Abstract
Purpose: :
Ocular pathology affecting the anterior segment can present diagnostic problems because it often involves structures not readily accessible by routine examination methods. Our purpose was to assess and compare utility of ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (OCT) in evaluation and management of patients with ocular pathology involving the anterior segment of the eye.
Methods: :
Retrospective review of imaging of 65 eyes with various conditions involving the anterior segment, examined with high-resolution ultrasonography VuMax Sonomed system (Sonomed Inc, NY) and anterior segment OCT (Carl Zeiss Meditec Inc, CA) over a period of 12 months.While UBM requires immersion of the eye in a saline solution via an eye cup, OCT is a non-contact, high-resolution technique customized for anterior segment evaluations. The findings were determined and clinical relevance of UBM and anterior segment OCT information was analyzed.
Results: :
Abnormalities were found in 61 eyes with the following etiologic diagnoses: anterior scleritis (5), intermediate uveitis (3), traumatic hyphema (4), foreign body (2), iris or ciliary body mass (8), intraocular lens (5) and various corneal pathology (34) including keratoconus, corneal edema, corneal scarring, keratitis, Salzman nodules. Indications for the UBM were visualization of anterior chamber structures, visualization of posterior iris or ciliary body, assessment of intraocular lens position, pre-operative assessment in eyes with hypotony or trauma, or poor visualization of the posterior segment, and for follow-up of documented abnormalities. Indications for anterior segment OCT were assessment of the angle, measurement of corneal thickness, visualization of anterior iris, preoperatory assessment. In most cases the high-resolution imaging techniques confirmed clinical diagnosis and helped in follow-up and surgical planning. In cases of poor visualization, it offered invaluable information about the anatomy of anterior segment not available by other ocular examination technique.
Conclusions: :
Both UBM and OCT are sensitive techniques that provide excellent diagnostic clues in patients with anterior segment involvement. UBM is invaluable for visualizing posterior iris and ciliary body. In our series these techniques were able to identify the cause of hypotony, discriminate between various forms of anterior scleritis and provide information critical to surgical planning. The combination of the two techniques offers a complete assessment of the anterior segment.
Keywords: imaging/image analysis: clinical • anterior segment • cornea: clinical science