B scan ultrasound and its significance in diagnosing posterior segment pathologies of eye: to see the unseen

Objective: To assess the diagnostic value of B-scan ultrasonography in evaluation of posterior segment disorders of eye in clear and hazy media, to correlate with clinical diagnosis, to comprehend its role in the management and to assess the limitations of B-scan ultrasound.
Material and Methods: In this Hospital Based Observational Descriptive Cross-Sectional Study of B-scan, 200 patients from august 2015 to April 2016 with known and suspicious posterior segment pathology were evaluated. Detailed ocular and systemic history, a thorough ocular examination including visual acuity, refraction, keratometry, ocular movement, and slit lamp and fundus examination with indirect ophthalmoscopy were done. B scan was done using E-Z Scan™ 5500+ Series Ophthalmic Ultrasound Scanner. Then analysis of the images was done in real-time and after freezing the images.
Results: 220 eyes of 200 patients with posterior segment pathologies were included in final data analysis, 124(62%) were male and 76(38%) were female. Majority of patients were in the age group of 51 to 70 yrs (51.5%), followed by 31 to 50 yrs (25%). No significant laterality preponderance. Majority of sample was made up of opaque media cases i.e. 183 eyes (83.18%) and meager number of cases presented with clear media i.e. 37 eyes (16.82%). On basis of final diagnosis, retinal detachment was diagnosed in 81 eyes (36.81%), followed by Vitreous Haemorrhage in 44 eyes(20%), posterior vitreous detachment found in 38eyes (17.27%). Intraocular Foreign body was seen in 3eyes. Correlation of clinical diagnosis with final diagnosis. Results were showed as supplemented (S), Correlated (C) and missed (M) Out of total scans, 162 eyes (73.63%) supplemented, 55 eyes (25%) correlated and 3 eyes (01.36%) missed the clinical diagnosis.
Conclusion: B-scan ultrasound is simple, non invasive, non-ionizing and cost effective imaging modality to detect and helps in efficient management of posterior segment pathologies of eye mainly in opaque media.