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Objective: To determine the role of real time ultrasound B-scan in postoperative prognosis among patients with advanced cataract by documenting preoperative frequency of different posterior segment pathologies. Study Design: Cross-sectional study. Place and Duration of Study: Radiology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Oct 2011. Methodology: The study utilized ultrasound eye, carried on the patients with closed eyes in supine position with ultrasound transmission gel applied to prevent transducer touching eyelid. Scan was performed in both sagital and transverse plane. Results: A total of 336 patients were included in this study, with mean age of 56.92±12.89 years, 162(48.21%) male rest female. Cataracts were found in 144 (42.86%) left eyes and 154 (45.83%) right eyes. Mature cataract was seen in 292 (86.9%) patients, while 32(9.52%) had traumatic and 304(90.47%) had non-traumatic cataract. In non-traumatic cataract, retinal detachment (RD) was in 14(4.6%) patients, vitreous detachment (VD) in 13(4.3%) and vitreous detachment/hemorrhage in 21(6.9%) patients. Optic disc cupping was seen in 6(2.0%) non-traumatic cases and other pathologies were seen in 7(2.3%) patients having nontraumatic and 3(9.38%) patients having traumatic cataract. Conclusion: Preoperative posterior segment evaluation with ultrasound in patients with dense cataract can be used to detect pathologies that may influence the surgical strategy and postoperative visual prognosis. [ABSTRACT FROM AUTHOR]

AimA free-floating vitreous cyst is a rare eye disease. This study aimed to find diagnostic imaging methods and imaging features for vitreous cysts.MethodsThis article presents a case report along with a literature review of published cases of vitreous cysts. The case report describes a highly myopic 60-year-old woman with a pigmented, free-floating vitreous cyst in her right eye. A search of the PubMed database using the keywords “vitreous cyst” was performed to identify other cases reported in the literature and to summarize the imaging methods used to diagnose and visualize vitreous cysts and the imaging features of vitreous cysts.ResultsA thorough ophthalmic examination was performed in the present case, including slit-lamp photography, B-scan ultrasound, broad line fundus imaging, spectral-domain optical coherence tomography (SD-OCT), and ultra-wide field SS-OCT. The literature review revealed the imaging methods used in previously reported cases of vitreous cysts in which ultra-wide field SS-OCT has the advantages of wide scanning depth and high imaging clarity.ConclusionSS-OCT has an advantage over SD-OCT in providing intuitive morphological characteristic images for the diagnosis of posterior vitreous cysts. The comprehensive assessment of multimodal imaging examinations, including SS-OCT, is of significant value for the diagnosis and differential diagnosis of vitreous cysts.

Cryoneurolysis is a relatively new method widely used in interventional pain management. The essence of the method consists in the introduction of the cryoprobe usually under ultrasound B-scan control in the immediate vicinity of the target nerve stricture and low temperature impact from -50 to -70 degrees. The cryointervention results in a conductive nerve block with subsequent Valerian degeneration and axonotmesis, whereby pain in the autonomic nerve zone disappears. Usually, permanent pain relief is achieved for a period of 6 to 9 months after which the nerve fibers regenerate and sensation is restored in the autonomic nerve zone. Despite encouraging results, large randomized clinical trials are needed to determine the place and indications of this method in daily clinical practice. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to measure optic nerve sheath diameter (ONSD) and lens thickness (LT) with B-mode USG in patients with glaucoma and compare them with a healthy control group. Materials and Methods: Seventy-two individuals were recruited, 35 with glaucoma and 37 age- and gender-matched controls without glaucoma. Patients with systemic hypertension, diabetes mellitus, and cataract, history of ocular trauma, higher refractive error, active ophthalmologic infection and smoking were excluded from the study. The ONSD and LT values of both eyes were measured in the supine position using 10MHz frequency B-scan ultrasound. Data analysis was performed by transferring to the SPSS version 25 program. Results: The mean ONSD of glaucomatous eyes (3.60 mm and 3.50 mm on the right and left, respectively) was found to be significantly thinner than the controls (4.20 mm and 4.55 mm on the right and left, respectively). The mean LT of eyes with controls (4.25 mm and 4.15 mm on the right and left, respectively) was significantly lower compared to glaucoma (4.40 mm and 4.30 mm on the right and left, respectively). Conclusion: In glaucoma, sonography is a reliable tool of evaluating the optic nerve sheath diameter and lens thickness. [ABSTRACT FROM AUTHOR]

AIM: To evaluate the diagnostic value of B-scan ultrasound and explore the cytological characteristics of patients with vitreoretinal lymphoma (VRL) and primary central nervous system lymphoma (PCNSL). METHODS: The clinical data and pathologic specimens from patients with VRL diagnosed at the North Huashan Hospital from 2016 to 2017 were retrospectively reviewed. The patients were diagnosed by slit lamp ophthalmoscopy, B-scan ultrasound, cytology of the vitreous, which was obtained by vitrectomy, and cytokine measurements of interleukin (IL)-10 and IL-6. RESULTS: Twenty-six eyes (19.4%) out of 134 eyes of 67 patients (47 men and 20 women) with PCNSL were diagnosed with VRL by B-scan ultrasound, and 14 eyes (10.4%) were diagnosed by slit lamp ophthalmoscopy. Twenty-four eyes (17.9%) of 17 patients were confirmed as having VRL with cytology. No difference in the association between intracranial lesion location and ocular involvement was found. VRL patients had higher levels of vitreous IL-10 and IL-10/IL-6 when compared with macular hole cases, but the difference was not statistically significant. CONCLUSION: A total of 25.4% of the PCNSL patients had VRL, B-scan ultrasound examination had characteristic features and is recommended over slit lamp ophthalmoscopy for the screening diagnosis of PCNSL with intraocular involvement. Moreover, the cytological and immunohistochemical analyses performed after 25-gauge diagnostic vitrectomy were accurate diagnostic techniques.

The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was conducted in Kinshasa from 2006 to 2019. Three hundred and twenty-three patients were included and separated into two groups. Group 1 included 262 patients with dense cataract. Group 2 consisted of 61 patients with pathologies of the ocular adnexa, and all were examined with a B-scan ultrasound. In group 1, there were 437 systematically screened eyes. Three hundred and ninety-eight eyes (91.08%) showed no abnormalities, 13 (2.97%) retinal detachments were identified, and 15 (3.43%) demonstrated a detached posterior hyaloid membrane. In the second group, 61 patients were examined (group 2). In 20 of them, surgery was performed for biopsy, tumor excision, mucoceles drainage, and palliative treatment. The need for routine B-scan examinations in dense cataract patients seems to be limited and can most likely be replaced by a thorough application of locally available examination techniques. B-scan application is recommended to manage orbital patients in the most cost-effective way.

AIM: To analysis the diagnostic value of B-scan on various kinds of strong echo signal of ocular-perforating injury.METHODS: Totally 176 patients(176 eyes)with ocular-perforating injury underwent B-scan ultrasound examination. We observed the B-scan imaging findings of the lens, vitreous cavity, eyeball wall and retrobulbar space.RESULTS: All 176 patients(176 eyes)underwent B-scan ultrasound examination had strong echo. Vitreous hemorrhage was found in 146 cases, dislocation of lens in 4 cases, intraocular foreign body in 105 cases, intravitreous bubble in 1 case, retinal detachment in 34 cases, choroidal detachment in 23 cases, posterior scleral rupture in 9 cases. Every patient had two or more signs above, and had strong echo signal. All kinds of strong echo signal of the cases were summarized as follows: thick vitreous hemorrhage; intraocular foreign body; dislocation of the lens; intravitreous bubble.CONCLUSION: Because of anterior chamber hemorrhage, cataract, vitreous hemorrhage, eyelid swelling and noncooperation of patients, we couldn't examine the posterior segment. So B-scan provides a great help to the ophthalmologist. It is very sensitive and has specific images on the detachment of retina, intraocular foreign body, posterior scleral laceration, hemorrhagic choroidal detachment. Complex perforating injury of eyeball often appears some confusing strong echo signals, but B-scan can identify those images. Thus, it is irreplaceable by other examinations.

We describe a new, specific, hyperechogenic artifact spot in B-mode ultrasound (US) in patients diagnosed with optic nerve drusen (OND). This is a retrospective chart review of 34 consecutive patients with OND using B-scan US. The patients underwent full ophthalmic evaluation and neuro-ophthalmic examination. In all cases, a typical hyperechogenic spot was seen within the acoustic shadows on medium or high gain settings. The length between the US probe and the OND, and the distance between the OND and the artifact were recorded for each patient. In all cases, a typical hyperechogenic spot was seen within the acoustic shadows on medium or high gain settings. Sonograms showed a hyperechogenic focus in all eyes. The average ratio between the cornea–OND distance (25.5 mm) and the OND–hyperechogenic spot (32.1 mm) distance was 1.26. The size of the hyperechogenic spot was proportional to the size of the deposit on the disc, with the most marked attenuation of the beam seen in the largest lesions. B-scan US is a very sensitive and reliable detector of both superficial and buried OND. The described hyperechogenic artifact spot may be an additional mode to support diagnosis of OND. This finding might be helpful for making a differential diagnosis between OND and papilledema. [ABSTRACT FROM AUTHOR]

Abstract: This study applies 2-D speckle tracking using B-scan ultrasound imaging to estimate the instantaneous and total displacement of the middle flexor digitorum superficialis (FDS) tendon proximal to the wrist. This is achieved by performing the study with human patients, during regular carpal tunnel surgeries. B-Scan images were collected with a 12-MHz transducer placed proximal to the wrist, while a video microscope simultaneously imaged the exposed flexor tendons in the palm as a reference for validation. The accuracy of the proposed speckle-based tracking method is compared using log-compressed Rayleigh (Fisher-Tippet)-, Gaussian (sum of squared differences)- and Laplacian (sum of absolute differences)-based statistics as similarity measures. Overall, tracking was successful and the Rayleigh technique performed better than the Laplacian or Gaussian technique. One goal of this research was to non-invasively monitor FDS tendon displacement in the wrist for the purposes of controlling a prosthetic device. An additional goal was to obtain pre- and post-operative clinical information. [Copyright &y& Elsevier]

We report the case of a 32-year-old man suffering from intraocular cysticercosis, with special emphasis on the use of B-scan ultrasound in the diagnosis and management of the condition. An 8000 B-Scan Scanmate was used to obtain the ultrasound images. The patient had worked on a pig farm a few years before presentation. He presented with shadows seen in the right eye. Binocular indirect ophthalmoscopy revealed that he had a choroidal detachment in the right eye inferotemporally. B-scan ultrasound revealed a subretinal subchoroidal cyst with a thick wall containing well defined intracystic echogenic entities representing scolices, and an associated retinal detachment. These findings appear to be pathognomonic. Excision of the cyst through a trans-scleral approach revealed a yellowish serous fluid, with scolices of cysticercus later confirmed histologically. B-scan ultrasound is extremely useful in the diagnosis of ocular cysticercosis and the findings can be pathognomonic. [ABSTRACT FROM AUTHOR]

Abstract: Background: Disc drusen have been found clinically in 0.3% of the population with up to 91% presenting bilaterally. Disc drusen gradually change in their ophthalmoscopic appearance throughout a patient’s lifespan. This case highlights the possible ocular complications of disc drusen and the complexity in their treatment because of the risk of visual acuity loss. Case report: A 43-year-old patient with documented bilateral buried disc drusen presented without symptoms for a routine examination. A subretinal neovascular membrane (SNVM) one quarter of a disc diameter in size with an adjacent subretinal hemorrhage was observed in the right eye with a small subretinal hemorrhage in the fellow eye. The patient was evaluated by a retinologist who deferred photocoagulation of the SNVM considering its nasal disc location. Conclusions: Diagnosing disc drusen is critical because of the serious pathology they can mimic, including disc edema. Although typically benign, patients with disc drusen should be monitored on a regular basis to rule out ocular complications, which can be potentially sight threatening. [Copyright &y& Elsevier]

Abstract: Background: Choroidal hemangioma is a rare, benign vascular ocular tumor that presents as either a circumscribed mass or as a diffuse variant. Circumscribed choroidal hemangiomas (CCH) resemble posterior segment lesions such as choroidal melanoma, choroidal metastases, central serous chorioretinopathy, or nonspecific retinal detachment. A circumscribed choroidal hemangioma often appears as a subtle red–orange mass or as a grayish lesion in the posterior choroid. In rare instances, CCH may be associated with subretinal fluid accumulation and retinal detachment. Case Report: A 35-year-old Hispanic man presented for a routine eye examination and was observed to have a choroidal lesion in the posterior pole. The lesion is an elevated subretinal mass located superotemporal to the fovea in the right eye. A Humphery visual field 24-2 test found a scotoma corresponding to the location of the lesion. B-scan ultrasound confirmed a fairly dense and large lesion. A-scan showed low to medium internal reflectivity and an acoustically solid lesion. Because the patient was asymptomatic, management through observation was recommended. Conclusions: Circumscribed choroidal hemangiomas must be adequately differentiated from other vascular tumors. A selective battery of diagnostic tests will facilitate the correct diagnosis. Management of CCH may depend on the character of the lesion and risks of ocular morbidity and vision loss. [Copyright &y& Elsevier]

Background: Vitrectomy for symptomatic vitreous floaters carries significant risks. Justification of surgery is difficult, particularly in healthy eyes with normal visual acuity and without a posterior vitreous detachment. This is the first reported case of optical coherence tomography being utilized to objectively assess the impact of a vitreous opacity on the macula. Case presentation: A 37-year-old Caucasian female complained of the sudden onset of a ring-like floater in the central visual field of her left eye. Visual acuity was 20/20, there was no intraocular inflammation and the posterior vitreous was not detached. Complete blood count with differential, serology screen (including cysticercosis and echinococcus), chest x-ray and abdominal ultrasound found no evidence of systemic infective or cystic disease. A color photograph and B-scan ultrasound confirmed a 4.31 mm free-floating semi-translucent vitreous cyst with a hyperechogenic, pigmented surface and faint internal strands suspended in the mid-vitreous cavity, in the visual axis. The cyst moved with ocular movements, but only within the vitreous lacuna it resided in. Humphrey and Goldmann visual fields were normal. However, spectral domain optical coherence tomography (OCT) demonstrated shadowing on either side of the fovea, consistent with the ring-like scotoma described by the patient. Removing the retinal layers from the 3D-reconstructed macular cube OCT revealed a circular shadow on the macula. The patient elected for conservative management and at 3-month follow-up her symptoms had almost fully resolved as the cyst migrated to the inferior vitreous cavity, no longer casting a shadow on the macula. Conclusion: To our knowledge, this is the first description of using OCT as an objective, qualitative assessment of symptoms caused by large vitreous opacities and may provide a simple yet useful adjunctive tool in evaluating the risk-benefit ratio of vitrectomy in patients with large symptomatic vitreous floaters. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was conducted in Kinshasa from 2006 to 2019. Three hundred and twenty-three patients were included and separated into two groups. Group 1 included 262 patients with dense cataract. Group 2 consisted of 61 patients with pathologies of the ocular adnexa, and all were examined with a B-scan ultrasound. In group 1, there were 437 systematically screened eyes. Three hundred and ninety-eight eyes (91.08%) showed no abnormalities, 13 (2.97%) retinal detachments were identified, and 15 (3.43%) demonstrated a detached posterior hyaloid membrane. In the second group, 61 patients were examined (group 2). In 20 of them, surgery was performed for biopsy, tumor excision, mucoceles drainage, and palliative treatment. The need for routine B-scan examinations in dense cataract patients seems to be limited and can most likely be replaced by a thorough application of locally available examination techniques. B-scan application is recommended to manage orbital patients in the most cost-effective way. [ABSTRACT FROM AUTHOR]

A 45 year-old man with bilateral acute angle-closure and myopia after starting treatment with topiramate, secondary to alcohol and heroin dependence. Using Visante® OCT (Optical Coherence Tomography) and B-scan Ultrasound he was diagnosed with bilateral ciliochoroidal effusion as the pathophysiological mechanism. Topiramate was stopped and ocular hypotensive therapy with a topical cycloplegic and corticosteroids were started, resolving ciliochoroidal effusion syndrome. Visante® OCT and B-scan Ultrasound are useful tools for the diagnosis and follow-up of patients with acute angle-closure and myopia due to topiramate. As a result of broad spectrum of indications for topiramate, physicians and ophthalmologists should be aware of the possible ophthalmological manifestations attributable to this drug., (Copyright © 2019 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Cogan's syndrome is characterized by a non-luetic interstitial keratitis associated with vertigo, tinnitus and profound deafness. Evidence of a systemic vasculitis is found in up to 50% of patients. Atypical forms of Cogan's syndrome have been described in which the ocular inflammatory disease may be more severe. We describe a case of atypical Cogan's syndrome in association with bilateral posterior scleritis. Serial B-scan ultrasound measurements of posterior scleral thickness were found to be useful in assessing disease activity, in combination with clinical findings. Combination therapy with prednisolone and cyclosporin controlled the ocular disease but the deafness was irreversible. The length of follow-up of this case highlights the frequent relapses and difficult management problems which may be faced. This multisystem disease requires the close co-operation of ophthalmologist, physician and otorhinolaryngologist. Aggressive therapeutic intervention with high-dose combined immunosuppressive agents may be necessary to control severe ocular inflammatory disease. [ABSTRACT FROM PUBLISHER]

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