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G.M. Pereira, B.A. Nassaralla, Jr., J.J. Nassaralla; Comparison of Ultrasound and Intraoperative Finding in Patients With Endophthalmitis or Vitreous Hemorrhage . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5649.
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To compare echographic and vitrectomy intraoperative (VI) findings in endophthalmitis or vitreous hemorrhage eyes.
A retrospective consecutive case series of patients with a possible clinical diagnosis of endophthalmitis or vitreous hemorrhage was performed on 63 patients at the Goiania Eye Institute between January 2003 and September 2005. Statistical analysis compared graded ultrasound (US) with VI findings. The US was performed immediately before the VI and findings included vitreous opacities (VO), vitreous membranes (VM), posterior vitreous detachment (PVD), retinal detachment (RD).
In approximately 3 years period, 63 eyes of 63 patients had echographic reports consistent vitreous hemorrhage (48 eyes – 76.19%) or with probable or possible endophthalmitis (15 eyes – 23.8%). The causes of hemorrhage were proliferative diabetic retinopathy (27 eyes – 56.25%), ocular trauma (14 eyes – 29.1%), posterior vitreous detachment with or without tear (2 eyes – 4.1%) and post–introcular surgery (5 eyes – 10.4%). All patients with endophthlmitis received intravitreal antibiotics or antifungals. The decision to use primary vitrectomy was made by the treating physician. The false–negative rate for RD was 6.34% (4 eyes) and false positive was 33% (6 of 18 eyes) the sensitivity of US was calculated 76% and specificity 94%. The false–negative rate for VO was 3.72% (2 eyes) and false positive was 0% (0 eyes) the sensitivity of US was calculated 96% and specificity 100%. The false–negative rate for VM was 6.34% (4 eyes) and false positive was 50% (2 of 4 eyes) the sensitivity of US was calculated 50% and specificity 96%. The false–negative rate for PVD was 12.68% (8 eyes) and false positive was 10% (4 of 40 eyes) the sensitivity of US was calculated 90% and specificity 92%.
Detailed ocular echography provides useful clinical information. US is an effective diagnostic in patients with media opacity with high sensitivity and specificity, but physician should have a care in making diagnosis.
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