Using Ultrasound Biomicroscopy Research Articles

Comparison of angle-to-angle distance and corneal diameter in pediatric eyes using ultrasound biomicroscopy.

To investigate the relationship between corneal diameter and internal corneal span determined from angle-to-angle distance using ultrasound biomicroscopy (UBM) in an observational cross-sectional patient population comprised of 54 eyes (28 healthy control eyes, ages 0.1 to 11.3 years; 26 eyes with primary congenital glaucoma, ages 0.1 to 3.5 years) from 41 pediatric participants ages 0.1 to 11.3 years (mean age: 3±3 years, median age: 2 years). Forty cornea photographs with reference ruler and 110 UBM images were obtained. Three observers measured horizontal and vertical corneal diameter and angle-to-angle distance in each cornea photo and UBM image using ImageJ and the average values were used. Main outcome measures were Pearson correlation coefficient, linear regression, mean difference between corneal diameter and angle-to-angle distance, and intra-class correlation coefficients among measurements from all three observers for each parameter. Corneal diameter and angle-to-angle distance had a strong positive correlation horizontally (Pearson r = 0.89, p<0.001) and vertically (r = 0.93, p<0.001). Correlation was consistent regardless of presence of primary congenital glaucoma and participant age. Regression analysis demonstrated a linear relationship between the parameters for horizontal (CD = 0.99*AA+0.28, R2 = 0.81, p<0.001) and vertical (CD = 0.91 *AA+1.32, R2 = 0.85, p<0.001) dimensions. Overall, reliability was good-excellent, ranging from an ICC of 0.76 for vertical corneal diameter to 0.90 for horizontal angle-to-angle distance. Based on the strong positive correlation found between corneal diameter and angle-to-angle distance in our study population, UBM image analysis can be used to accurately estimate corneal diameter from angle-to-angle distance in children with healthy eyes and primary congenital glaucoma. UBM may provide a useful intraocular alternative for estimating corneal diameter and monitoring diseases that affect the cornea in infants and children, such as congenital glaucoma.

Ultrasound biomicroscopy analysis of ciliary muscle dynamics and its relation to intra-ocular pressure after phacoemulsification in dogs.

This study investigates the relationship between ciliary muscle dynamics, thickness, and the regulation of intraocular pressure (IOP), focusing on the progression of cataracts and changes post-phacoemulsification. It explores how these factors impact canine ocular health, particularly in the context of cataract development and subsequent surgical intervention. Data was collected using Ultrasound Biomicroscopy (UBM) from dogs at the Veterinary Medical Teaching Hospital of Chungbuk National University, Korea. The study involved 57 eyes from 35 dogs, categorized into five groups: 13 normal eyes, 14 with incipient cataracts, 12 with immature cataracts, 6 with mature cataracts, and 12 post-phacoemulsification. UBM measurements assessed various ciliary muscle parameters including ciliary body axial length (CBAXL), ciliary process-sclera angle (CPSA), longitudinal fibers of ciliary muscle thickness (Lf-CMT), and longitudinal and radial fibers of ciliary muscle thickness (LRf-CMT). Findings indicated a decrease in CBAXL and an increase in Lf-CMT as cataracts progressed in severity. Post-phacoemulsification, there was a notable increase in CBAXL and a decrease in CPSA, Lf-CMT, and LRf-CMT, compared to both cataractous and normal eyes. Regression analysis revealed a significant positive association between CBAXL and IOP, alongside a negative association between Lf-CMT and IOP. These findings suggest that variations in ciliary muscle dynamics and thickness, as influenced by cataract progression and phacoemulsification, have distinct impacts on intraocular pressure. The study proposes that phacoemulsification leads to ciliary muscle contraction, causing an inward and anterior movement of the ciliary muscle. This movement results in the narrowing of the ciliary cleft and constriction of the unconventional outflow pathway, potentially causing an increased risk of glaucoma post-surgery. Our research contributes to understanding the anatomical and physiological changes in the canine eye following cataract surgery and underscores the importance of monitoring IOP and ciliary muscle dynamics in these patients.

Assessment of Zonular Integrity in Phakic Eyes Following Pars Plana Vitrectomy Using Ultrasound Biomicroscopy (UBM): A Prospective Paired Eye Comparative Study.

To assess zonular integrity in phakic patients post vitrectomy using ultrasound biomicroscopy (UBM). Prospective, comparative, non-randomized, double masked, paired eye study. We used ultrasound biomicroscopy (UBM) to evaluate phakic patients with history of unilateral pars-plana vitrectomy. 1.Phakic patients with history of pars plana vitrectomy in one eye as the only procedure. 2.Normal unoperated fellow eye. 3.Complete gas or air resolution from the vitreous cavity at the time of UBM assessment. 1. Monocular patients. 2. History of intraoperative lenticular trauma. 3. The use of silicone oil tamponade. 4. History of trauma or pseudo-exfoliation in either eye.5. History of other ocular conditions that can affect the integrity of zonules, such as uveitis or ectopia lentis. 6. Eyes with extreme myopia/long axial length (> -8.00 D / > 30.0 mm). 7.History of intravitreal injection in either eye. 8. Age less than 18 years. A high frequency (50 MHz) UBM device was used by a masked technician to obtain radial section images from zonular bundles at 8 different clock positions. Image quality was assessed in real time, captured and saved. Two experienced masked observers (HC and CB) then assessed the quality of the images and graded the zonular findings. Only patients with adequate studies have been included. A unique grading system that was specifically devised for this study was used as the following: (0) clear, well-defined zonule(s); (1) uneven, disrupted zonules or stretched zonules; (2) extensive loss of zonules. Each clock hour was graded according to this system and the total score was then calculated for each eye. In the primary outcome, two main groups were analyzed: the vitrectomized, and healthy contralateral non-vitrectomized eyes. The mean total UBM score (TUS) from each group was compared and analyzed. Thirty five patients were recruited into this study. Eleven patients were males and twenty four were females. The mean age was 66.3 years. Thirty patients had vitrectomy for vitreomacular interface disorders (either macular hole or epiretinal membrane), one patient had vitreous hemorrhage and the remaining four patients had rhegmatogenous retinal detachments. With regards to tamponade agents, SF6 was used in 21 (60%) patients, air in 9 (26%) patients, and C3F8 in 5 (14%) patients. The mean UBM total score (TUS) in the vitrectomized eyes was 2.28 (SD: 1.83) versus 2.24 (SD: 1.77) in the non-vitrectomized eyes (p=0.9531. Overall, in the comparative analysis of mean scores based on two-graders' assessments for each clock position in vitrectomized and non-vitrectomized eyes, there were no significant differences noted between the groups. This study found no evidence for a difference in the mean total UBM score (TUS) in eyes following vitrectomy when compared to their contralateral healthy, non-vitrectomized eyes. This likely indicates that vitrectomy may not affect the integrity of zonules in phakic patients, at least for patients with vitreomacular interface disorders undergoing uncomplicated surgery.

Bleb characteristics assessed by ultrasound biomicroscopy correlate with intraocular pressure after Ahmed glaucoma valve surgery in dogs.

To assess the characteristics of blebs formed after Ahmed glaucoma valve (AGV) surgery in dogs using ultrasound biomicroscopy (UBM) and to analyze their correlation with postoperative intraocular pressure (IOP). 16 eyes (13 dogs) were diagnosed with primary angle-closure glaucoma and were followed up after AGV surgery from June 2021 to September 2023. In this prospective study, UBM examinations were performed to assess bleb characteristics, including bleb wall thickness and reflectivity. IOP at the time of UBM imaging and the duration from AGV surgery to UBM imaging were recorded. Histological examination of an enucleated eye removed due to uncontrolled IOP leading to blindness was also conducted. A significant correlation was observed between IOP and relative reflectivity (Pearson r = 0.60; P = .01), and a negative correlation was observed between bleb wall thickness and relative reflectivity (Pearson r = -0.72; P = .002). No significant correlation was observed between the duration from AGV surgery to UBM imaging and either bleb wall thickness or relative reflectivity, respectively. Histological examination of the enucleated eye revealed collagen-rich fibrous encapsulation of the bleb wall, including myofibroblasts that exhibited positive α-smooth muscle actin immunostaining. In dogs that underwent AGV surgery, less dense, thick-walled blebs on UBM tended to maintain IOP within the normal range. However, denser, thinner-walled blebs showed IOP levels above the normal range despite the use of antiglaucoma medications. UBM is a useful tool for evaluating bleb characteristics and their influence on IOP regulation after AGV surgery in dogs.

The correlation of anterior segment structures in primary congenital glaucoma by ultrasound biomicroscopy with disease severity and surgical outcomes

PurposeTo evaluate the anterior segment structures using ultrasound biomicroscopy (UBM) in primary congenital glaucoma (PCG) and explore their correlation with disease severity and surgical outcomes.MethodsClinical information of PCG patients who underwent UBM prior to their first glaucoma surgeries from September 2014 to March 2021 were reviewed. The study included 214 UBM images of 154 PCG eyes and 60 fellow unaffected eyes. Anterior segment characteristics were analyzed. UBM parameters, including the iris thickness (IT) at variant distances from the pupil edge and iris root, anterior chamber depth (ACD), and pupil diameter (PD), were compared between two groups and their relationship with clinical factors and surgical outcomes were analyzed in PCG eyes.ResultsPCG eyes had unclear scleral spur, thin iris, wide anterior chamber angle, deep anterior chamber, rarefied ciliary body, elongated ciliary processes, and abnormal anterior iris insertion. ITs were thinner, ACD was deeper, and PD was larger in PCG eyes than fellow unaffected eyes (all P < 0.001). In PCG eyes, thinner ITs correlated with bilateral involvement and earlier age at presentation, and larger PD correlated with earlier age at presentation (P = 0.030) and higher intraocular pressure (P < 0.001). Thinner IT2 (P = 0.046) and larger PD (P = 0.049) were identified as risk factors for surgical failure.ConclusionUBM is a powerful technique to exam anterior segment structures in PCG. The anatomical features are associated with disease severity and surgical outcomes, providing essential clinical insights.

The options of ultrasound biomicroscopy in the diagnosis of post-traumatic pathology of the anterior segment of the eyeball

BACKGROUND: In the literature, there are scarce publications on the use of ultrasound biomicroscopy in patients with post-traumatic changes in the anterior segment of the eyeball.&#x0D; AIM: The aim of this study is to study the anatomical and topographic features of post-traumatic conditions of the anterior segment of the eyeball, to determine the criteria for the progression of the disease, to evaluate the possibilities of using the data obtained to determine the tactics of surgical treatment and of individual approach to the choice of implantable optical and diaphragmatic implants.&#x0D; MATERIALS AND METHODS: The study is based on the analysis of the results of ultrasound biomicroscopy of 360 patients with the sequelae of traumatic injuries of the anterior segment of the eyeball. The patients were divided into groups depending on the nature and degree of damage to the iris. The IA group combined clinical cases where the iris defect was less than 30%; the IB group more than 30%.&#x0D; RESULTS: Using ultrasound biomicroscopy, not only the zones of interest were visualized, but the anatomical relationship between the morphological structures of the anterior eye segment and the ciliary body was determined in vivo, their acoustic density was evaluated, and the necessary linear parameters of the eye were measured in the case of ordering and subsequent implantation of intraocular products.&#x0D; CONCLUSIONS: Ultrasound biomicroscopy should be considered as an integral part of the diagnostic examination of patients at the stage of preparation for opto-reconstructive procedure.

Оценка смещений интраокулярной линзы по данным ультразвуковой биомикроскопии

Purpose. To analyze the postoperative IOL displacements toward the haptic plane using ultrasound biomicroscopy (UBM). Material and methods. Biometry data of 172 patients (211 eyes) 71.32 ± 7.75 years old were analyzed, among whom 41.25% were men. IOL position were analyzed at 1 and 3 months after standard phacoemulsification. Results. The IOL was visualized with UBM. Stabilization of lens position was observed by the 3rd month of observation. The displacement of optical part IOL in forward was determined in 24.95%, backward – in 16.57% of cases. Eyes with opposite IOL displacements differed significantly in crystalline lens diameter, ciliary sulcus diameter and the power of implanted IOL. Conclusions. An important technique in the search for possible causes of changes in postoperative refraction is visualization of IOL displacement. The number of displacements of the intraocular lens increases by 3 months, which may cause in visual acuity changes. Keywords: Intraocular lens (IOL) optical part displacement, ultrasound biomicroscopy (UBM), phacoemulsification

The Diagnostic Value of Ultrasound Biomicroscopy in Anterior Segment Diseases.

The purpose of this study was to analyze the use of ultrasound biomicroscopy (UBM) in the diagnosis and follow-up anterior segment diseases. The records of patients who presented to our clinic for UBM between January 1, 2004, and December 31, 2018 were reviewed retrospectively. Demographic characteristics, indications for UBM imaging and findings of the patients were recorded. Also, the change in clinical indications over the years were analyzed. The study included 1.256 eyes of 917 patients, of whom 723 (57.6%) were female and 533 (42.4%) were male. The mean age was 48.7±14.8 years (range: 12-85 years). Indications for UBM imaging were to evaluate glaucoma pathogenesis and surgical outcomes (n=764, 60.8%), iris and ciliary body masses (n=263, 20.9%), congenital anomalies of the crystalline lens and complications of cataract surgery (n=86, 6.8%), the etiology of hypotony (n=57, 4.5%), corneal diseases (n=46, 3.7%), anterior segment findings after trauma (n=22, 1.8%), conjunctival pathologies (n=11, 0.9%), and scleral pathologies (n=7, 0.6%). In patients with glaucoma, the most common reason for requesting UBM according to years was to investigate the plateau iris configuration. UBM is an important imaging method used in the determination of the pathophysiology of anterior segment diseases, clinical evaluation, planning of surgical treatment and analyzing the outcomes.

Prediction of postoperative effective lens position using iris root depth in primary angle-closure diseases.

To evaluate the role of a new parameter, iris root depth (IRD), in intraocular lens power calculation using ultrasound biomicroscopy (UBM) in primary angle-closure diseases (PACDs), and to compare the accuracy of 6 formulas in PACDs: Barrett Universal II (BUII), Haigis, Hill-Radial Basis Function (RBF) v. 3.0, Hoffer Q, Kane and Sanders Retzlaff Kraff/Theoretical (SRK)/T. Zhongshan Ophthalmic Center, Guangzhou, China. Retrospective consecutive case series. Patients diagnosed with PACDs who had undergone cataract surgery were reviewed to first evaluate the performance of 6 formulas. Then preoperative UBM examinations of 58 eyes were used to measure IRD and predict effective lens position (ELP) to generate the Haigis IRD formula. The accuracy of Haigis IRD was compared with BUII, Haigis and Kane formulas. The SD of predicted error was the main indicator evaluating formula performance, according to heteroscedastic analysis. 103 eyes (103 patients) were included. The SDs of Kane (0.59, P = .01), RBF 3.0 (0.61, P = .02) and SRK/T formula (0.62, P = .04) were significantly lower than Hoffer Q. Modified with IRD, Haigis IRD generated the lowest SD (0.41), which was significantly lower than Haigis formula (0.54, P = .03) and was equal to Kane formula (0.45, P = .37). Kane, RBF 3.0 and SRK/T were more accurate in PACD eyes. Optimized with IRD, Haigis IRD formula achieved the lowest SD and had comparable accuracy with Kane formula. IRD could be a promising parameter to improve accuracy of IOL power calculation for PACDs.

Analysis of intraocular lens displacement relative to the haptic plane by ultrasound biomicroscopy data

This study analyzed cases with postoperative displacement of intraocular lens (IOL) relative to the haptic plane using ultrasound biomicroscopy (UBM). The study analyzed biometry data of 231 patients (277 eyes) aged 72.39±7.77 years, among them 43.25% were males. IOL position and refraction were analyzed at 1, 3 and 6 months after standard phacoemulsification. UBM was performed to analyze the position of the IOL. Stabilization of lens position was observed by the 3rd month of observation. Among the cases with displacement of the optical part relative to the haptic plane, the forward shift was determined in 24.85%, backward - in 16.67% of cases. Eyes with opposite IOL displacements differed significantly in lens diameter, ciliary sulcus diameter and the power of implanted IOL. IOL shift towards the retina produced significant hyperopic refractive error. A discriminant function was compiled using preoperative biometry data comprising the model for predicting backward IOL displacement with high probability. However, we failed to obtain a qualitative model for forward IOL displacements. Calculation error in modern formulas could occur because of IOL displacement, including the shift of the optical part relative to the haptic plane in postoperative period. Analysis of biometry data allows calculating IOL displacement towards the retina with a high probability, which could help avoid hyperopic refraction error postoperatively.

Plateau iris syndrome: Epidemiology, diagnosis, and treatment: A narrative review.

Plateau iris syndrome (PIS) was first coined in 1958 to describe the iris configuration of a patient, 2 years later; the concept of plateau iris was published. In 1992, the anatomic aspects of plateau iris were studied using ultrasound biomicroscopy (UBM) determining it as a form of primary angle-closure glaucoma caused by a large or anteriorly positioned ciliary body that leads to mechanical obstruction of the trabecular meshwork, this condition is most often found in young patients. We aim to review the current literature and knowledge on the diagnosis and treatment options of PIS; the search was conducted in PubMed, LILACS, and BIREME internet search sites using keywords and snowball search strategy of articles published until 2022, focusing on PIS history, epidemiology, clinical diagnosis, UBM feature, and treatment.

Use of ultrasound biomicroscopy to predict the outcome of anterior segment reconstruction in congenital fibrovascular pupillary membrane with secondary glaucoma

AimsTo evaluate the efficacy and safety of anterior segment reconstruction (ASR) in congenital fibrovascular pupillary membrane-induced secondary glaucoma (CFPMSG) basing ultrasound biomicroscopy (UBM) classification.MethodsThis ambispective cohort study enrolled patients with...

Actual lens positions of three intraocular lenses in highly myopic eyes: an ultrasound biomicroscopy-based study

AimTo evaluate the actual lens positions (ALPs) of three intraocular lenses (IOLs) in highly myopic eyes and to identify relevant factors using ultrasound biomicroscopy (UBM).MethodsNinety-three highly myopic eyes (93 patients)...

The Imaging Characteristics of Lens Subluxation on the Ultrasound Biomicroscopy.

Background To evaluate the imaging characteristics of the lens subluxation with the use of ultrasound biomicroscopy. Methods From October 2018 to September 2019, 55 eyes diagnosed with lens subluxation were enrolled in the group. All patients underwent detailed eye examination and panoramic ultrasound biomicroscopy. Results The most common sites of lens suspensory ligament injury were superior temporal side (32.73%) and superior nasal side (23.63%). The most common range of subluxation in all patients was 30°. Comparing the measurement indicators of all patients, ciliary body thickness (CBT) in affected eyes was smaller than that in healthy eyes (0.79 ± 0.21, 1.04 ± 0.16), the distance between ciliary process and crystal equator increased (1.91 ± 0.70, 1.17 ± 0.32), and iris-ciliary processes distance (ICPD) increased (1.04 ± 0.51, 0.80 ± 0.17) (P < 0.05). The range of subluxation in patients with lens subluxation was positively correlated with the distance between ciliary processes and the crystal equator. Conclusions The ultrasound biological microscope has a good application significance in the diagnosis of lens subluxation. From this study, we suggest that the three indexes of CBT, ICPD, and the distance between the ciliary process and crystal equator are of high reference value in ultrasound biomicroscopy among patients with lens subluxation.

Evaluation of the characteristics of primary iridociliary cysts using ultrasound biomicroscopy at a tertiary care centre

ObjectifPrésenter les caractéristiques des kystes irido-ciliaires primaires à l’échographie biomicroscopique dans un centre de soins tertiaires du Canada. NatureÉtude rétrospective. ParticipantsAu total, 189 patients (212 yeux) ont été adressés au Sinai Health System (Toronto) en raison d'une suspicion d'anomalies de l'iris. MéthodesOn a examiné les dossiers médicaux des patients qui nous ont été adressés entre mars 2016 et octobre 2019. Tous les patients ont été évalués par échographie biomicroscopique et ont reçu un diagnostic de kyste irido-ciliaire. Les données sur l’âge, le sexe, l'atteinte (iris vs corps ciliaire), la latéralité du kyste, sa taille et sa localisation ont été notées lors de l'examen initial et du suivi. RésultatsParmi les 189 patients (212 yeux) qui présentaient un kyste irido-ciliaire, les femmes (65,1 %) étaient plus nombreuses que les hommes (34,9 %). L'incidence la plus élevée a été enregistrée chez les femmes de 21 à 30 ans (13,2 %). L’épithélium pigmentaire de l'iris était touché dans 84,4 % des cas, et seul le corps ciliaire était atteint dans 3,8 % des cas. Le kyste touchait à la fois l’épithélium pigmentaire de l'iris et le corps ciliaire dans 10,8 % des cas. Le diamètre des kystes s’échelonnait de 0,5 à 4,41 mm et dépassait 1 mm dans 78,7 % des cas; 86,8 % des kystes étaient unilatéraux. On comptait 12 % de polykystose, tandis que 8,5 % des kystes étaient multiloculaires; 1 % des kystes présentaient ces deux caractéristiques. Vingt-trois (23) yeux (12,2 %) ont fait l'objet d'une échographie biomicroscopique 1 an plus tard. La taille des kystes irido-ciliaires était demeurée stable, et ces derniers n'avaient pour ainsi dire pas pris de volume dans 73,9 % des cas (n = 17). Cependant, on a observé une augmentation de la taille du kyste irido-ciliaire chez 1 patient après 4 mois. ConclusionOn trouve peu de données sur les kystes irido-ciliaires dans la littérature médicale. L’échographie biomicroscopique est un outil clinique utile pour évaluer les anomalies de l'iris. Les kystes irido-ciliaires ont tendance à demeurer stables au fil du temps et à entraîner peu de complications.

Prevalence of Plateau Iris in Primary Angle Closure Glaucoma: An Egyptian Hospital Based Ultrasound Biomicroscopy Study.

PurposeTo determine the distribution and the anatomical characteristics of plateau iris (PI) in primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM).MethodsFifty UBM images of PACG cases were studied over one year by retrospective analysis. The data from UBM images including angle opening distance at 500 and 750 μm (AOD500 and AOD750), trabecular-iris angle (TIA), angle recess area at 750 μm (ARA750), maximum ciliary body thickness (CBTmax), anterior placement of ciliary processes (APCP), central anterior chamber depth (CACD), axial lens thickness (ALT), and ciliary sulcus status were analyzed and compared between the PI and non-PI cases.ResultsEighteen cases had PI (36%). The mean AOD500, AOD750, and TIA were significantly smaller in PI than in non-PI eyes (P = 0.01; P = 0.046; and P = 0.026). Values of the ARA750 and CBTmax were not significantly different between the two groups (P = 0.208 and P = 0.368). CACD was deeper in the PI group (P = 0.011). ALT was higher in the non-PI group (P = 0.001). The mean APCP of the PI group was more than those of the non-PI group (P < 0.001). The number of cases with obliterated ciliary sulcus in more than two quadrants was significantly more in the PI group (P < 0.001).ConclusionAround one-third of PACG eyes were found to have PI on UBM imaging. The number of obliterated ciliary sulcus and APCP were important UBM parameters that help in PI diagnosis.

Corneal thickness and anterior chamber depth of the normal adult horse as measured by ultrasound biomicroscopy.

To determine corneal thickness (CT) and axial anterior chamber depth (ACD) using ultrasound biomicroscopy (UBM) in normal adult horses. To compare corneal thickness measurements between UBM and ultrasonic pachymetry. Sixty eyes of 30healthy adult horses aged 8-24years. Ultrasonic pachymetry (velocity of 1640m/s) was utilized to obtain measurements of the central, superior, temporal, inferior, and nasal cornea. Triplicate images of the same corneal locations were acquired using UBM (50MHz). Images of the axial anterior chamber were used to measure ACD. Intraocular pressure (IOP) was estimated using rebound tonometry, and axial globe length was measured using ultrasonographic biometry. CT (mean±SDµm) measured by UBM was 854±61 (central), 994±58 (superior), 930±57 (temporal), 979±55 (inferior), and 898±48 (nasal). CT measured by UBM was greater than that measured by ultrasonic pachymetry at all locations and was statistically significant at all locations except inferior (p=0.0006-0.048). No sex nor age effect was detected for CT at any location. The repeatability of ultrasonic pachymetry was superior to that of UBM. Mean±SD ACD was 5.74±0.41mm. A weak positive correlation was identified between central CT and IOP and between central CT and axial globe length. Normal data for CT and ACD of the adult horse obtained using UBM are provided. CT determined by UBM was greater relative to pachymetry at all corneal locations.

Ultrasound biomicroscopy as a tool in the evaluation and management of ocular hypotony in uveitis.

Purpose:Chronic uveitis can lead to hypotony that may result in severe visual impairment. We highlight the use of ultrasound biomicroscopy (UBM) as an imaging tool to decide the modality of therapy and management of uveitic hypotony.Methods:This was a retrospective hospital-based interventional case-series study that included a total of 36 eyes of 25 patients with uveitic hypotony seen between January 1997 and January 2020.Results:Thirty-six eyes of 25 patients with uveitic ocular hypotony were included. Unilateral involvement was seen in 56%. The median age of presentation was 21 years with a median follow-up of 21.5 months. Anterior uveitis was noted in 13.88%, intermediate uveitis in 52.77%, and panuveitis in 33.33% eyes. UBM findings commonly noted were pars plana membranes, supraciliary effusion, blunted ciliary process, and ciliary body traction. Other findings included ciliochoroidal detachment and ciliary body edema. Moreover, 22.2% eyes were managed with medical therapy alone, whereas 77.8% eyes received both medical and surgical intervention based on UBM findings. Furthermore, 66.7% eyes showed improvement in intraocular pressure, 13.9% eyes maintained the same IOP, whereas 19.4% eyes had worsening of IOP at final follow-up.Conclusion:We found UBM as a useful imaging tool in evaluating and judiciously deciding the mode of management of uveitic hypotony.

Evaluation of Lacrimal Sac Diameter in Different Age groups Using Ultrasound Biomicroscopy

Background: Chronic dacryocystitis is the most frequent disorder in the lacrimal drainage system. The disease has been considered to be strongly associated with obstruction of the lacrimal duct, which creates a fertile environment for bacterial colonization and promotes lacrimal sac inflammation. Objective: The aim of this work was to evaluate lacrimal sac diameter in different age groups using ultrasound biomicroscopy (UBM). Patients and Methods: Twenty-four eyes of 24 normal individuals. They were divided according to age into 3 groups; group A: age ranging between 30 and 40 years, group B: age ranging between 40 and 50 years and group C: age above 50 years. Lacrimal sac diameter was assessed. Ocular examination and special tests were done for lacrimal drainage system (regurge test and fluorescein dye disappearance test) with imaging of lacrimal passages by ultrasound biomicroscopy. Results: All patients had no symptoms of epiphora, negative both regurge test and dye disappearance test and clear contents of the lacrimal sac. There was no statistically significant difference between groups regarding either longitudinal or horizontal lacrimal sac diameter. Conclusion: UBM can be used for imaging and measuring lacrimal passages and thus can be useful as an adjunctive to clinical examination and surgical planning in cases with lacrimal system diseases.

Repeatability and Reliability of Quantified Ultrasound Biomicroscopy Image Analysis of the Ciliary Body at the Pars Plicata

Most of the ciliary body and ciliary processes of the eye cannot be directly visualized in vivo because of the posterior location of the pars plicata to the posterior chamber and iris. However, ciliary anatomy can be effectively imaged using ultrasound biomicroscopy (UBM) by placing the probe close to the limbus, perpendicular to this structure. Previous studies measuring ciliary body parameters in meridian UBM images found that these parameters were measured with poor reliability and repeatability. This study evaluates the intra-observer reliability and inter-observer agreement of a standardized protocol for measuring six ciliary parameters in transverse or quadrant UBM images that capture an entire row of ciliary processes. All six ciliary parameters have high intra-observer reliability, with ciliary body thickness, ciliary process length and ciliary process density measurements being the most consistent for each observer. The coefficient of variation for each observer ranged from 1.4%–15%. Inter-observer agreement was also high for all six parameters, with an intra-class correlation coefficient >0.8. Utilizing transverse UBM images of the pars plicata allows for consistent quantitative analysis in control subjects.