超声生物显微镜在非金属巩膜异物诊断中的应用

目的:探讨超声生物显微镜在非金属巩膜异物诊断中的作用及应用。方法:回顾性分析我院2009-01/2012-11收治的有反复发作的局部眼红眼痛的症状及体征的非金属球壁异物患者15例15眼,全部为非急性期。进行数字化裂隙灯眼表照相,经过UBM检查确诊为巩膜异物,手术后证实为非金属异物。结果:有明确的植物眼外伤史10例10眼,病史不详5例5眼。病程1～6mo,均表现局部反复出现的眼红眼痛,药物治疗好转,停药后再次发作。裂隙灯下见局部的隆起,轻或重的充血,角膜无水肿。UBM检查见结膜下巩膜有高密度影,其后组织不显影声影,诊断:巩膜可疑异物。术后取出异物,11例11眼为植物异物,2例2眼为煤渣样异物,1例1眼为玻璃异物,1例1眼为石子异物。结论:超声生物显微镜能及时、尽早发现非金属巩膜异物,减少误诊。针对巩膜长期局部反复充血的患者,无论有无外伤史,均应应用UBM检查有否巩膜异物的存在。     

眼前节异物的超声生物显微镜检查诊断

目的 探讨眼前节异物超声生物显微镜(UBM)影像的特点以及应用价值.方法 采用UBM检查36例(36只眼)可疑眼前节异物患者,分析UBM影像特征,同时行常规眼眶薄层(1 mm)CT检查.结果 UBM显示36例(36只眼)在手术后都证实眼前节有异物存在.影像显示异物以高强度回声为特征,其中17只眼有声影,7只眼有明显的"...     

超声生物显微镜对睫状体平坦部微小异物诊断的应用价值

目的探讨超声生物显微镜(UBM)检查对于眼前节微小异物的诊断价值。方法对12例(12只眼)机械性眼外伤患者经眼科常规超声检查未探及明确异物,而依据患者病史及临床检查高度怀疑存在球内异物可能的患者应用UBM检查。主要指标:眼前节及睫状体平坦部超声图像。结果 12例患者均被发现存在微小异物,其中房角异物1眼,晶状体异物1只眼,睫状体平坦部异物10只眼,8只眼眼眶CT检查同时提示眼部异物的存在。结论 UBM检查是诊断睫状体平坦部异物,尤其是微小异物的重要手段,是传统检查手段的有效补充。     

超声生物显微镜在眼前段微小异物诊断的应用

目的探讨超声生物显微镜（UBM）在眼前段微小异物诊断中的应用。方法应用UBM对7例眼前段异物诊断和定位并经手术摘出证实。结果7例异物均经UBM定位后手术顺利取出。结论相对于其他影像学检查，UBM在眼前段异物诊断和定位中具有明显的优越性。     

超声生物显微镜在眼前节异物诊断中的应用

目的:评估超声生物显微镜在外伤性眼前节异物的诊断与治疗中的作用。方法:对9例有明确异物入眼史的外伤眼行常规X线、B超及UBM检查,确诊后手术取出异物。结果:UBM检查9例显示异物存留,而X线以及B超仅5例提示异物存留。UBM提示已经手术证实异物位置为:前房1例,后房2例,睫状体扁平部5例,虹膜根部1例。异物大小从0.1mm×0.25mm到1mm×3mm不等。异物通过联合其它眼内手术直接取出或于相应位置磁吸取出。结论:眼内异物大部分可经X线或B超得以诊断,但后房、睫状体等位置异物较难发现,特别是当异物为极其细小的非金属异物时,X线、B超常不易发现。应用UBM检查,因其极高分辨率,能获得后房及睫状体清晰影像,不但可以清晰显示异物位置,而且能显示异物与周围组织关系,从而为临床诊断及术式选择提供很大的帮助。眼科学报1999;15:236-237。     

睫状体脱离手术前后超声生物显微镜检查的临床价值

目的探讨睫状体脱离手术前后超声生物显微镜（ultrasone biomicroscope,UBM）检查的临床价值。方法72例睫状体脱离术前术后进行UBM检查,以观察和对比手术前后的改变。结果经UBM检查72例均诊断为睫状体脱离,其中18例为睫状体上腔与前房沟通型,54例为睫状体与巩膜间连续裂隙样断离。结论UBM检查对挫伤性睫状体脱离的诊断、指导手术和判断手术效果具有重要的临床指导价值。     

超声生物显微镜诊断睫状体微小异物

目的探讨超声生物显微镜（UBM）在睫状体微小异物诊断中的临床意义。方法用UBM对4例（4眼）怀疑睫状体微小异物诊断、定位,手术将异物摘出后证实与术前诊断、定位一致。结果4例（4眼）UBM定位后,异物被顺利摘出。结论UBM诊断睫状体微小异物有重要的临床意义和实用价值。     

超声生物显微镜在眼前段异物检查中的应用

目的评价超声生物显微镜(UBM)对眼前段异物的诊断价值,分析其声像图的特点.方法因临床诊断或怀疑眼前段异物而进行UBM检查共17例17眼,比较不同影像学方法的探测和定位能力,分析10例异物UBM声像图的特征.结果 UBM诊断异物阳性9例,阴性7例,与最后诊断相符;另1例异物可疑,手术取出异物.诊断符合率为16/17(94.11%).手术取出异物的8例,UBM异物定位解剖层次正确,方位相同或相近.结论 UBM对眼前段异物检出率高、定位能力强,诊断异物的依据是:较高的回声强度、异物特有的硬直边缘和明显的声影.     

眼前段微小异物UBM定位及异物摘出联合手术

目的：探讨眼前段微小异物的超声生物显微镜（UBM）定位的意义及异物摘出联合白内障摘出等手术的效果，方法：应用其他检查方法未能确定的12例眼前段微小异物，同时合并铁质沉着症，通过UBM检查，明确异物位置并采取异物摘出联合白内障囊外摘出，玻璃体切除，晶状体切除和／或人工晶状体植入手术。结果：12眼均顺利摘出异物，同期植入人工晶状体9眼中的8眼获得0．5以上良好视力，结论：高度怀疑眼前段微小异物，UBM检查是一种极好的定位方法：联合手术可使视力迅速恢复。     

超声生物显微镜在眼铁质沉着症检查中的应用

目的:探讨眼铁质沉着症的超声生物显微镜(UltrasoundBiomicroscopy,UBM)图像特征及异物的检出率。方法:应用UBM对16例眼铁质沉着症患者进行检查,分析UBM图像,同时与X线眼眶照片检查结果及手术结果进行对照。结果:16例眼铁质沉着症患者UBM检查均显示不同组织的铁锈沉着。X线眼眶照片显示异物残留者10例中,UBM检查显示异物残留者4例,X线检查未见异物残留者6例中,UBM检查显示异物残留者1例,手术取出异物11例。UBM显示异物图像为高强反射声影,有超声伪影,铁质沉着症的UBM图像特征为多发性点状、斑片状或线状高强回声、无超声伪影。结论:UBM能准确显示眼内异物位置及铁锈沉着部位,但异物的检出率较X线照片低。     

超声生物显微镜诊断挫伤性睫状体脱离的意义

目的 探讨超声生物显微镜(UBM)在挫伤性睫状体脱离诊断中的应用价值。方法 2001年1月～2004年3月收治的35例(35眼)挫伤性睫状体脱离，术前行UBM及前房角镜榆查，进行对比分析，并经手术证实。结果 35眼经UBM与前房角镜检查，全部确诊为挫伤性睫状体脱离。UBM检查结果16眼为沟通型，19眼未见沟通：前房角镜检查结果全部为沟通型。结论 UBM能准确诊断挫伤性睫状体脱离，不受屈光间质浑浊的影响。在判断是否沟通方面，前房角镜检查优于UBM。两者的结合与互补是临床上不可缺少的     

Frosted cylindrical lens induced artefact on Humphrey automated perimetry

Background: The aim of this study was to assess the effect of a cylindrical corrective lens with frosted sides on Humphrey automated perimetry performed with a translucent spectacle occluder in the contralateral eye. Methods: Ten healthy volunteers with cylindrical refractive errors of more than 1.50 DC had Humphrey visual fields (30‐2) measured with the contralateral eye occluded with either a translucent spectacle occluder or an opaque patch. The order of testing with each occluder was randomised. Additionally, visual field examination with the opaque patch was performed on three volunteer subjects with deep‐set eyes to establish the clinical significance of the frosted cylindrical lens induced artefact (CLA). The back vertex distances for the correcting lenses were measured for all tests. Results: Eight out of 10 volunteers tested with the translucent occluder demonstrated CLA, which was absent when the opaque patch was used. The presence of an artefact corresponding to the axis of the cylinder was observed, when the vertex distance was more than 15 mm. Three subjects with deep‐set eyes presented with CLA, even with the use of an opaque patch. Discussion: Cylindrical lens artefacts can occur with increasing vertex distance when using a translucent spectacle occluder instead of an opaque patch. CLA is also seen in subjects with deep‐set eyes.     

Application of immersion B-scan ultrasonography in diagnosis of complex retinal detachment, persistent hyperplastic primary vitreous and intraocular tumors

AIM: To evaluate the diagnostic value of panoramic immersion B-scan ultrasonography (Pano-immersion B-scan, PIB) in complex retinal detachment (RD), persistent hyperplastic primary vitreous (PHPV) and intraocular tumors. METHODS: The clinical data of 44 patients collected from May 2012 to December 2019 in Chinese PLA General Hospital was retrospectively studied. All of these patients underwent PIB of the eye, because it was difficult to diagnose by routine ocular fundus examination, conventional ultrasound or/and ultrasonic biomicroscope (UBM) due to opacity of refractive media, pupillary occlusion, large involvement or special location of the lesion. The imaging features of difficult cases in PIB were analyzed. The diagnosis accuracy rating of PIB were evaluated and contrasted with conventional ultrasound or UBM by the standard of intraoperative diagnosis or/and pathological results. RESULTS: According to intraoperative diagnosis or pathological results as gold standard, among the 44 cases, there were 19 cases missed diagnosis, misdiagnosed or difficult-to-diagnose by conventional ultrasound or UBM, including 4 cases of long-standing RD difficult to diagnose, 4 cases misdiagnosed, and 11 cases incompletely observed or miss diagnosed. The diagnostic accuracy rate of PIB and conventional ultrasound or UBM were 100% (44/44) and 56.82% (25/44), and the sensitivity of them were 100% and 56.82%. All the patients underwent PIB and were diagnosed as RD (15 cases), retinal and choroidal detachment (4 cases), subchoroidal hematocele (1 case), vitreous opacity and/or organic membrane formation (4 cases), PHPV (12 cases), iris and/or ciliary body tumors (3 cases), and choroidal tumors (6 cases). According to the intraoperative diagnosis or pathological results, the diagnostic coincidence rate of PIB was 100%, which was significantly higher than conventional ultrasound and UBM. CONCLUSION: PIB can help to accurately diagnose complex RD, PHPV, and intraocular masses with special location or/and excessive size. It has important diagnostic value for patients with equivocal findings at conventional ultrasound examination.     

Use of Ultrasound Biomicroscopy, Indocyanine Green Angiography and HLA-B51 Testing as Adjunct Methods in the Appraisal of Behçet's Uveitis

Purpose: Behçet's uveitis is not common in western Europe and thedisease presentation is less obvious than in ``endemic'' countries such as Turkeyand Japan. This makes the diagnosis more difficult. Early diagnosis is important,as the prognosis is better if therapy is started early. New methods such as ultrasoundbiomicroscopy (UBM) and indocyanine green angiography (ICGA) can improve thecharacterisation and diagnosis of uveitis. Our purpose was to present our experiencewith these new methods as well as HLA-B51 testing in the appraisal of patients withBehçet's uveitis.Patients and Methods: Patients seen by the authors between 1997 and 2001with Behçet's uveitis or suspected Behçet's uveitis and who underwentICG angiography or UBM were included. Symptoms and signs, results of laboratorywork-up including HLA-B51 antigen testing and the delay to diagnosis, were analysed.Fluorescein and ICG angiography and UBM testing were performed according tostandard protocols used for uveitis patients and their contribution towards diagnosisand management were analysed.Results: Uveitis was non granulomatous in all patients. Fluorescein angiography showed moderate to severe diffuse retinal vasculitis compatiblewith Behçet's uveitis in all cases. HLA-B51 testing was positive in 5 of 7tested cases, being useful to orient the diagnosis. UBM contributed to thediagnosis in all five tested cases, being the determining element in 3 patients.It allowed redirection of the diagnosis from pars planitis to Behçet's in 2patients with poorly transparent media because it failed to show the typicalpars planitis deposits. In a case originally diagnosed as Behçet's it allowedcorrection of the diagnosis to pars planitis because of the presence of the typicalUBM pars plana depositis. ICG angiography allowed detection of choroidalvasculitis in all five tested cases.Conclusions: In Behçet's patients who did not present with a full-blownclinical picture, as they are often seen in non-endemic areas, UBM examinationand HLA-B51 testing were valuable additional diagnostic elements helping toredirect the diagnosis correctly and to reduce the diagnostic delay in these patients.The hitherto unknown choroidal vasculitis shown by ICG angiography in all fiveinvestigated patients indicates that choroidal involvement probably occurs in mostnewly diagnosed Behçet's patients.     

超声生物显微镜诊断眼前节微小异物

目的：探讨超声生物显微镜（ＵＢＭ）在眼前节异物诊断中的作用。并与其它影像学检查比较。方法：ＵＢＭ对６例（６只眼）眼前节异物进行诊断、定位，手术取异物证实诊断。结果：６例６只眼经ＵＢＭ定位后，成功地取出异物。其中３例为其它影像诊断未能发现的异物。结论：ＵＢＭ为眼前节尤其是周边部微小异物的诊断开辟了新的途径，为手术成功地取出异物提供了可靠的依据。     

Ultrasound biomicroscopy in opaque grafts with post-penetrating keratoplasty glaucoma

PURPOSE: To evaluate the anterior segment in opaque grafts with post-penetrating keratoplasty glaucoma (PPKG) by using ultrasound biomicroscopy (UBM). METHODS: An observational clinical case series of patients with opaque corneal grafts with PPKG who underwent UBM examination of the anterior chamber is reported. Indication for keratoplasty, lens status, intraocular pressure at the time of presentation, and the time of diagnosis of glaucoma were noted. Examination included slit-lamp biomicroscopy, posterior-segment ultrasound evaluation, and UBM evaluation of the anterior segment. RESULTS: Thirty-one eyes of 31 patients with PPKG were recruited into the study. The mean intraocular pressure was 35.5 +/- 5.8 mm Hg (range, 26-52 mm Hg). The mean time of follow-up after penetrating keratoplasty was 6.97 +/- 2.98 months (range, 2-16 months). Of the 31 patients, 11 had undergone penetrating keratoplasty for therapeutic purposes (infectious keratitis), whereas the remaining 20 had undergone keratoplasty for optical reasons. Fourteen (45.1%) patients were pseudophakic, 13 (41.9%) were aphakic, and 4 (12.9%) were phakic. The types of synechiae noted on the UBM included peripheral anterior synechiae in 30/31 (96.7%) eyes, synechiae at the graft-host junction in 13/31 (41.93%) eyes, both peripheral anterior synechiae and graft-host junction synechiae in 12/31 (38.7%) eyes, central iridocorneal synechiae in 6/31 (19.3%) eyes, and intraocular lens iris synechiae in 3/31 (9.6%) eyes. CONCLUSIONS: Secondary angle closure caused by anterior synechiae formation is one of the important causes of PPKG in eyes with opaque grafts. UBM serves as a useful tool for anterior-segment evaluation in such cases and can help in planning the site for glaucoma filtering surgeries and drainage devices.     

Highlight-shading relationship as a cue for the perception of translucent and transparent materials

Natural surfaces, such as those of food and drink, have translucent properties. Translucent materials involve complex optics, such as sub-surface scattering and refraction, but humans can easily distinguish them from opaque materials. Here, we investigated image features that are diagnostic of the perceived translucency and transparency, focusing on the fact that variations in the opacity of a surface affect largely the non-specular component (shading pattern) of an image and little the specular component (highlights). In a simple rating experiment with computer-generated objects, we show that the non-specular image component tends to be blurred, faint, and even partially contrast-reversed for objects that appear more translucent or transparent. A subsequent experiment further demonstrated that manipulation of the contrast and blur of the non-specular image component dramatically alters the apparent translucency of an opaque object. The results support the notion that the spatial and contrast relationship between specular highlights and non-specular shading patterns is a robust cue for the perceived translucency and transparency of three-dimensional objects.     

Ultrasound biomicroscopy: role in diagnosis and management in 130 consecutive patients evaluated for anterior segment tumours

BACKGROUND/AIM: Ultrasound biomicroscopy (UBM) is an important tool for assessing anterior segment pathology. This study sought to evaluate UBM in the management of anterior segment tumours. METHODS: Retrospective analysis of medical records of consecutive patients referred to the ocular oncology unit, University of California San Francisco (UCSF), for suspected anterior segment tumours from 1999 to 2004. RESULTS: 132 eyes from 130 patients were evaluated, including 55 uveal melanomas (UM), 21 iris naevi, 30 iris cysts, and 26 remaining lesions. Of the melanomas, 45 were also evaluated with conventional A/B-scan. There was 29% correspondence between the anatomical structures invaded by melanoma as identified by B-scan v disease extent defined by UBM. Ciliary body and peripheral iris involvement by melanomas was significantly more frequently observed by UBM than B-scan. Seven of 30 benign cysts were diagnosed as cystic before UBM evaluation. In three cases, neuroepithelial cysts were associated with intercurrent pathology including iris naevus (n = 2) and ciliary body melanoma (n = 1). Two ciliary body melanomas showed cavitation, including one patient with a pseudocyst. Histopathological correlation was possible in six cases. CONCLUSION: UBM is an indispensable tool for the management of anterior segment tumours. This study demonstrates the superiority of UBM v conventional B-scan for the precise localisation of uveal melanoma, especially involving the ciliary body and peripheral iris.     

超声乳化术治疗闭角型青光眼合并白内障患者应用超声生物显微镜的价值

目的:评价白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并白内障的临床效果以及超声生物显微镜(ultrasoundbiomicroscope,UBM)的指导作用。方法:闭角型青光眼合并白内障患者56例60眼,均接受超声乳化联合人工晶状体植入术。根据术前UBM检查结果分组。(1)按术前房角关闭粘连范围分组,A1组6眼,房角关闭粘连≤1/2周,B1组24眼,1/2周<房角关闭粘连≤3/4周,C1组30眼,房角关闭粘连≥3/4周;(2)根据术前晶状体厚度分组,A2组36眼,晶状体厚度≥4.80mm,B2组24眼,晶状体厚度<4.80mm。术前及术后1mo常规行眼压、最佳矫正视力以及UBM检查中央前房深度、房角结构变化等,进行统计学分析。结果:术后大部分患者最佳矫正视力均不同程度地提高,前房加深,房角不同程度地重新开放。术后A1组眼压较术前无明显统计学差异;B1和C1组与术前相比均有显著统计学差异,其中B1组1眼,C1组8眼于术后3～21d眼压再次升高,给予降眼压药物治疗或行滤过手术后降至正常范围;A2组术后2眼以及B2组术后7眼在术后眼压>21mmHg,手术成功率分别为94.4%及70.8%,差异有统计学意义。结论:UBM证实房角关闭粘连范围≤3/4周,晶状体明显增厚的闭角型青光眼合并白内障的患者,单纯行超声乳化联合人工晶状体植入有良好效果,房角关闭粘连范围>3/4时术后易出现青光眼复发。UBM检查有助于术前选择手术方式及术后预测远期疗效。