Purpose
To compare vitreoretinal findings observed under dilated fundus examination and B-scan ultrasound in symptomatic acute posterior vitreous detachment (PVD).
Methods
Prospective, comparative study including 286 eyes with acute symptomatic PVD between December 2010 to November 2013. Comprehensive ophthalmic examination included slit-lamp biomicroscopy, entire dilated ocular fundus examination with indirect ophthalmoscopy (using 20X Diopters lens) by retina specialist followed by ultrasound examination with a 10MHz probe (Quantel Medical Cinescan) by ultrasound specialist in all cases. In cases of disagreement between both diagnostic methods, a subsequent indirect ophthalmoscopy based on the ultrasound findings was performed. Statistical analysis was conducted with SPSS version 20.0.
Results
56 eyes (19.6%) had no PVD. 230 eyes (80.4%) had PVD. The vitreoretinal findings observed with ultrasound in patients with PVD were: visualization of high reflectivity operculum in 24 eyes (10.43%), retinal tears 14 (6.08%), and retinal detachment 2 eyes (0.86%). With respect to the eyes that had operculum: 10 eyes (45.5%) presented at inferotemporal quadrant and 18 eyes (81.8%) were at the peripheral retina, mean operculum anterior-posterior diameter was 1.2 mm +/- 0.3 mm. There was statistical significant differences (p<0.00) about operculum findings between ocular ultrasound and initial fundus examination (ultrasound found 24 (8.4%) eyes with operculum, compared to 4(1.4%) eyes with fundus examination), however, a subsequent indirect ophthalmoscopy based on the echographic findings bear out the presence of the operculum in 22 eyes and 20 of which required treatment. There were not statistically significant differences in retinal tears, vitreous hemorrhage and retinal detachment findings between the initial fundus examination and ultrasound examination (p > 0.5 all).
Conclusions
Both fundus and ultrasound examination gives very valuable information on the analysis on vitreoretinal findings after acute PVD, however ocular ultrasound was better detecting peripheral retinal operculum in these patients.
Keywords: 697 retinal detachment •
763 vitreous •
692 retinal adhesion