Role of Ultrasound Biomicroscopy (UBM) in the Detection and Localisation of Anterior Segment Foreign Bodies

Abstract

Introduction: The 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 Methods: The 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. Results: The 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. Conclusion: UBM 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. Key words: B-scan ultrasonography, Computed tomography, Ocular trauma, Retained foreign bodies

Efficiency of different imaging methods in detecting ocular foreign bodies

“…UBM is recognized as an effective imaging tool especially for the anterior segment, and previous studies show that it provides useful information on these structures in both physiological and pathological conditions. 13 UBM is currently irreplaceable in the management of various ocular disorders, including corneal diseases, glaucoma, ocular trauma, intraocular lens analysis, and anterior segment tumors. 18,22 To the best of our knowledge, Ambartsumian et al were the first researchers to report UBM findings in patients with OFBs.…”

“…23 Moreover,Guha et alreported that UBM detected 94.4% of the OFBs evaluated, while B-scans and CT detected 36.5% and 88.9%, respectively. 13 Since then, UBM has been reported to be an effective technique in detecting OFBs and characterizing their composition. 24 CT is the most widely used method for detecting and localizing foreign bodies 25 and was historically considered the most sensitive imaging technique for OFBs.…”

“…However, the results of several examination methodologies can vary greatly in clinical practice. 3,[13][14][15][16][17][18] Moreover, formal epidemiological studies have reported widely different results between various imaging methods. 3,[13][14][15][16][17] For example, Patel et al reported sensitivities for B-scan ultrasonography (i.e., B-scans) and CT of 51.9% and 94.5%, respectively, in the evaluation of suspected OFBs.…”

“…3,[13][14][15][16][17][18] Moreover, formal epidemiological studies have reported widely different results between various imaging methods. 3,[13][14][15][16][17] For example, Patel et al reported sensitivities for B-scan ultrasonography (i.e., B-scans) and CT of 51.9% and 94.5%, respectively, in the evaluation of suspected OFBs. 3 In contrast, Yu et al reported that CT detected 100% of the OFBs evaluated, while B-scans detected 93.2%.…”

“…3 In contrast, Yu et al reported that CT detected 100% of the OFBs evaluated, while B-scans detected 93.2%. 17 On the other hand, the number of cases in most studies was limited, 3,[13][14][15][16] and in one study the OFBs were not confirmed during surgery. 13 In this study, a relatively large number of patients with OFBs confirmed during surgery were assessed to explore the strengths and limitations of various common examination modalities in detecting these objects.…”