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Ophthalmic Ultrasonography

Arun
Professor Director, Department of Ophthalmic Oncology Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
D. Singh
of Ophthalmology
Brandy C. Hayden
Director of Ophthalmic Ultrasonography Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
MD
BS CDOS ROUB
For
additional online content visit
www.expertconsult.com
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2012
UNDERS is an imprint of Elsevier Inc.
SA
© 2012, Elsevier Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website:
www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
ISBN: 978-1-4377-2636-7
British Library Cataloguing in Publication Data
Singh, Arun D. Ophthalmic ultrasonograph
1. Eye–Ultrasonic I. Title II. Hay
617.7’1543–dc22
W
orking together to grow
imaging.
den, Brandy C.
y.
libraries in developing countries
.elsevier.com | www.bookaid.org | www.sabre.org
www
in China
Printed
digit is the print number:
Last
9 8 7 6 5 4 3 2 1
Video
Video
contributors: Arun D Singh and Brandy C Hayden
Table of Contents
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3.1
Instructional video:
Instructional video:
3.2
Instructional video:
3.3
3.4
Instructional video:
3.5
Instructional video:
3.6
Instructional video:
Intraocular mass:
3.7
Intraocular mass:
3.8
3.9
Vitreous hemorrhage
3.10a
Intraocular mass:
Intraocular mass:
3.10b
Vitreous hemorrhage
3.11
7.1
Instructional video:
7.2
Contact biometric
Basic Positioning
Axial Scans
Longitudinal scans
Transverse scans
Five Scan Screening
Detailed B-scan Examination
Transverse scan
Longitudinal scan
with PVD: Mobility
B-scan: Vascularity
A-scan: Vascularity
with a retinal detachment: B-Scan: Convection Movement
Biometric A scan
A-scan: Compression
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7.3
Immersion biometric
Immersion biometric
7.4
Vitreous hemorrhage:
10.1
10.2
Vitreous hemorrhage:
10.3
Posterior
Tractional
10.4
Open funnel
10.5
11.1A
Choroidal melanoma:
11.1B
Choroidal melanoma:
12.1A
12.1B
16.1
Vitritis: Mobility
Vitreous lymphoma:
Dislocated cry
vitreous detachment: Mobility
retinal detachment: Mobility
retinal detachment: Mobility
A-scan: Non-compression
A-scan: Misalignment
Dispersed: Mobility
Layered: Mobility
Moderate vascularity
Marked vascularity
Mobility
stalline lens: Mobility

Preface

Ultrasonograph in all aspects of ophthalmic practice. Ultrasonography is routinely used not only for biometry for calculating the power of intraocular lens implants prior to cataract surgery but also in the management of patients with trauma, uveitis, vitreoretinal disorders, and differentia­tion of intraocular tumors. The advent of high-resolution ultrasonography of the anterior segment (ultrasound biomicroscopy) has added new depth of understanding of glaucoma and anterior segment disorders. Digital ultrasound biomicroscopy of the cornea is essential for planning refractive surgery.
The contents of Ophthalmic Ultrasonography have been chosen with particular attention to recent advances. The pertinent findings in most chapters have been illustrated to improve understanding of key concepts. We have included 26 video clips offering details of how to perform and interpret ophthalmic ultrasonography. Chapters on ocular prenatal imaging, laboratory applications, and ultrasound-guided anesthesia broaden the horizons of ultrasonography applications in ophthalmology. Concepts currently under investigation are summarized in the chapter on future considerations.
y has become an important clinical tool
Ophthalmic Ultrasonography represents the cumulative experience of more than 30 contributors, the majority of whom practice with us at the Cole Eye Institute. Despite individual styles and preferences, great editorial care has been taken to follow a uniform layout, to avoid overlap, and to present balanced views.
Arun D. Singh, MD
Department of Ophthalmic Oncology
Cole Eye Institute
Cleveland Clinic
9500 Euclid Avenue
Cleveland, OH 44195, USA
Brandy C. Hayden, BS CDOS ROUB
Director of Ophthalmic Ultrasonography
Cole Eye Institute (i-10)
Cleveland Clinic Foundation
9500 Euclid Avenue
Cleveland, OH 44195, USA
ix
List
of Contributors
Norma
A Department of Ophthalmology Federal University of São Paulo Medical Coordinator Diagnostic Center in Ophthalmology Fleury Medicina e Saúde São Paulo, Brazil
Timothy
R London Vision Clinic London, UK
Brian
Cornea, Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Erin
R Department of Radiology Wake Forest University Baptist Medical Center Winston-Salem, NC, USA
Hajir
Physician, Valley Retina Associates Medical Group Encino, CA, USA
Vikram
Pr Director of Ultrasound Department of Imaging Sciences University of Rochester Medical Center Rochester, NY, USA
William
Staff,
Cleveland Clinic Adjunct Associate Professor of Biomedical Engineering Case Western Reserve University Cleveland, OH, USA
Steven
Pr University of Miami’s Miller School of Medicine Bascom Palmer Eye Institute Miami and Palm Beach Gardens, FL, USA
Allemann MD
djunct Professor of Ophthalmology
J. Archer MA(Oxon) DipCompSci(Cantab)
esearch Manager
K. Armstrong MD
External Disease and Refractive Surgery Fellow
Broaddus MD
adiology Resident
Dadgostar MD PhD
Vitreoretinal Surgery
S. Dogra MD
ofessor of Radiology
J. Dupps Jr MD PhD
Cornea and Refractive Surgery, Biomedical Engineering
and Transplant
Gayer MD MBA
ofessor of Anesthesiology and Ophthalmology
Daniel
T. Ginat MD MS
R
adiology Resident Department of Imaging Sciences University of Rochester Medical Center Rochester, NY, USA
Marine
R London Vision Clinic London, UK
Brandy
Dir Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Linda
Health Bruce W Carter Department of Veterans Affairs Medical Center Miami, FL, USA
Ronald
Medical Cole Eye Institute Professor of Ophthalmology Lerner College of Medicine of Case Western Reserve University Cleveland Clinic Cleveland, OH, USA
Breno
Ophthalmology Resident Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Careen
Full Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Lisa
Staff Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Glauco
Cornea Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Gobbe MST(Optom) PhD
esearch Optometrist
C. Hayden BS CDOS ROUB
ector of Ophthalmic Ultrasonography
Kelley CRA COA ROUB
Technician Supervisor
R. Krueger MD MSE
Director, Department of Refractive Surgery
da Rocha Lima MD
Y. Lowder MD PhD
Professional Staff
D. Lystad MD
Neuro-Ophthalmology
Reggiani Mello MD
and Refractive Surgery Fellow
xi
of Contributors
List
Maria Helena Mandello Carvalhaes Ramos MD
ssistant Doctor
A Diagnostic Center in Ophthalmology Fleury Medicina e Saúde São Paulo, Brazil
Dan Z. Reinstein MD MA(Cantab) FRCSC FRCOphth
Medical London Vision Clinic London, UK Department of Ophthalmology St. Thomas’ Hospital – Kings College London, UK Department of Ophthalmology Columbia University Medical Center New York, NY, USA Centre Hospitalier National d’Ophtalmologie Paris, France
Edward
A Cleveland Clinic Lerner College of Medicine of Case Western
Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Reecha
Ophthalmology Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Marcony
Cornea Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Lynn
Staff Assistant Professor of Pathology Cleveland Clinic Cleveland, OH, USA
Jonathan
A Cleveland Clinic Lerner College of Medicine Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Director
J. Rockwood MD
ssociate Professor of Ophthalmology
Reserve University
Sachdeva MD
Resident
R. Santhiago MD
and Refractive Surgery Fellow
Schoenfield MD
Pathologist
E. Sears MD
ssociate Professor
Sumit Sharma MD
R
esident, Ophthalmology Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Eric Scot Shaw BS
esearch Assistant
R Department of Anesthesiology, Perioperative Medicine and Pain
Management University of Miami, Miller School of Medicine Miami, FL, USA
Ronald
Pr Department of Ophthalmology Columbia University Medical Center New York, NY, USA Riverside Research Institute New York, NY, USA
Arun
Pr Director, Department of Ophthalmic Oncology Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Rishi
A Cleveland Clinic Lerner College of Medicine Case Western Reserve University Staff Physician Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
H. Silverman PhD
ofessor of Ophthalmic Science
D. Singh MD
ofessor of Ophthalmology
P. Singh MD
ssistant Professor of Ophthalmology
Nathan C. Steinle MD
Vitreoretinal Fellow Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Virgínia
ost Doctoral Research Fellow
P Federal University of São Paulo São Paulo, Brazil
Elias
Head, Director, The Center for Genetic Eye Diseases Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Mary
Clinical Cole Eye Institute Cleveland Clinic Cleveland, OH, USA
Amit
Dir Lerner Research Institute Cleveland Clinic Cleveland, Ohio, USA
L L Torres MD
I. Traboulsi MD
Department of Pediatric Ophthalmology and Strabismus
E. Turell MD
Fellow in Ophthalmic Oncology
Vasanji PhD
ector, Biomedical Imaging and Analysis Center
xii

Dedication

T
o my parents who educated me beyond their means, my wife Annapurna, and my children, Nakul and Rahul, who make all my efforts worthwhile (A.D.S.).
To my parents Michael and Barbara Hayden who
have always encouraged me, Judith Abel, Eric Carlson and
Timothy Murray for introducing me to academics, and J. Douglas Woodrich and Gretchen Arnold Doran for believing in who I am (B.C.H.).
xiii
A
cknowledgments
W
e are grateful to Daniel Martin, MD, Chairman, Cole Eye Institute, for his encouragement. We gratefully acknowledge the contributions of Rachael Briggs, Anne Pinter, Karen King, Sharon Allen, Shawn Perry, Jennifer Pertz, and the staff of the imaging department in retriev­ing and preparing the large amount of material used in this book.
We could not have completed this project on time without the support of Sharon Nash (Development Editor), Vinod Kumar Iyyappan (Project Manager), and Alison Woodhouse (copy-editor). We are indebted to Russell Gabbedy (Acquisition Editor) for offering us the opportunity to compile this book.
Arun D. Singh, MD Department of Ophthalmic Oncology Cole Eye Institute Cleveland Clinic 9500 Euclid Avenue Cleveland, OH 44195, USA
Brandy C. Hayden, BS CDOS ROUB Director of Ophthalmic Ultrasonography Cole Eye Institute (i-10) Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland, OH 44195, USA
xv