Abstract
Abstract Background Evaluation of pupillary light reflex (PLR) is an important neurological test with a variety of clinical applications. Obstacles such as severe soft tissue damage or hyphema may obstruct the visual access to the pupil, thus rendering direct PLR observation difficult or impossible. Multipurpose ultrasonic systems, however, can overcome this problem. Methods Using ultrasound imaging, a coronal view of the iris and pupil allowed visualization of PLR upon contralateral stimulation with a penlight. The technique was tested in ten healthy volunteers and a trauma case study. Results Satisfactory visualization of the iris was achieved in all subjects, in an average time of 1 min 10 s. Temporal parameters of pupillary constriction, oscillations (hippos) and relaxation could also be measured on M-mode displays. Conclusions Real-time coronal imaging of the iris using multipurpose ultrasound imaging is found to be a practical, fast and recordable method that can be used for evaluating PLR.
Highlights
The first ophthalmic ultrasound image was published in 1956 [1]
Satisfactory visualization of the iris was achieved in all subjects, in an average time of 1 min 10 s
Real-time coronal imaging of the iris using multipurpose ultrasound imaging is found to be a practical, Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users
Summary
The first ophthalmic ultrasound image was published in 1956 [1]. Since ultrasound imaging technologies have evolved to offer crucial diagnostic information in many ophthalmic conditions, such as complications of ocular trauma [2,3,4,5]. Ultrasound in ophthalmology is employed in several clinical applications such as general-purpose ocular imaging (B-mode), ultrasound biometry that pursues precise distance measurements (A-mode), and ultrasound biomicroscopy (UBM) limited to the anterior segment, which uses high frequencies (e.g., 50 MHz) to provide a very high resolution of 33 lm and less [6,7,8,9,10]. On the other hand, are increasingly available for emergency imaging needs, and they have been demonstrated to provide excellent ophthalmic images when fitted with high-frequency probes [11]. Evaluation of pupillary light reflex (PLR) is an important neurological test with a variety of clinical applications. Obstacles such as severe soft tissue damage or hyphema may obstruct the visual access to the pupil, rendering direct PLR observation difficult or impossible. The technique was tested in ten healthy volunteers and a trauma case study
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