In the Philippine setting, hospitals, particularly government, provincial and regional hospitals are equipped with general body scanners. Ophthalmic ultrasound particularly the ocular B-scan ultrasound is not available. Can a B-scan general body ultrasound be used for visualizing gross intra-ocular disease? It is the objective of this study to describe the usefulness of a 7.5MHz general body ultrasound in detecting and supporting diagnosis for specific intra-ocular conditions. After a thorough history and physical examination, a total of 11 eyes were examined with diagnosis of retinal detachments, vitreous hemorrhage, dislocated lens, intra-ocular foreign body and a normal eye for comparison. All examinations were done by only one senior radiology resident. Results obtained from the 7.5MHz transducer were compared to either an ophthalmic B-scan ultrasound, X-rays or as reported by direct visualization. The result of this study is encouraging because the 7.5MHz B-scan general body ultrasound transducer was able to help in the diagnosis of intraocular diseases and intraocular foreign bodies especially when the posterior pole was not visible.
Human ; ECHOGRAPHY ; EYE ; OPHTHALMOLOGY ; OPHTHALMOSCOPY ; ULTRASONOGRAPHY

Objective: This study correlated the patterns of ocular B- and A-scans of intraocular retinoblastoma (RB) with corresponding histopathology sections. It aimed to establish a more objective basis for determining intraocular retinoblastoma by ultrasonography (UTZ) and to determine the degree of malignancy and viability of the tumor cells. Methods: New cases of retinoblastoma seen at the University of the Philippines-Philippine General Hospital (UP-PGH) from January 1994 to December 2003 were reviewed. Included were patients who underwent enucleation and whose eyeballs were processed at the UP Institute of Ophthalmology. Those with good quality ocular ultrasonographs (UTZ) and clear matching histopathologic sections were finally selected. Findings were correlated and analyzed.Results: Retinoblastoma (RB) showed multiplicity of lesions on UTZ corresponding to multiple lesions on histopathology. The following characteristic patterns were seen: Very malignant RB or pseudorosettes: fine, grainy densities on B-scan with short to medium broad spikes on A-scan ("V-W" pattern). Moderate differentiation with moderate necrosis and early calcific plaques: fine, dense grainy opacities on B-scan with multiple thin, high spikes admixed with tall, broad spikes of calcium deposits on A-scan. Well-differentiated RB with compact viable cells and no necrosis: large, white densities on B-scan with an initial high spike and high internal reflectivity, sometimes "plateauing," on A-scan with no calcific deposits. Complete tumor necrosis with calcific plaques: echolucent space with dense, white, plaque-like opacities on B-scan; flat or low spikes mixed with tall, broad spikes corresponding to calcium plaques on A-scan. Normal vitreous, serous subretinal fluid, or recent hemorrhage: echolucent area on B-scan with flat or low spikes on A-scan. Conclusion: The three most frequent findings in intraocular retinoblastoma were calcific plaques with liquefaction necrosis, multiplicity of lesions, and pseudorosettes. Ocular ultrasound of retinoblastoma showed good histopathologic correlation.
Human ; RETINOBLASTOMA ; ULTRASONOGRAPHY ; RETINAL NEOPLASMS ; RETINAL DISEASES ; EYE DISEASES ; PATHOLOGY

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye trauma. METHODS: In one patient, the refraction of both eyes (the left eye was injured, but the right eye was not) was measured with an autorefractometer. The cycloplegic refraction was measured at the early stage of trauma and again 3 months after the blunt eye injury. The angle and depth of the anterior chamber, the ciliary body, and the choroids were examined by ultrasound biomicroscopy (UBM) over 3 months. The depth of the anterior chamber, the thickness of the lens, and the axial length were measured by A-scan ultrasonography in both eyes. During the 3 months after the injury, we made comparisons between the menifest and the cycloplegic refractions, the depths of anterior chambers, the thickness of the lenses, the axial lengths, and the UBM-determined appearances of the angles and depths of the anterior chambers, the ciliary bodies, and the choroids in both eyes. RESULTS: We suspect that the depth reduction in the anterior chamber, the increase in anterior to posterior lens diameter, and the edema in the ciliary body are all related to the change in the refractive power following the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and ultrasonography of the anterior segment in the eye may be helpful to diagnose and confirm changes in the refractive power that occur after trauma.
Adolescent ; Anterior Eye Segment/ultrasonography ; Ciliary Body/*injuries/ultrasonography ; Eye Injuries/*complications ; Female ; Humans ; Microscopy, Acoustic ; Myopia/*etiology/ultrasonography ; Refraction, Ocular ; Uveal Diseases/etiology/ultrasonography ; Visual Acuity ; Wounds, Nonpenetrating/*complications

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye trauma. METHODS: In one patient, the refraction of both eyes (the left eye was injured, but the right eye was not) was measured with an autorefractometer. The cycloplegic refraction was measured at the early stage of trauma and again 3 months after the blunt eye injury. The angle and depth of the anterior chamber, the ciliary body, and the choroids were examined by ultrasound biomicroscopy (UBM) over 3 months. The depth of the anterior chamber, the thickness of the lens, and the axial length were measured by A-scan ultrasonography in both eyes. During the 3 months after the injury, we made comparisons between the menifest and the cycloplegic refractions, the depths of anterior chambers, the thickness of the lenses, the axial lengths, and the UBM-determined appearances of the angles and depths of the anterior chambers, the ciliary bodies, and the choroids in both eyes. RESULTS: We suspect that the depth reduction in the anterior chamber, the increase in anterior to posterior lens diameter, and the edema in the ciliary body are all related to the change in the refractive power following the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and ultrasonography of the anterior segment in the eye may be helpful to diagnose and confirm changes in the refractive power that occur after trauma.
Adolescent ; Anterior Eye Segment/ultrasonography ; Ciliary Body/*injuries/ultrasonography ; Eye Injuries/*complications ; Female ; Humans ; Microscopy, Acoustic ; Myopia/*etiology/ultrasonography ; Refraction, Ocular ; Uveal Diseases/etiology/ultrasonography ; Visual Acuity ; Wounds, Nonpenetrating/*complications

The maintenance of corneal endothelial cells is essential for success of corneal transplantation. Endothelial cell count by specular microscope and measurement of donor corneal thickness is useful in measuring the function of cornea. We studied difference of corneal thickness in central and peripheral corneal region in enucleated eye. We measured corneal thickness of 48 eyes(48 persons) with ultrasound pachymetry that were presented to The Eye Bank of Catholic University Medical College. Average age was 61.42+/-16.12 years and average time was 163.02+/-102.52 minutes until measurement of corneal thickness after death. Increased amount of corneal thickness was 136.73+/-101.44micrometer in center and 61.37+/135.46micrometer in periphery compared with normal average corneal thickness. According to these results, corneal edema due to functional loss of endothelial cells after death lead to increased corneal thickness, especially in central region being more statistically significant than peripheral region (p=0.002).
Cornea ; Corneal Edema ; Corneal Transplantation ; Endothelial Cells ; Eye Banks ; Humans ; Tissue Donors ; Ultrasonography

Numerous eye diseases have been examined by means of time-amplitude ultrasonography for a period of more than ten years. A diagnostic ultrasonic examination is of great help in the following pathologic conditions: intraocular foreign body, retinal detachment, vitreous opacities, melanoma of the choroid, retrolental fibrorlasia, as well as in dermoid cysts and abscesses of the anterior orbit, etc. In my investigations, I have reeently also used the EKOLINE 20 ultrasonic equipment and frequencies of 6 to 11 Mc. Time-amplitude ultrasonography were performed on 7 cases (orbital tumor, 2 cases of intraocular foreign body, retinal detachment and vitreous hemorrhage, eale's disease, intraocular tumor and vitreous hemorrhage). In addition to a brief review of literature, Time-amplitude ultrasonography findings of 7 cases of ocular diseases have been reported.
Abscess ; Choroid ; Dermoid Cyst ; Eye Diseases ; Foreign Bodies ; Melanoma ; Orbit ; Retinal Detachment ; Ultrasonics ; Ultrasonography* ; Vitreous Hemorrhage

PURPOSE: This study evaluated whether the axial length of the fellow eye measured by A-scan biometry can be utilized for selecting the proper size of the orbital implant. METHODS: Thirty four eyes of 34 adult patients who had undergone eviscerations between March 2000 and May 2002 were included. We measured the axial length of the fellow eyes by A-scan preoperatively. Postoperatively, the central thickness and volume of ocular prosthesis were measured to determine the ideal size of prosthesis. RESULTS: Average diameter of the fellow eyes was 22.6mm. Average difference in diameter between the fellow eyes and orbital implants was 1.8mm among eyes with 20-22 mm in adults, and 3.8mm among eyes with 22-24mm. Average central thickness of the ocular prosthesis was 6.47 mm, and average volume was 2.2 ml. Complications occurred in 4 cases, and 2 of those cases were corrected by operations. CONCLUSIONS: Preoperative measurement of the diameter of the fellow eye using A-scan ultrasonography can be useful in selecting the size of the orbital implant before evisceration in adult patients. It also helped the selection of the proper sized ocular prosthesis and the prevention of many postoperative complications.
Adult ; Biometry ; Eye, Artificial ; Humans ; Orbit* ; Orbital Implants* ; Postoperative Complications ; Prostheses and Implants* ; Ultrasonography

PURPOSE: To compare preoperative and postoperative ocular biometry in patients with iris-fixated phakic intraocular lens (pIOLs): Artisan and Artiflex. MATERIALS AND METHODS: This study included 40 eyes with Artisan and 36 eyes with Artiflex pIOL implants. Anterior chamber depth (ACD) and axial length (AL) were measured by applanation ultrasonography (A-scan) and partial coherence interferometry (IOLMaster) preoperatively and 3 months after pIOL implantation. RESULTS: ACD measurements after Artisan or Artiflex pIOL implantation were smaller than preoperative measurements. Specifically, the difference after Artisan pIOL implantation was -1.07+/-0.17 mm by A-scan and -0.08+/-0.08 mm by IOLMaster. The difference after Artiflex pIOL implantation was -1.31+/-0.15 mm by A-scan and -0.05+/-0.07 mm by IOLMaster. After Artisan pIOL implantation, differences in AL measurements by A-scan were insignificant (difference: -0.03+/-0.15 mm), whereas postoperative AL measurements by IOLMaster were significantly longer than preoperative measurements (difference: 0.12+/-0.07 mm). After Artiflex pIOL implantation, AL measurements by both A-scan and IOLMaster were significantly longer than preoperative measurements (difference: 0.09+/-0.16 mm by A-scan and 0.07+/-0.10 mm by IOLMaster). In the Artiflex group, differences in AL measurements by A-scan correlated with the central thickness of the Artiflex pIOL. CONCLUSION: ACD and AL measurements were influenced by iris-fixated phakic IOL implantation.
Adult ; Biometry ; Eye/ultrasonography ; Female ; Humans ; Interferometry ; Lens Implantation, Intraocular/*adverse effects ; Male ; Middle Aged ; Postoperative Complications

Retinoblastoma, the most common primary intraocular malignancy of childhood, usually presents in the first three years of life. Atypical presentation of retinoblastoma can masquerade as virtually any ocular or orbital pathology, which may lead to diagnostic dilemmas especially in the presence of other systemic diseases. We report a 20-month-old boy who was diagnosed with coronary aneurysm as a complication of Kawasaki disease, and presented with sudden left eye redness. His mother noticed the presence of white pupillary reflex three months earlier. Atypical acute ocular presentation secondary to Kawasaki disease was initially suspected, but the presence of multiple calcification and mild proptosis on imaging suggested characteristics of advanced retinoblastoma. Histopathological examination of the enucleated eye, which revealed a classical rosette pattern appearance, confirmed the diagnosis. Atypical presentations of retinoblastoma are usually associated with advanced disease. The presence of other systemic conditions further complicates the diagnosis. Early diagnosis is important to reduce the mortality and morbidity.
Coronary Aneurysm ; complications ; diagnosis ; Diagnosis, Differential ; Eye ; diagnostic imaging ; physiopathology ; Eye Diseases ; diagnosis ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; Retinal Neoplasms ; complications ; diagnosis ; diagnostic imaging ; Retinoblastoma ; complications ; diagnosis ; diagnostic imaging ; Treatment Outcome ; Ultrasonography

INTRODUCTIONThe aim of this study was to investigate the role of ultrasound biomicroscopy (UBM) in imaging anterior segment foreign bodies and compare it with conventional B-scan ultrasound and computed tomography (CT).

MATERIALS AND METHODSThe charts of 18 eyes with anterior segment foreign bodies were reviewed. The rates of detection of foreign bodies using ultrasound, CT scan and UBM were compared.

RESULTSThe foreign body detection rates were 36.5% by ultrasound, 88.9% by CT scan, and 94.4% by UBM. The diagnosis of presence of a foreign body using UBM was made based on high reflective echoes causing shadowing or reverberations. In 7 eyes, UBM detected injury to the zonules, guiding the operative procedure. In the 8 eyes for which all tests were performed, rates of detection of foreign bodies were 25% (2/8) with ultrasound, 87.5% (7/8) with CT, and 100% (8/8) with UBM.

CONCLUSIONUBM is a valuable adjunct for the accurate localisation of small foreign bodies, including cilia. It offers a higher detection rate than that provided by ultrasound and CT scan.

Adolescent ; Adult ; Anterior Eye Segment ; ultrastructure ; Diagnostic Errors ; prevention & control ; Eye Foreign Bodies ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Microscopy, Acoustic ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasonography ; methods ; Wounds, Penetrating ; complications