Abstract
Purpose:
To study the prevalence of intraocular tumors detected by screening ultrasonography in eyes with opaque media.
Methods:
A retrospective review of ultrasounds done in 119 eyes that had opaque media and a diagnosis of blindness or phthisis between January 1, 1994 and December 31, 2013. Patients were excluded if ultrasound was ordered in eyes with clear media or when ultrasound was used for acute etiologies of vision loss including endophthalmitis, retinal detachment, or acute vitreous hemorrhage. Data were extracted on visual acuity, intraocular pressure, presence or absence of ocular pain, etiology of opaque media, number of ultrasounds received during study time period, and ultrasound findings. Follow up was defined as the time range for which an eye was followed from initial documentation of opaque media to last visit with opaque media. In addition, ultrasounds obtained for screening prior to evisceration or enucleation was noted along with pathology findings.
Results:
A total of 173 ultrasounds corresponding to 119 eyes were reviewed. No intraocular tumors were detected. Mean age of patients was 59 years. Visual acuity was hand motions or worse in 89 eyes (74.8%), elevated intraocular pressure was found in 23 eyes (19.3%) and ocular pain was noted in 30 eyes (25.4%). 50 eyes had less than twelve months of follow up. The remaining 69 eyes with opaque media (58%) had at least one year follow up. The mean follow was 65 months (median 56 months; range 12-129). Of these, 2 eyes (2.9%) had an annual ultrasound, 43 eyes (62%), had an ultrasound done every 13 months- 5 years, and 19 eyes (27.5%) had an ultrasound every 61 months to 10 years. In addition, 16 eyes with opaque media for at least 6 years only received a screening ultrasonography at presentation (11 eyes had 6-8 years follow up; 5 eyes had more than 8 years of follow up). 6 eyes had screening ultrasonography prior to evisceration or enucleation with pathology clear of intraocular tumors.
Conclusions:
No prior studies have been done to examine the utility of interval screening ultrasonography in blind eyes with opaque media. In this series of eyes with opaque media, no intraocular tumors were detected by screening ultrasonography. Further long term study is necessary to determine the utility of consecutive ultrasonography in eyes with opaque media and the appropriate interval of screening ultrasonography.