Abstract
Purpose :
Orbital sonography is a safe, fast, non-invasive imaging modality for evaluation of orbital inflammatory diseases at bedside; there are newer smart-phone-based handheld ultrasound devices that have been used in emergency and hospital settings. This study aims to assess the performance of a handheld ultrasound device in detecting orbital inflammation.
Methods :
This cross-sectional study of patients assessed the efficacy of the Butterfly IQ+ (Butterfly Network, Burlington, MA) portable ultrasound device for detecting orbital inflammation in patients presenting to Harborview Medical Center with concern for pre-septal or orbital cellulitis between April and June 2022. A trained examiner imaged bilateral orbits of participants in two planes at a fixed depth of 4 cm and recorded dynamic video of the exam. Each subject’s clinical ophthalmic diagnoses from same day exam and computed tomography (CT) scan were recorded, and a blinded reader assessed scans for presence or absence of orbital inflammation.
Results :
Twelve total subjects were imaged, 6 with orbital inflammation, and 6 with pre-septal cellulitis. All 6 subjects with orbital inflammation were correctly identified, and all 6 subjects without orbital inflammation were correctly identified by the blinded reader. The handheld ultrasound probe was able to capture features consistent with concurrent CT scans, including the presence of orbital abscess in 4 subjects. Limitations of the device include a large probe that may not anatomically be feasible for patients with deep orbits.
Conclusions :
The Butterfly IQ+ ultrasound device was highly effective in identifying orbital inflammation and orbital abscesses. The non-invasive nature of ultrasound makes it promising for serial scans to monitor patients’ response to treatment over time, especially in the pediatric population where radiation exposure from CT is a concern.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.