Evaluation of Posterior Segment Pathologies by B-Scan in Vitreous Hemorrhage

Abstract

INTRODUCTION: Vitreous hemorrhage is the extravasation, or leakage, of blood into the areas in and around the vitreous humor of the eye.¹The vitreous humor is the clear gel that fills the space between the lens and the retina of the eye. Ocular Bscan ultrasonography is a noninvasive method for diagnosis. It is used when the media is opacified enough to preclude a complete and clear (including view of the oraserrata) funduscopic examination.²B-scan provides cross sectional display of diseased tissues and is valuable in detecting unsuspected posterior segment diseases³ .The frequency used in the diagnostic ophthalmic ultrasound for posterior segment is 8-10 MHz. B-scan instrumentation can be modified to an immersion technique used for the anterior segment study.B-Scan can image through severely swollen lids, corneal opacities, uveitis and persistent pupillary membrane. Over the last 30 years ultrasonography has greatly advanced and this has enabled us to study posterior segment of the eye in the presence of opaque media.^4-5

OBJECTIVES: To determine the frequency of posterior segment pathologies in patients with vitreous hemorrhage

STUDY DESIGN: Descriptive Cross-Sectional

SETTING: Department of Ophthalmology, JPMC Karachi

DURATION: Six months after the approval of synopsis from 27 September 2019 to 27 March 2020

SUBJECTS AND METHODS: The total of 203patients, with vitreous hemorrhage was included in this study. B-scan ultrasound machine US Scan- 3300 (NIDEK) were used for the evaluation of vitreous opacities and underlying posterior segment pathologies. Topical anesthetic eye drop were used to achieve ocular surface anesthesia. All the clinical and ultrasound findings were recorded in pre designed proforma.

RESULTS: Two hundred and three (203) eyes of one hundred eighty eight (188) patients were assessed for posterior segment pathologies in this study and the results were analyzed as: Mean ± SD of age was 39.45±12.56 with C.I (37.64-41.25) years. Gender distribution showed 124 (66%) were male and 64 (34%) were female were female. Out of 203 eyes 71(36%) had retinal detachment, 30 (15%) had posterior detachment, 12 (6%) had intraocular foreign body and 90 (44%) eyes were normal.

CONCLUSION: The most common posterior segment pathology was retinal detachment followed by posterior detachment and intraocular foreign body. B-scan ultrasound is very useful diagnostic tool in detection and evaluation of vitreo-retinal pathologies in patients with opacities in the vitreous cavity.