón, sino que han descrito técnicas para exploraciones más especiales, como para el sistema musculoesquelético, el vascular, el ocular, entre otros. La literatura sobre el tema ha reseñado el desarrollo y aplicación de la ecografía ocular modo A, específica para la valoración oftalmológica por parte veterinarios especializados en esta área. Actualmente, un gran número de clínicas veterinarias cuenta con ecógrafos con modo B tiempo real, que permiten una excelente valoración descriptiva de la anatomía ocular para orientar posibles diagnósticos. Este artículo de revisión presenta de forma concisa las principales indicaciones de la ecografía ocular modo B y la técnica de realización, y describe cualitativamente las imágenes normales de la exploración de este órgano de los sentidos.

Abstract: In recent decades, veterinary ultrasound has experienced a great technological and technical progress. Veterinary doctors not only use it for common evaluation of abdomen, or even heart, but techniques have been described for more special examinations, such as for the musculoskeletal, vascular, and ocular systems, among others. Literature on the subject has reviewed the development and application of A-mode ocular ultrasound, specific for ophthalmologic evaluation by veterinarians specialized in this area. Currently, a large number of veterinary clinics has real-time B-mode ultrasound scanners, which allow an excellent descriptive evaluation of the ocular anatomy to guide possible diagnoses. This review article concisely presents the main indications and realization technique for B-mode ocular ultrasound, as well as qualitatively describes normal scan images of this sense organ.

Resumo: Nas últimas décadas, a ecografia veterinária tem vivido um grande avanço tecnológico e técnico. Os médicos veterinários não somente a utilizam para as avaliações comuns de abdômen, ou, inclusive o coração, mas também têm descrito técnicas para explorações mais especiais, como para o sistema musculoesquelético, o vascular, o ocular, entre outros. A literatura sobre o tema resenhou o desenvolvimento e aplicação da ultrassonografia ocular modo A, específica para a avaliação oftalmológica por parte de veterinários especializados nesta área. Atualmente, um grande número de clínicas veterinárias conta com scanners com modo B tempo real, que permitem uma excelente avaliação descritiva da anatomia ocular para orientar possíveis diagnósticos. Este artigo de revisão apresenta de forma concisa as principais indicações da ultrassonografia ocular modo B e a técnica de realização, e descreve qualitativamente as imagens normais da exploração deste órgão dos sentidos.

Contribution of ocular B-mode and triplex Doppler in the evaluation of 10 Poodle dogs with cataracts / Contribuição diagnóstica da ultrassonografia ocular e Doppler Triplex na avaliação de 10 cães Poodle com catarata

The findings of b-mode and especially triplex Doppler ocular ultrasound in the evaluation of 10 Poodle dogs with cataracts, which bring a contribution not yet reported in veterinary medicine, were reported. Ten Poodle dogs of varied ages and presenting cataracts were used. All animals were evaluated for ophthalmic and ultrasound examination. The ultrasound examination allowed the evaluation of the sonographic anatomy of the eye and measurement of the axial thickness of the lens (ATL). Using the Doppler mode, the blood flow of the ophthalmic artery and its vascular indexes, systolic velocity (SV), resistive index (RI) and pulsatility index (PI) were measured. Values found for ATL were 5.89±1.05 for the right eye (OD) and 6.07±1.32 for the left eye (OS). Values found using Doppler evaluation were SV OD: 26.54±7.05 and SV OS: 29.21±11.18; PI OD: 1.89±0.61 and PI OS: 1.7±0.35; RI OD: 0.76±0.1 and RI OS: 0.72±0.09 (OS). It was concluded that triplex Doppler was important for the determination of vascular indexes of the ophthalmic artery, which can be used for monitoring animals with hemodynamic alterations of the eyes and monitoring the therapy of ocular diseases.

Descreveram-se os achados da ultrassonografia ocular convencional e, principalmente, do modo Doppler Triplex na avaliação de 10 cães da raça Poodle com catarata, contribuindo com parâmetros ainda não relatados em medicina veterinária. Foram utilizados 10 cães de diferentes idades e da raça Poodle, apresentando graus variados de catarata. Os animais foram submetidos ao exame oftalmológico e ultrassonográfico. Por meio da ultrassonografia avaliaram-se a anatomia ultrassonográfica dos bulbos oculares e a espessura axial da lente (EAL). Por meio do modo Doppler verificaram-se o tipo de fluxo sanguíneo da artéria oftálmica e seus índices vasculares, a velocidade sistólica (VS), o índice de resistência (RI) e a pulsatividade (PI). Os valores de EAL para olho direito (OD) foi de 5,89±1,05 e para o olho esquerdo (OE) de 6,07±1,32. Por meio do Doppler, observaram-se VS para OD de 26,54±7,05 e VS para OE de 29,21±11,18; PI para OD de 1,89±0,61 e PI para OE de 1,7±0,35; RI para OD de 0,76±0,1 e PI para OE de 0,72±0,09. Concluiu-se que o modo Doppler Triplex mostrou-se importante para determinação das medidas dos índices vasculares da artéria oftálmica, podendo ser utilizada para o acompanhamento de alterações hemodinâmicas nos olhos dos animais acometidos e no acompanhamento da terapia de doenças oculares.

Avaliação ultra-sonográfica do segmento posterior de olhos de cães diabéticos e não diabéticos portadores de catarata / Ultrasonographic evaluation of the eyes' posterior segment of diabetic and non-diabetic dogs with cataracts

A catarata impossibilita a passagem de luz dentro do olho, dificultando o exame físico direto das estruturas oculares. É necessária a identificação prévia de quaisquer alterações oculares que contra-indiquem a cirurgia de catarata. A ultra-sonografia, ou ecografia ocular, é um exame seguro, de baixo custo, não invasivo, de fácil realização, que completa o exame oftálmico. Foi realizada avaliação ultra-sonográfica, com transdutor linear, freqüência de 10 MHz, de 225 olhos de 123 cães, sendo cães controle (Grupo 1), 52 cães não diabéticos portadores de catarata (Grupo 2) e 35 cães diabéticos portadores de catarata (Grupo 3), todos eles atendidos no Hospital Veterinário da Universidade de São Paulo. Foram encontradas as seguintes alterações ultra-sonográficas no Grupo 1: degeneração vítrea em 43 por cento, descolamento de vítreo posterior em 7,7 por cento, hialose asteróide em 4,6 por cento dos olhos; no Grupo 2: degeneração vítrea em 58,9 por cento, descolamento de vítreo posterior em 8,4 por cento, hialose asteróide em 2,1 por cento, processo inflamatório e/ou hemorrágico em 2,1 por cento e descolamento de retina em 4,3 por cento dos olhos; e no Grupo 3: degeneração vítrea em 50,7 por cento, descolamento de vítreo posterior em 13,8 por cento, hialose asteróide em 12,3 por cento, processo inflamatório e/ou hemorrágico em 3,1 por cento e descolamento de retina em 3,1 por cento dos olhos. Concluiu-se, que (1) cães diabéticos, principalmente os que apresentam a doença há mais de 2 anos, tem maior predisposição para o desenvolvimento de hialose asteróide; (2) não houve diferença entre a freqüencia de descolamento de retina encontrada em cães diabéticos e não diabéticos; e (3) a ultra-sonografia ocular é em exame seguro, eficaz e importante na avaliação pré-operatória de cães portadores de catarata.

Cataracts jeopardize the light penetration into the eye and may restrain direct exam of eye structures. It is necessary to identify very early any eye disease that could cause the failure of cataract surgery. The ocular ultrasonography or echography is a safe, non invasive, inexpensive and easy procedure that complements ocular examination. Two hundred and twenty five eyes of 123 dogs were evaluated using a 10 Mhz linear transducer ultrasound. The dogs were divided into three groups, as there is Group 1: 36 healthy control dogs; Group 2: 52 non diabetic dogs with cataracts; and Group 3: 35 diabetic dogs with cataracts; all of them were patients of the Veterinary Teaching Hospital, University of Sao Paulo. The ultrasonographic findings were in Group 1: vitreous degeneration in 43 percent, posterior vitreous detachment in 7.7 percent, asteroid hyalosis in 4.6 percent of the eyes; in Group 2: vitreous degeneration in 58.9 percent, posterior vitreous detachment in 8.4 percent, asteroid hyalosis in 2.1 percent, inflammatory or haemorrhagic process in 2.1 percent, retinal detachment in 4.3 percent of the eyes; and in Group 3: vitreous degeneration in 50.7 percent, posterior vitreous detachment in 13.8 percent, asteroid hyalosis in 12.3 percent, inflammatory or haemorrhagic process in 3.1 percent, retinal detachment in 3.1 percent of the eyes. It could be concluded that (1) diabetic dogs, mainly the ones with diabetes for more than 2 years, have greater chances to develop asteroid hyalosis; (2) there were no significant differences in retinal detachment frequencies for the diabetic and non diabetic dogs; and (3) the ocular ultrasonography is a safe, effective and important exam for the pre-operatory evaluation of dogs with cataracts.