Diagnostic Accuracy of Ocular Ultrasound in the Assessment of Vitreous Hemorrhage and Associated Ocular Diseases Ocular Ultrasound in Vitreous Haemorrhage
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Abstract
Background: Background: Vitreous hemorrhage (VH) is a condition that impairs vision and can lead to blindness if not diagnosed and managed promptly. Ocular ultrasound is commonly used for its non-invasive and rapid diagnostic capabilities, particularly in emergency settings.
Objective: To evaluate the diagnostic accuracy of ocular ultrasound in detecting vitreous hemorrhage and associated ocular diseases.
Methods: A cross-sectional observational study was conducted at the University of Lahore Teaching Hospital from October 2023 to March 2024. Seventy patients with symptomatic VH were included. Ocular ultrasound was performed using a 7.5 MHz B-scan probe. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Data were analyzed using SPSS version 25.
Results: The study included 43 males (61.42%) and 27 females (38.60%). Ocular ultrasound demonstrated a sensitivity of 77.8%, specificity of 35.3%, PPV of 56.0%, NPV of 60.0%, and an overall accuracy of 57.14% (p < 0.05).
Conclusion: Ocular ultrasound is a valuable, sensitive tool for the initial diagnosis of vitreous hemorrhage, but its moderate specificity suggests a need for confirmatory testing to ensure accurate diagnosis
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References
Salcedo-Villanueva G, Trujillo-Alvarez M, Becerra-Revollo C, Ibarra-Elizalde E, Mayorquín-Ruiz M, Velez-Montoya R, et al. A proposed method to quantify vitreous hemorrhage by ultrasound. Clin Ophthalmol. 2019 Dec;13:2377-84.
Jin X, Qin D, Wang Y, Li S, Han J, Li M. Vitreous hemorrhage. Atlas of Ocular Trauma. 2019;57-72.
Goff MJ, McDonald HR, Johnson RN, Ai E, Jumper JM, Fu AD. Causes and treatment of vitreous hemorrhage. Compr Ophthalmol Update. 2006 May 1;7(3):97-111.
Hutcheson KA, Nguyen AT, Preslan MW, Ellish NJ, Steidl SM. Vitreous hemorrhage in patients with high-risk retinopathy of prematurity. Am J Ophthalmol. 2003 Aug 1;136(2):258-63.
Hasegawa T, Otani A, Sasahara M, Gotoh N, Ooto S, Tamura H, et al. Prognostic factors of vitreous hemorrhage secondary to exudative age-related macular degeneration. Am J Ophthalmol. 2010 Feb 1;149(2):322-9.
Almendárez JE, Vargas DM, González C, Takane M, Koga W. Ultrasound findings in ocular trauma. Arch Soc Esp Oftalmol (Engl Ed). 2015 Dec;90(12):572-7.
Schott ML, Pierog JE, Williams SR. Pitfalls in the use of ocular ultrasound for evaluation of acute vision loss. J Emerg Med. 2013 Jun 1;44(6):1136-9.
Tandon A, Khullar T, Bhatt S. Sonography in acute ocular pathology: a kaleidoscopic view. Emerg Radiol. 2019 Apr 10;26:241-8.
Shinar Z, Chan L, Orlinsky M. Use of ocular ultrasound for the evaluation of retinal detachment. J Emerg Med. 2011 Jan 1;40(1):53-7.
Ahmed J, Shaikh FF, Rizwan A, Memon MF. Evaluation of vitreo-retinal pathologies using B-scan ultrasound. Pak J Ophthalmol. 2009;25(4):188-92.
Lean JS, Gregor ZD. The acute vitreous haemorrhage. Br J Ophthalmol. 1980 Jul 1;64(7):469-71.
Lorenzo-Carrero J, Perez-Flores I, Cid-Galano M, Fernandez-Fernandez M, Heras-Raposo F, Vazquez-Nuñez R, et al. B-scan ultrasonography to screen for retinal tears in acute symptomatic age-related posterior vitreous detachment. Ophthalmology. 2009 Jan 1;116(1):94-9.
Baker N, Amini R, Situ-LaCasse EH, Acuña J, Nuño T, Stolz U, et al. Can emergency physicians accurately distinguish retinal detachment from posterior vitreous detachment with point-of-care ocular ultrasound? Am J Emerg Med. 2018 May 1;36(5):774-6.
Rabinowitz R, Yagev R, Shoham A, Lifshitz T. Comparison between clinical and ultrasound findings in patients with vitreous hemorrhage. Eye (Lond). 2004 Mar;18(3):253-6.
Lahham S, Shniter I, Thompson M, Le D, Chadha T, Mailhot T, et al. Point-of-care ultrasonography in the diagnosis of retinal detachment, vitreous hemorrhage, and vitreous detachment in the emergency department. JAMA Netw Open. 2019 Apr 5;2(4)
Propst SL, Kirschner JM, Strachan CC, Roumpf SK, Menard LM, Sarmiento EJ, et al. Ocular point-of-care ultrasonography to diagnose posterior chamber abnormalities: a systematic review and meta-analysis. JAMA Netw Open. 2020 Feb 5;3(2)
Mahmoud KH. Accuracy of ultrasonography findings in cases of ocular trauma.
Shazlee MK, Ali M, SaadAhmed M, Hussain A, Hameed K, Lutfi IA, et al. Diagnostic accuracy of ultrasound B scan using 10 MHz linear probe in ocular trauma; results from a high burden country. Pak J Med Sci. 2016 Mar;32(2):385-90.
Ojaghihaghighi S, Lombardi KM, Davis S, Vahdati SS, Sorkhabi R, Pourmand A. Diagnosis of traumatic eye injuries with point-of-care ocular ultrasonography in the emergency department. Ann Emerg Med. 2019 Sep 1;74(3):365-71.
Haghighi SH, Begi HR, Sorkhabi R, Tarzamani MK, Zonouz GK, Mikaeilpour A, et al. Diagnostic accuracy of ultrasound in detection of traumatic lens dislocation. Emerg. 2014;2(3):121-4.