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Accuracy of B-scan ultrasonography in acute fundus obscuring vitreous hemorrhage using a standardized scanning protocol and a dedicated ophthalmic ultrasonographer

Authors Sandinha MT, Kotagiri AK, Owen RI, Geenen C, Steel DHW

Received 4 February 2017

Accepted for publication 11 April 2017

Published 27 July 2017 Volume 2017:11 Pages 1365—1370

DOI https://doi.org/10.2147/OPTH.S133938

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Maria T Sandinha,1 Ajay K Kotagiri,1 Rona I Owen,1 Caspar Geenen,1 David HW Steel1,2

1Sunderland Eye Infirmary, Sunderland, 2Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK

Purpose: To assess the accuracy of B-scan ultrasound (U/S) in diagnosing cases of acute fundus obscuring vitreous hemorrhage (FOVH) using a standardized scan protocol and dedicated ophthalmic ultrasonographer.
Methods: Consecutive patients presenting with acute FOVH of unknown cause, between January 2013 and December 2014, were prospectively recruited. Patients underwent a scan performed by a dedicated ultrasonographer, utilizing a systematic scan sequence and using an ocular specific U/S device. The U/S findings were compared to the findings during vitrectomy or after spontaneous hemorrhage clearance.
Results: Fifty-eight eyes (58 patients) were included. An underlying rhegmatogenous retinal detachment (RRD) and retinal tears without RRD were reported in nine and 14 patients, respectively. Nineteen of these patients underwent vitrectomy, and the other four underwent laser retinopexy or cryopexy alone. An additional six patients with suspected but uncertain retinal tears underwent vitrectomy, during which tears were confirmed in three, two had retinal vessel avulsions, and one had retinal new vessels. There was “complete” agreement between the B-scan findings and clinical findings in 78% of patients, “partial” agreement in 19%, and agreement was not tested in 3%. When the agreement was “partial”, the disagreements did not affect patient management. The sensitivity was 100% for the detection of RRD, and for the detection of new retinal tears in patients without retinal detachment.
Conclusion: B-scan U/S scan was highly sensitive in identifying the pathology in acute FOVH. Our results show an improvement from previously reported results, likely related to the standardized scan protocol and dedicated ophthalmic ultrasonographer.

Keywords: diagnosis, ultrasonography, ultrasound B-scan, rhegmatogenous retinal detachment, retinal tear, retinal break

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