Role Of Ultrasound In Vitreous Hemorrhage - A Prospective Study In A Teaching Hospital

Abstract

Objective: To detect and assess posterior segment pathology in cases of vitreous hemorrhage
by ultrasound examination in patients presenting to ophthalmology department of Services
Institute of Medical Sciences, Lahore.
Material & Methods: This study included 179 patients (200 eyes) with vitreous hemorrhage
who underwent A and B scan ultrasound by one examiner at Eye unit I in Services Hospital,
affiliated to Services Institute of Medical Sciences, Lahore, for the duration of four years from
January 2003 to January 2007. 114 were male and 65 were females. All patients had dense
vitreous hemorrhage which prevented visualization of the retina. Age range was between 10 to
67 years. Before ultrasound, all the patients were completely examined in OPD including a
comprehensive history, record of visual acuity and intraocular pressure. Detailed fundus
examination was carried out after dilatation of pupils with mydriacyl (tropicamide) eye drops with
78 D lens and indirect ophthalmoscope.
Results: Unilateral cases were 60 and bilateral cases 70. Proliferative diabetic retinopathy with
vitreous hemorrhage was observed in 90 eyes, (tractional retinal detachment was present in 38
eyes, both tent like and table top configuration were observed on B scan while vitreous
hemorrhage with proliferative diabetic retinopathy was observed in 52 eyes). Rhegmatogenous
retinal detachment was observed in 10 eyes. Vitreous hemorrhage due to penetrating injuries
occurred in 55 eyes and out of these 55, metallic intra-ocular foreign body was present in 05 eyes.
Eales disease with vitreous hemorrhage was present in 25 eyes. Posterior vitreous detachment
was noted in 20 eyes with vitreous haemorrhage.
Conclusion: Vitreo-retinal surgeons consider A-and B-Ultrasound the most important
examination tool. It should be typically performed early and frequently after presentation of
patient with vitreous hemorrhage.