Diagnosis of posterior vitreous detachment with B-mode ultrasonography and optical coherence tomography

Abstract

Objective To compare the findings of posterior vitreous detachment (PVD) with B-mode ultrasonography and spectral-domain optical coherence tomography (SD-OCT),and to find the best way for clinical diagnosis of PVD.Methods This is a prospective case series study based at our hospital between May and September 2012.Patients aged 50 years or older with no obvious ocular pathology,no history of intraocular operation and refractive power within ± 3 Diopter were recruited and examined with B-mode ultrasonography and SD-OCT.Posterior hyaloid status were assessed by two experienced technicians respectively.Patients with idiopathic macular pucker and macular hole indicated for vitrectomy were also included,and preoperative findings of posterior vitreous cortex status were compared with intraoperative findings.SPSS software was used for statistical analyses.Results Two hundreds and four eyes of 102 patients met the criteria were examined,in which 10 eyes of 10 patients received 23G vitrectomy.There were 31 males and 71 females.Mean age was (63.2± 7.2) years old (ranged from 50 to 80 years old).Status of posterior vitreous cortex were measured by SD-OCT in 70 eyes (34.3％),56 eyes (27.5％) of which manifested different stages of PVD and 14 eyes (6.8％) with attached posterior vitreous cortex (NPVD).The other 134 eyes (65.7％) had no findings of posterior vitreous cortex with SD-OCT.B-mode ultrasonography showed 98 eyes (48.0％) with C-PVD.Combining the results detected by both ultrasound and SD-OCT,altogether 145 eyes (71.1％) were found with different stages of PVD.Comparison of B-mode ultrasonography and SD-OCT to intraoperative findings in 10 operated eyes showed that:seven eyes with no findings in SD-OCT actually had C-PVD; three eyes with PVD in SD-OCT were proved having PVD during operation; five eyes manifested N-PVD in B-mode ultrasonography,only one of which was proved having N-PVD; five eyes with C-PVD in B-scan were observed having C-PVD.Only one eye had a matched result of C PVD with three detecting ways.Conclusions B-mode ultrasonography provides a significant higher detection rate of PVD than SD-OCT; SD-OCT has more advantages than ultrasound in detecting the earlier stage of PVD.Combining B-mode ultrasonography and SD-OCT can significantly improve the PVD detection rate and provide considerably more information of PVD. Key words: Vitreous detachment/ultrasonography; Ultrasonography; Tomography, optical coherence