Assessing Ultrasound Methodologies for Characterizing Tractional Retinal Detachments in Patients with Diabetic Retinopathy

Abstract

Purpose : Ultrasound (US) is the only point-of-care technology with the potential to create 3D models of the intraocular and extraocular anatomy in the context of media opacity. In this study, we evaluated the use of an actuator to rotate or translate an ultrasound probe over living human eyes to acquire image volumes and characterize a retinal detachment.

Methods : Patients diagnosed with proliferative diabetic retinopathy with tractional retinal detachment (TRD) were selected for this study. After obtaining informed consent, US images were obtained with an actuated horizontal scan and a rotational scan of the eyes with lids open and lubricated with Genteal in primary gaze using a 12 MHz Accutome probe (Malvern, PA). Ultrasound images were manually segmented using 3D slicer. Three dimensional reconstructions were rendered and compared with intraoperative findings. Models produced from horizontally and rotationally actuated ultrasounds were subjectively compared.

Results : Volumetric ultrasound acquisition was successful using a custom motorized actuator. 3D models of tractional retinal detachment produced from ultrasonography recapitulated intraoperative findings. Models produced from ultrasound volumes acquired from horizontal actuation produced a smaller field of view than those produced from rotational actuation. Rotational actuation produced hemispheric disconnect between sides of the model produced from the superior versus inferior portion of the ultrasound images. Research subjects reported better imaging experience with rotational than horizontal volumetric imaging.

Conclusions : Motorized actuation of ultrasound probes over the eye enables controlled volumetric imaging of the eye. Complex 3D anatomy visualized in volumetric ultrasound recapitulates findings observed in tractional retinal detachment surgery. Technical methods are needed to minimize image artifacts from rotational actuation to ensure the widest field of view.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

(A) Rotational and (B) Horizontal US Scanning Patterns

 

Reconstructed 3D model from images using rotatonal scanning pattern of tractional retinal detachment