Quantitative comparison of Zeiss-Humphrey model 840 and Rion UX-02 systems of ultrasound biomicroscopy

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

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.

Diagnosis of Peripheral Retinoschisis Using Ultrasound Biomicroscopy

BACKGROUND AND OBJECTIVE

Retinal imaging can help differentiate retinoschisis (RS) from retinal detachment (RD). This study describes new sonographic features of RS using ultrasound biomicroscopy (UBM) and evaluates their diagnostic value.

PATIENTS AND METHODS

Medical records of subjects diagnosed with RS and RD who underwent imaging prior to intervention were reviewed. Images were evaluated for detachment shape ultrasound (US) B-mode, as well as presence of intraretinal pillars, retinal layers split, and intraretinal cysts on UBM.

RESULTS

Of 48 eyes from 48 patients in the study, 25 were diagnosed as RS and 23 as RD. "Retinal layers split" was the most common UBM finding in the RS group (72%), followed by intraretinal pillars (64%) and intraretinal cysts (36%). No RD case exhibited these findings (P < .001).

CONCLUSIONS

UBM might assist in difficult cases to differentiate between RS and RD by detection of the unique sonographic features of RS described herein. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e196-e202.].

Effects of small-incision phacoemulsification and intraocular lens implantation on anterior chamber depth and intraocular pressure

PURPOSE

To examine prospectively the effects of small-incision phacoemulsification and intraocular lens implantation (PEA+IOL) on anterior chamber depth (ACD) and intraocular pressure (IOP) using a newly developed scanning peripheral ACD analyzer (SPAC).

MATERIALS AND METHODS

Twenty-eight eyes of 21 patients who underwent PEA+IOL without any complications were examined and divided into 7 eyes each of grades 1 to 4 according to the Van Herick technique. The SPAC measured ACD consecutively from the vicinity of the pupil center to the periphery at 0.4-mm intervals. Changes in ACD and IOP as a result of PEA+IOL were investigated, and the factors contributing to the changes in ACD and IOP were examined.

RESULTS

PEA+IOL increased ACD significantly at all groups. The average changing rates were 3.19 +/- 0.67 times (Van Herick grade 1), 2.00 +/- 0.80 times (Van Herick grade 2), 1.92 +/- 0.32 times (Van Herick grade 3), and 1.36 +/- 0.65 times (Van Herick grade 4), respectively. The closer to the pupil center the measurement point was, the larger was the increase in ACD. However, the rates of increase in ACD were similar among the measurement points. The increases in ACD were significantly large in patients having a shallow preoperative ACD and a small optic axis length. The IOP reduction became significantly large in eyes with a shallow preoperative ACD.

CONCLUSIONS

The SPAC enabled quantitative measurement of changes in ACD from the vicinity of the pupil center to the periphery as a result of PEA+IOL. Changes in ACD resulting from PEA+IOL were thought to exert a greater effect on aqueous humor outflow facility as the postoperative ACD became shallower.

Comparison of Latanoprost Monotherapy and Combined Therapy of 0.5% Timolol and 1% Dorzolamide in Chronic Primary Angle-Closure Glaucoma (CACG) in Japanese Patients

To compare the efficacy, adverse effects, and patient compliance of latanoprost monotherapy with unfixed combination therapy with 0.5% timolol maleate and 1% dorzolamide in the treatment of chronic primary angle-closure glaucoma (CACG), 36 Japanese patients with CACG following laser iridotomy (LPI) were treated for 12 weeks with instillation of latanoprost alone or with unfixed combination therapy of 0.5% timolol maleate and 1% dorzolamide hydrochloride. After 12 weeks of treatment, latanoprost reduced intraocular pressure (IOP) from 22.2 +/- 2.0 mmHg to 14.8 +/- 1.9 mmHg (33% reduction); timolol maleate and dorzolamide hydrochloride also reduced IOP from 22.5 +/- 2.2 mmHg to 17.1 +/- 2.7 mmHg (24% reduction). Latanoprost monotherapy significantly lowered IOP compared with unfixed combination therapy of 0.5% timolol maleate and 1% dorzolamide hydrochloride. Furthermore, a systemic adverse effect of bradycardia was not observed in the latanoprost monotherapy group. Concerning compliance, no significant difference was observed between the two groups. Thus, latanoprost monotherapy is more effective than unfixed combination therapy with 0.5% timolol maleate and 1% dorzolamide in the treatment of CACG following relief of pupillary block in Japanese patients.

Uveal effusion in primary angle-closure glaucoma

PURPOSE

To determine the prevalence of uveal effusion in acute and chronic primary angle-closure glaucoma (PACG) or primary angle closure (PAC) and to compare it with the prevalence in eyes with open-angle glaucoma (OAG) or ocular hypertension.

DESIGN

Prospective consecutive case series.

PARTICIPANTS

Five hundred one eyes of 351 consecutive patients with PAC and 156 eyes of 116 randomly selected primary OAG or ocular hypertension patients. The PAC group included 40 eyes of 35 patients with acute PACG and 30 unaffected fellow eyes, 39 eyes and 35 fellow eyes with a history of acute PACG, and 357 eyes with chronic PAC.

METHODS

Ultrasound biomicroscopic examination was performed to diagnose uveal effusion and to measure anterior chamber depth (ACD).

MAIN OUTCOME MEASURES

Presence of uveal effusion and ACD.

RESULTS

Uveal effusion was demonstrated in 23 eyes (58%) with acute PACG and 7 fellow eys (23%) (chi2 = 8.17, P = 0.0043). Among eyes with chronic PAC, uveal effusion was present in 69 [corrected](14%[corrected]), a higher prevalence than was found in open-angle patients (2 eyes [1.3%]) (chi2 = 19.3, P<0.001). In the chronic PAC group, the ACD of phakic eyes with uveal effusion (1.92+/-0.42 mm) was significantly shallower than that of phakic eyes without effusion (2.06+/-0.32 mm) (P = 0.019).

CONCLUSIONS

Uveal effusion diagnosed by ultrasound biomicroscopy is a special feature in PAC, and is prevalent in acute PACG. Uveal effusion in phakic eyes with PAC is associated with shallowing of ACD.

Ultrasound biomicroscopy of the aging rhesus monkey ciliary region

Ultrasound biomicroscopy of the living rhesus monkey ocular ciliary region was undertaken to identify age-dependent changes that might relate to the progression of presbyopia. Monkeys were anesthetized and pharmacologically cyclopleged, the eyelids were held open with a lid speculum, and sutures were placed beneath the medial and lateral rectus muscles. Ultrasound biomicroscopy imaging of the nasal and temporal quadrants of the eye were performed, and the live images were recorded to videotape. Subsequent image analysis was performed to obtain objective morphometric measurements of the ciliary body region. The ciliary body inner radius of curvature, outer radius of curvature, inner arc length, area, thickness, perimeter, zonular fiber length, and circumlental space were measured. Zonular space was calculated. The circumlental space decreased with increasing age in the temporal quadrant. The other morphologic measurements were not significantly correlated with age or body weight. Most morphologic measurements were significantly different comparing temporal vs. nasal quadrants. Bifurcation of the posterior zonular fibers was frequently observed. Although temporal circumlental space was the only measurement found to change with age, ultrasound biomicroscopy of the living rhesus ciliary region did identify distinct nasal vs. temporal asymmetries, which may reflect anatomical requirements for convergence-associated accommodation.