Ultrasound biomicroscopy as a vital tool in occult phacomorphic glaucoma

Abstract

Ultrasound is a fundamental tool used in all medical specialties, including ophthalmology. Nowadays, ultrasound biomicroscopy (UBM), a method with higher resolution, allows the investigation of in vivo details of the anterior segment of the eye at microscopic resolution. The examination is especially useful in patients with secondary glaucoma that involves a lens component such as phacomorphic glaucoma and occult phacomorphic glaucoma (OPG). The purpose of this paper was to familiarize audience with UBM and the importance of this investigation in OPG, by presenting a series of cases in which performing an UBM was vital because it provided the information needed in order to safely accomplish a curative surgical treatment that preserved our patients' visual acuity.

Ultrasound biomicroscopy in glaucoma assessment

“…Thus, it may cause a quick IOP elevation that affects the optic nerve head and, in time, leads to glaucomatous optic neuropathy [ 41 ]. The same mechanism has been reported in young individuals with a large clear lens that obstructs the angle, but the phacomorphic component is hidden due to the lack of cataract [ 42 ].…”

Diagnostic methods and therapeutic options of uveal melanoma with emphasis on MR imaging—Part I: MR imaging with pathologic correlation and technical considerations

“…High-frequency (12.5-100 MHz) UBM is an imaging tool providing high-resolution images of the anterior segment, since the high-frequency probe manages to penetrate up to 4-5 mm in depth. It is suitable to study melanomas of the iris and ciliary body, to detect whether an iris lesion has invaded the ciliary body and to search for extrascleral extension [4,14,[28][29][30].…”

Anterior Chamber Angle Assessment Techniques: A Review

“…Currently, most commercial UBM systems uses frequencies up to 50 to 100 MHz [30]. The 50 MHz probe is able to penetrate 4 mm, has a resolution of 40 μm and is thought to balance the best depth and resolution [30,32]. The procedure is alike the conventional B-scan ultrasonography, but needs an immersion scleral shell or a disposable ClearScan water balloon on the probe tip [32].…”

“…The 50 MHz probe is able to penetrate 4 mm, has a resolution of 40 μm and is thought to balance the best depth and resolution [30,32]. The procedure is alike the conventional B-scan ultrasonography, but needs an immersion scleral shell or a disposable ClearScan water balloon on the probe tip [32]. The angle structures such as iris, ciliary body and SS can easily be identified by UBM, with SS being a landmark for various quantitative measurement parameters [33].…”