Ultrasound biomicroscopy findings in fireworks-related blunt eye injuries

Mohammadi, Seyed Farzad; Zandian, Mehdi; Fakhraie, Ghasem; Majdi, Mercede; Tabatabai, Seyed-Ali; Rahnama, Azadeh; Lashay, Alireza

doi:10.5301/ejo.5000017

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…reported 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 …”

Section: Discussionmentioning

confidence: 99%

“…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. CT creates images by detecting changes in the intensity of X-rays as they penetrate objects.…”

Section: B-scan (Nmentioning

confidence: 99%

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Efficiency of different imaging methods in detecting ocular foreign bodies

Cheng,

Zhao,

Chen

et al. 2023

Medical Physics

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BackgroundOcular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements.PurposeTo compare the efficiency of different imaging methods in detecting and localizing OFBs.MethodsWe conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B‐scan ultrasonography (B‐scans) were selected.ResultsThis study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8–78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2–120 months). Most OFBs were metallic (51.82%) or plant‐based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B‐scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant‐based versus non‐plant‐based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B‐scans were less efficient for plant‐based and eyeball wall‐located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118).ConclusionsCT, radiography, and B‐scans showed lower detection rates for plant‐based, small, and eyeball wall‐located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected.

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Section: Discussionmentioning

confidence: 99%

Section: B-scan (Nmentioning

confidence: 99%

Efficiency of different imaging methods in detecting ocular foreign bodies

Cheng,

Zhao,

Chen

et al. 2023

Medical Physics

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“…UBM was effective in identifying iridodialysis, cyclodialysis, angle recession, lens subluxation, and anterior segment foreign body in these patients. Many of these findings were not identified on clinical examination, and were only found upon UBM imaging, illustrating the value of UBM as an essential tool in the assessment of subclinical injury to the anterior segment, particularly in the setting of explosive or ballistic injury mechanism [51]. Another study evaluated 53 eyes of patients who had fireworks related injuries in Southern China.…”

Section: Ocular Traumamentioning

confidence: 99%

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

Alexander

Wei

Palmer

et al. 2020

Eye

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Ultrasound biomicroscopy (UBM) is the only available option for noninvasive, high-resolution imaging of the intricate iridociliary complex, and for anterior segment imaging with corneal haze or opacity. While these unique features render UBM essential for specific types of trauma, congenital anomalies, and anterior segment tumors, UBM imaging has found clinical utility in a broad spectrum of diseases for structural assessments not limited to the anterior intraocular anatomy, but also for eyelid and orbit anatomy. This imaging tool has a very specific niche in the pediatric population where anterior segment disease can be accompanied by corneal opacity or clouding, and anomalies posterior to the iris may be present. Pediatric patients present additional diagnostic challenges. They are often unable to offer detailed histories or fully cooperate with examination, thus amplifying the need for high-resolution imaging. This purpose of this systematic review is to identify and synthesize the body of literature involving use of UBM to describe, evaluate, diagnose, or optimize treatment of pediatric ocular disease. The collated peer-reviewed research details the utility of this imaging modality, clarifies the structures and diseases most relevant for this tool, and describes quantitative and qualitative features of UBM imaging among pediatric subjects. This summary will include information about the specific applications available to enhance clinical care for pediatric eye disease.

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“…B-scan imaging and ultrasound biomicroscopy (UBM) can also assist in characterizing anterior and posterior segment pathology in the setting of ocular trauma. UBM can elicit additional findings such as cyclodialysis or angle recession [ 14 , 15 ]. B-scan ultrasonography can provide information regarding potential globe rupture, IOFBs, lens dislocation, vitreous hemorrhage, membranes, retinal tears, and retinal or choroidal detachments [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Demographics, Presenting Features, and Outcomes of Adult Patients with Ocular Trauma

Clevenger,

Cao,

Steinkerchner

et al. 2024

Journal of Ophthalmology

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Introduction. Ocular trauma is a common cause of permanent vision loss in adults. The combination of an accurate clinical examination and imaging offers the best prognostic indicators for patients and helps to navigate treatment modalities. This is a retrospective chart review of examination and imaging findings for ocular trauma and how they correlate with treatment course and visual acuity (VA) outcomes. Methods. Adult patients with ocular trauma presenting to a single institution between January 2013 and December 2020 were evaluated. Initial examination and imaging findings were compared for associations with each other and with VA outcomes. Results. 136 ocular traumas on 134 patients were included. The median presenting logMAR VA was 2.7 (interquartile range (IQR) 1.2–3.7) with 62% open globe injuries. The most commonly reported finding on initial CT scan was globe deformity (30%), on B‐scan was choroidal detachment (20%), and on ultrasound biomicroscopy was intraocular foreign body, ciliochoroidal effusions, or angle recession (21% each). Worse vision was observed for patients positive for retinal detachment on initial B‐scan compared to those negative for this finding at 6‐month (median logMAR 2.7 vs. 0.5; P < 0.0001) and at final post‐injury evaluation (median logMAR 3.7 vs. 0.4; P < 0.0001). Similarly, worse VA was observed for patients with choroidal detachment on initial B‐scan compared to those without this finding at 6‐month (median logMAR 1.4 vs. 0.5; P = 0.002) and at final post‐injury evaluation (median logMAR 2.0 vs. 0.4; P < 0.0001). If positive conjunctiva/sclera examination findings were identified, 66% had positive findings on B‐scan, whereas if the conjunctiva/sclera examination findings were absent, 41% had positive findings on B‐scan (P = 0.005). If anterior chamber (AC) examination findings were positive, 59% had positive findings on B‐scan, whereas if the AC examination findings were absent, 37% had positive findings on B‐scan (P = 0.03). Discussion. The predictive value of examination findings in this study may offer insight as to long‐term visual prognosis. Positive B‐scan or CT findings should increase suspicion for open globe injuries.

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Ultrasound biomicroscopy findings in fireworks-related blunt eye injuries

Abstract: Our study showed the value of UBM in the assessment of severely contused eyes and hyphema. It made possible evaluation for dialyses and recessions at presentation. Ultrasound biomicroscopy illustrated diverse subclinical disruptions in clinically invisible anterior segment structures.

Cited by 5 publications

References 14 publications

Efficiency of different imaging methods in detecting ocular foreign bodies

Efficiency of different imaging methods in detecting ocular foreign bodies

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

Demographics, Presenting Features, and Outcomes of Adult Patients with Ocular Trauma

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