Ultrasound Biomicroscopy Research Articles

Visual prognosis and complications of congenital ectopia lentis: study protocol for a hospital-based cohort in Zhongshan Ophthalmic Center

IntroductionCongenital ectopia lentis (CEL) is a rare ocular disease characterised by the dislocation or displacement of the lens. Patients with mild lens dislocations can be treated with conservative methods (eg,...

Pharmacological Accommodative Changes of the Anterior Segment and Its Impact on the Vault in Implantable Collamer Lens Implantation.

To estimate the accommodative changes of the anterior segment and its impact on the central and peripheral vaults after Visian Implantable Collamer Lens (ICL) (STAAR Surgical) implantation. Eighty eyes of 40 consecutive patients (mean age: 28.05 years; range: 19 to 42 years) were examined 3 months after ICL implantation. Eyes were randomly divided into a mydriasis group and a miosis group. Anterior chamber depth (ACD) to crystalline lens (ACD-L), anterior chamber depth to ICL (ACD-ICL), central distance from endothelium to sulcus to sulcus (ASL), central distance from sulcus to sulcus to crystalline lens (STS-L), central distance from ICL to sulcus to sulcus (STS-ICL), and central (cICL-L), midperipheral (mICL-L), and peripheral (pICL-L) vaults were measured by ultrasound biomicroscopy at baseline and after induction with tropicamide or pilocarpine. After tropicamide treatment, cICL-L, mICL-L, and pICL-L decreased from 0.531 ± 0.200, 0.419 ± 0.173, and 0.362 ± 0.150 mm to 0.488 ± 0.171, 0.373 ± 0.153, and 0.311 ± 0.131 mm, respectively. The values decreased from 0.540 ± 0.185, 0.445 ± 0.172, and 0.388 ± 0.149 mm to 0.464 ± 0.199, 0.378 ± 0.156, and 0.324 ± 0.137 mm after pilocarpine administration, respectively. The ASL and STS showed a significant increase in the mydriasis group (all P ≤ .038), but a decrease in the miosis group (all P < .001). The ACD-L increased and STS-L decreased in the mydriasis group (all P < .001), indicating the backward shift of the crystalline lens, whereas crystalline lens forward shift was observed in the miosis group. Additionally, the STS-ICL decreased in both groups (all P ≤ .021), suggesting the ICL backward shift. Both central and peripheral vaults decreased during the pharmacological accommodation process, and the ciliaris-iris-lens complex contributed to the changes. [J Refract Surg. 2023;39(6):414-420.].

Исследование предоперационной симметрии дистанции «экватор хрусталика – цилиарные отростки» у пациентов с сочетанием возрастной катаракты с клиническими проявлениями инволюционной соединительнотканной дисплазии

Purpose. Study of state of the Zonule of Zinn in patients with combination senile cataract with systemic involutional connective tissue dysplasia. Material and methods. 97 patients (97 eyes) – combination senile cataract with involutional pathology in connective tissue (the main group). 1st subgroup: 31 patients with kyphoscoliotic deformity of the 3d and 4th degree (classification by V.D. Chaklin (1973)); 2nd subgroup – 66 patients with chronic venous insufficiency 2nd and 3d degree (the CEAP classification) against the background of varicose veins of the lower extremity. Patients of both subgroups were comparable in terms of cataract stages and nuclear cataract lens density in Buratto classification. The control group – 55 patients (55 eyes) similar sex and age with senile cataracts without involutional connective tissue pathology. We estimated the symmetry of distance «lens equator – ciliary processes» in 2 meridians: at 6 and 12 hours. The presence of asymmetry of 0.3 mm or more was sign of weak zonular support (according to ultrasonic biomicroscopy). Results. In the control group, the distance was 0.3 mm in 3 eyes (5%), with intraoperative formation of folds in the anterior capsule. In 10 eyes of the 1st subgroup of the main group (32%), the presence of distance asymmetry was revealed: intraoperative, signs of subluxation of the lens of the 1st degree were detected in 7 eyes. In the 2nd subgroup of the main group, distance asymmetry was detected in 24 eyes (37%). Folded anterior lens capsule was determined intraoperative in 14 eyes (21%) during anterior capsulorhexis and lens mobility during nucleus emulsification. Conclusion. A statistically significant difference in frequency of asymmetries of distances «lens equator – ciliary processes» in 2 opposite meridians was revealed between groups of patients with senile cataract against the background of systemic somatic involutional pathology of connective tissue and without it (35% vs. 5%; p &lt; 0.01). Keywords: senile cataract, Zonule of Zinn, involutional changes in connective tissue, ultrasound biomicroscopy

Unilateral pigmented paravenous retinochoroidal atrophy with acute angle-closure glaucoma: a case report

BackgroundPigmented paravenous retinochoroidal atrophy (PPRCA) is an uncommon fundus disease characterized by perivenous aggregations of pigment clumps and retinochoroidal atrophy distributed along the retinal veins. We report a Chinese female case of unilateral PPRCA with acute angle-closure glaucoma (AACG).Case presentationA 50-year-old Chinese female presented with vision loss and elevated intraocular pressure (IOP) in the right eye and then underwent trabeculectomy. She referred to our clinic for further evaluation and treatment. The funduscopic examination revealed grayish retinochoroidal atrophy and osteocyte-like pigment clumping lesions along the retinal veins and peripapillary preretinal hemorrhage in the right eye. The patient also presented with AACG in the same eye on the basis of past medical history of acute attack, shallow anterior chamber depth (ACD), narrow angle showed by ultrasound biomicroscopy (UBM) and glaucomatous neuropathy identified by optical coherence tomography (OCT). Other examinations like fluorescein fundus angiography (FFA), electroretinogram (ERG) and electrooculography (EOG) all confirmed the aforementioned diagnose.ConclusionPPRCA is a rare disease, uncommon in females and symmetrical in both eyes. We present a rare case of unilateral PPRCA accompanied with AACG.

Imaging iridotrabecular contact in angle closure.

With ultrasound biomicroscopy (UBM), radial scans are taken by using a typical ciliary process, to show the details of the iridocorneal angle, the anterior surface of the ciliary body, and its relation to the posterior iris. Appositional closure represents potentially reversible contact between the peripheral iris and trabecular meshwork. The appositional closure can further be classified according to the configuration of iridotrabecular contact (ITC). UBM can be performed in dark and light conditions, which has been shown to be useful for detecting changes in iridocorneal angle configuration associated with dark and light. To image ITC configuration in appositional angle closure and also image iridocorneal angle in dark and bright light room illumination. Synopsis: UBM demonstrates two types of ITC configuration in appositional closure which are, B-type and S-type. It can also demonstrate the presence of sinus of Mapstone in S-type of ITC. UBM allows imaging of dynamic changes in the iris and shows that the degree of appositional angle closure is a dynamic process that can change rapidly depending on the lighting conditions. https://youtu.be/tgN4SLyx6wQ.

Differences Between Angle Configurations in Different Body Positions by Ultrasound Biomicroscopy in Patients with Cortical Age-Related Cataract.

To investigate the differences in parameters related to angle configuration and lens position in patients with cortical age-related cataract by ultrasound biomicroscopy (UBM) in different body positions. Prospective study with 55 patients with cortical age-related cataract proposed for phacoemulsification, examined using a Compact Touch STS UBM (Quantel Medical, France). UBM bag/balloon technology was applied to measure the central anterior chamber depth (ACD) and lens vault (LV) in horizontal and vertical orientation in sitting and supine positions, angle opening distance (AOD500), trabecular iris angle (TIA) and iris lens angle (ILA) in four quadrants: superior, inferior, nasal, and temporal. We found no significant difference in ACD between sitting and supine positions (p = 0.053); LV was significantly greater in the supine position (p < 0.001); AOD500 in superior and inferior quadrants were significantly longer in the sitting position (p = 0.001; p < 0.001); TIA in superior and inferior quadrants was significantly greater in the sitting position (p < 0.001; p < 0.001), and TIAmax-min was significantly smaller in the sitting position (p = 0.001); ILA in temporal quadrant was significantly larger in the sitting position (p = 0.015) and ILAmax-min was significantly smaller in the sitting position (p < 0.001). The anterior chamber angle was narrower and the lens was positioned more anteriorly in the supine than in the sitting position in cortical age-related cataract. Different positions may affect the angle configuration and the relative space of lens through different directions of mechanics and modes of action.

High-frequency ultrasound biomicroscopy findings of the skin of dogs with atopic dermatitis.

The high-frequency ultrasonographic appearance of skin of dogs with atopic dermatitis (cAD) has not been described. To compare high-frequency ultrasonographic findings among lesional, macroscopically nonlesional skin of dogs with cAD, and the macroscopically nonlesional skin of healthy dogs. Additionally, to determine whether there is any correlation between the ultrasonographic findings in lesional skin and local Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) or its domains (erythema, lichenification, excoriations/alopecia). As a secondary aim, six cAD dogs were re-evaluated after management intervention. Twenty dogs with cAD (six were re-examined after treatment) and six healthy dogs. In all dogs, ultrasonographic examination was performed on the same 10 skin sites, using a 50 MHz transducer. Wrinkling of skin surface, presence/width of subepidermal low echogenic band, hypoechogenicity of dermis and thickness of the skin were evaluated and scored/measured blindly. Dermal hypoechogenicity was more common and severe in lesional compared to macroscopically nonlesional skin of dogs with cAD. In lesional skin, presence/severity of wrinkling of skin surface and of dermal hypoechogenicity were positively correlated with presence/severity of lichenification, while severity of dermal hypoechogenicity was positively correlated with local CADESI-04. A positive correlation between the change in skin thickness and the change in the severity of erythema during treatment was noted. High-frequency ultrasound biomicroscopy may be useful for the evaluation of skin of dogs with cAD and for evaluating the progression of skin lesions during treatment.

Improvement in the ideal range of vault after implantable collamer lens implantation: a new vault prediction formula.

To derive and validate a novel vault prediction formula to improve the predictability and safety of implantable collamer lens (ICL) implantation. Thirty-five patients (61 eyes) with previous posterior chamber intraocular lens implantation were included. Various parameters, such as horizontal-visible iris diameter (HVID), photopic pupil diameter (PPD), axial length (AL), white-to-white (WTW), anterior chamber width (ACW), angle-to-angle (ATA), crystalline lens rise (CLR), anterior chamber depth (ACD), horizontal sulcus-to-sulcus (HSTS), and ciliary sulcus angle (CSA) were measured. Vault was measured at 3 months after surgery using CASIA2 anterior segment optical coherence tomography. The formula was derived using multiple linear regression analysis and named as WH formula. It was validated in 65 patients (118 eyes) to determine the percentage of the ideal postoperative vault range and to compare the differences between the WH formula and the NK, KS, and STAAR formulas. Final ICL size, ATA, CSA, and CLR were included in the prediction formula model (adjusted R2 = 0.67, p < 0.001). The achieved vault 1 month after the surgery was 556.19 μm ± 166.98 μm in the validation group, and the ideal vault range was 200-800 μm (92%). The difference between the achieved vault and that predicted using the WH formula was not statistically significant (p = 0.165), whereas the difference between the achieved vault and that predicted using the NK and KS formulas was statistically significant (p < 0.001 and p < 0.001, respectively). The 95% agreement limit range of the achieved vault and the vault predicted using the WH formula was narrower than those predicted using the NK and KS formulas (-295.20-258.82 μm). This study combined the results of optical coherence tomography and ultrasound biomicroscopy measurements of the anterior segment of the eye and incorporated ciliary sulcus morphology quantification into the prediction formula. The study derived a prediction formula for vault by combining ICL size, ATA, and CLR. The derived formula was found to be superior to the currently available formulas.

Preliminary study on the efficacy of lacrimal duct reconstruction with pedicled conjunctival flap in the treatment of severe lacrimal canalicular obstruction with conjunctivochalasis.

To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis. This study was performed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019. The clinical data included the degree of preoperative epiphora and postoperative relief, preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy, postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test, etc. Syringing was carried out to determine the reconstruction and patency of the lacrimal duct. All 9 patients (9 eyes) had severe canalicular obstruction with conjunctivochalasis. The patients included 4 males and 5 females aged between 47-65y with an average age of 52.2±6.7y. At 3mo follow-up, the tube was removed and the patients were followed for a further 3mo. After tube removal, 6 patients showed no epiphora. These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results. Two patientshad epiphora. Also, syringing showed partial patency of the reconstructed lacrimal duct. One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct. The total effective rate of the operation was 8/9, with no serious complications. Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.

Efficacy and safety of laser peripheral iridoplasty with different energy levels and locations in the treatment of primary angle closure disease assessed by swept-source anterior segment optical coherence tomography

BackgroundTo explore the efficacy and safety of laser peripheral iridoplasty (LPIp) with different energy levels and locations in the treatment of primary angle closure disease (PACD) assessed by swept-source anterior segment optical coherence tomography (AS-OCT).MethodsWe enrolled patients with PACD following best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber gonioscopy, ultrasound biomicroscopy(UBM), optic disc OCT, and visual field examinations. After Pentacam and AS-OCT measurements, the patients were randomly divided into four treatment groups for LPIp with two different energy levels (high vs. low energy) and two locations (far from the periphery vs. near the periphery) and combined with laser peripheral iridotomy. BCVA, IOP, pupil diameter, central anterior chamber depth, anterior chamber volume, anterior opening distance (AOD)500, AOD750, trabecular iris angle (TIA)500, and TIA750 in four quadrants before and after laser treatment were compared.ResultsWe followed up 32 patients (64 eyes; average age, 61.80 ± 9.79 years; 8 patients/16 eyes per group) for up to 2 years. The IOP of all enrolled patients was decreased after surgery compared to that before (t = 3.297, P = 0.002), the volume of the anterior chamber was increased (t=-2.047, P = 0.047), and AOD500, AOD750, TIA500, and TIA750 were increased (all P < 0.05). Within-group comparisons showed that BCVA in the low-energy/far-periphery group was improved after surgery (P < 0.05). After surgery, the IOP was decreased in the two high-energy groups, whereas the volume of the anterior chamber, AOD500, AOD750, TIA500, and TIA750 were increased in all groups (all P < 0.05). However, when comparing every two groups, the high-energy/far-periphery group showed a stronger effect on pupil dilation than the low-energy/near-periphery group (P = 0.045). The anterior chamber volume in the high-energy/near-periphery group was larger than that in the high-energy/far-periphery group (P = 0.038). The change in TIA500 was for 6 points smaller in the low-energy/near-periphery group than in the low-energy/far-periphery group (P = 0.038). Other parameters showed no significant group differences.ConclusionLPIp combined with iridotomy can effectively reduce IOP, increase anterior chamber volume, increase chamber angle opening distance, and widen the trabecular iris angle. Intraoperatively, high-energy laser spots positioned one spot diameter from the scleral spur can obtain the best effect and safety. Swept-source AS-OCT can safely and effectively quantify the anterior chamber angle.

Paradoxical autosomal recessive bestrophinopathy-like phenotypes shown in an autosomal dominant pedigree.

This study aimed to evaluate the clinical and genetic characteristics of eight members from a Chinese Han family who displayed autosomal recessive bestrophinopathy (ARB)-like retinal changes in autosomal dominant (AD) inheritance pattern. Clinical investigations included slit-lamp, tonometry, fundus photography, spectral-domain optical coherence tomography, fundus autofluorescence, electrooculography, and ultrasound biomicroscopy. Ocular axial length measurements were collected retrospectively. The targeted exome sequencing (TES) was applied for the genetic analysis of the proband. PCR-based Sanger sequencing was performed on the family for validation and co-segregation analysis. Eight members in the three-generation pedigree complained about vision loss and seven of them had detailed clinical assessments, demonstrating ocular phenotypes including extramacular and vascular arcades subretinal deposits and Arden ratio decline on electrooculography that resembled ARB. Bilateral anterior chamber structure abnormalities were observed in seven cases and three patients were diagnosed with angle-closure glaucoma. Despite clinical phenotypes supporting ARB, there was only a single heterozygous mutation of c.227T > C (p.Ile76Thr) in the BEST1 gene detected in all eight patients, which showcased AD inheritance. An ARB-like phenotype could be caused by a heterozygous mutation of the BEST1 gene and inherited in an AD fashion.

Ultrasound biomicroscopy (UBM) in the diagnosis of acute fibrin pupillary block in a pseudophakic eye

Ultrasound biomicroscopy (UBM) in the diagnosis of acute fibrin pupillary block in a pseudophakic eye

Intraocular medulloepithelioma clinical features and management of 11 cases

AimsTo describe the clinical features, imaging characteristics, histopathology, treatment and outcomes of intraocular medulloepithelioma.MethodsMedical records of 11 patients with clinically or histopathologically confirmed medulloepithelioma were retrieved and reviewed. Clinical features,...

Clinicopathological features of corneal invasion by filtering bleb

PurposeTo describe the clinicopathological characteristics and explore the possible etiology of cornea invasion by filtering bleb (CIFB) after filtering surgery.MethodsWe reviewed 22 patients treated for CIFB between March 2005 and March 2022. The patients were followed up for more than 1 year. Slit-lamp examination, optical coherence tomography (OCT), ultrasound biomicroscopy, and histopathological examination were performed to observe the morphology of the bleb and depth of corneal invasion. Depending on the severity of the lesion, treatments consisting of local massage, acupuncture separation, or surgical resection were administered.ResultsThe mean age of the patients was 56.3 ± 8.8 years. All patients underwent filtering surgery in the moderate or advanced stage of glaucoma. The filtering bleb was closely connected with the cornea, and its posterior boundary was locally adhered. Forward displacement of the internal opening of the filtering bleb was found in 4 of 7 surgically treated patients. OCT and pathological examination showed that the filtering blebs invaded the corneal stroma. Removal of the adhesion of the posterior boundary of the filtering bleb by different treatment methods successfully improved the patients’ conditions.ConclusionFiltering blebs can invade the corneal stroma. Adhesion of the posterior boundary and forward displacement of the internal opening of the filtering bleb are the possible causes of CIFB. Removal of the adhesion of the posterior boundary of the filtering bleb can halt the progression of CIFB.

Современные методы диагностики аномалии Петерса

Peters anomaly is a rare disease, significant in its consequences and leading to disability. According to the literature, Peters anomaly was recorded in approximately 700 cases in Russia, and around the world about 35,000 people have various forms of this pathology. The main cause of occurrence is the presence of a genetic mutation. The disease has a variety of phenotypic manifestations, differently interpreted by the authors depending on the research methods used and clinical experience. An important step in determining the optimal tactics and timing of surgical intervention for Peters anomaly is a thorough diagnostic examination of the child. The data presented in the literature indicate that optical coherence tomography and ultrasound biomicroscopy are highly informative research methods for corneal opacity. Their data are indispensable in making the correct diagnosis of Peters anomaly, determining the subtype and severity of the process, as well as choosing further tactics for managing patients. An urgent direction for further research is the identification of informative signs of Peters anomaly using modern research methods, the development of a complex of multimodal algorithms for multifaceted diagnostics in establishing a diagnosis, as well as the development of a systematic approach in determining subtypes, choosing tactics for managing and treating this pathology. Key words: Peters anomaly, diagnostic methods, etiology, follow-up, surgical treatment

Morphometric Assessment of the Ciliary Body in Patients With Marfan Syndrome and Ectopia Lentis: A Quantitative Study Using Ultrasound Biomicroscopy

To explore the biometric characteristics of the ciliary body in patients with Marfan syndrome (MFS) and ectopia lentis (EL). Cross-sectional study. Seventy-two consecutive patients with MFS and EL and 72 nondiseased control subjects were recruited. Ciliary body biometric parameters such as ciliary muscle cross-sectional area at 2000 µm from the scleral spur (CMA2000), ciliary muscle thickness at 1000 µm from the scleral spur (CMT1000), and maximum ciliary body thickness (CBTmax) were measured from multiple directions with ultrasound biomicroscopy (UBM). The relationship between ciliary body parameters and other ocular characteristics was also evaluated. Average CMA2000, CMT1000, and CBTmax were 0.692 ± 0.015 mm2, 0.405 ± 0.010 mm, and 0.855 ± 0.023 mm in eyes of patients with MFS, respectively, and were significantly smaller than these values in control subjects (all P < .001). The prevalence of ciliary body thinning was 22.2% in the MFS group vs 0 in the control group (P < .001); eyes with more severe EL had smaller CMA2000 (P=.050), thinner CMT1000 (P=.022), and shorter CBTmax (P=.015). Patients with microspherophakia (MSP) had even smaller CMA2000 (P=.033) and CMT1000 (P=.044) than those without MSP. The most common subluxation direction was in the superonasal quadrant (n=25; 39.7%), which probably correlates with the thinnest CMT1000 in the inferotemporal quadrant (P=.005). Patients with MFS and EL had thinner ciliary muscles, shorter ciliary processes, and a higher prevalence of ciliary body thinning, especially those with MSP. Both the extent and direction of subluxation were associated with ciliary body biometry.</ABSTRACT>.

Two different procedures for managing ocular melanosis presenting scleral pigmentation with glaucoma in a Shih‐Tzu dog: A case of definitive diagnosis in one eye and a presumed diagnosis in the contralateral eye

A 12-year-old castrated male Shih-Tzu dog was referred for uncontrolled glaucoma and uveitis with highly pigmented sclera, in both eyes (OU). On ophthalmic examination, the menace response, dazzle reflex and pupillary light reflex were negative OU. The intraocular pressure was 27mmHg in the right eye (OD) and 70mmHg in the left eye (OS) despite the administration of antiglaucoma eyedrops. Ultrasound biomicroscopy revealed a closed ciliary cleft OU. Ocular ultrasonography revealed hyperechoic materials in the vitreous OU and retinal detachment OS. When presented for recheck, an extensive malacic corneal ulcer was observed OS. To relieve pain in the blind eyes, enucleation OS and pharmacologic ciliary body ablation (CBA) OD were performed. Histologically, ocular melanosis, which is an inherited disease in the Cairn Terrier breed, was identified in the enucleated eye. The uvea was heavily pigmented. The iris and ciliary body were mildly distorted by a single population of large, round, nonneoplastic cells with pigmented cytoplasm. There was no evidence of an intraocular mass or metastasis before and after intravitreal CBA. This is the first report of bilateral ocular melanosis in a Shih-Tzu dog. Ocular melanosis is a possible differential diagnosis for globe presenting scleral pigmentation with glaucoma in even non-Cairn Terrier breeds and pharmacologic CBA could be considered as a treatment for ocular melanosis with end-stage glaucoma.

Commentary: Reliability, repeatability, and accuracy of Sirius topographer in assessing anterior segment morphology following laser peripheral iridotomy in primary angle-closure disease.

Commentary: Reliability, repeatability, and accuracy of Sirius topographer in assessing anterior segment morphology following laser peripheral iridotomy in primary angle-closure disease.

Commentary: Clinical profile, demographic distribution, and outcomes of ocular siderosis: Electronic medical record-driven big data analytics from an eye care network in India.

Commentary: Clinical profile, demographic distribution, and outcomes of ocular siderosis: Electronic medical record-driven big data analytics from an eye care network in India.

Ultrasound in ocular oncology: Technical advances, clinical applications, and limitations.

Due to its accessibility and ability for real-time image acquisition of ocular structures, ultrasound has high utility in the visualization of the eye, especially in ocular oncology. In this minireview, we summarize the technical rationale and applications of ultrasound modalities, A-scan, B-scan, high-frequency ultrasound biomicroscopy (UBM), and Doppler measurement. A-scan ultrasound uses a transducer of 7-11 MHz, making it useful for determining the echogenicity of ocular tumors (7-8 MHz) and measuring the axial length of the eye (10-11 MHz). B-scan ultrasound operates at 10-20 MHz, which can be used for measuring posterior ocular tumors while UBM operates at 40-100 MHz to evaluate anterior ocular structures. Doppler ultrasonography allows for the detection of tumor vascularization. While ultrasonography has numerous clinical applications due to its favorable penetration compared with optical coherence tomography, it is still limited by its relatively lower resolution. Ultrasound also requires an experienced sonographer due to the need for accurate probe localization to areas of interest.