EXPERIMENTAL AND CLINICAL OBSERVATIONS ON THE ECHOGRAMS IN VITREOUS HAEMORRHAGES

An ultrasonographic study of diabetic vitreo-retinal disease with low visual acuity

Ninety-three diabetics (168 eyes) with opaque ocular media and low visual acuity (range amaurosis to 0.1) were examined by ultrasonography (A- and B-scan) using a Coleman Ophthalmoscan 100. Dense vitreous membranes were found in 112 (67%) eyes, 100 (60%) of which showed posterior membranes. Preretinal or prepapillary proliferations (extraretinal stalks) were demonstrated in 71 (42%) eyes. Fifty-four (32%) eyes had retinal detachments (40 localized, 14 total). These were present in 10 (50%) of the 20 amaurotic eyes. The ultrasonic accuracy was checked in 49 eyes at vitrectomy. It was 78% for retinal detachments and 67% for prepapillary and preretinal proliferations. The stalks circumscribed within 2 mm or less were the hardest to detect. Ultrasonography thus aids to predict the prognosis after vitrectomy. The visual prognosis appears to be much more optimistic in eyes with vitreous membranes and prepapillary proliferations than in those with vitreous membranes associated with preretinal proliferations.

Rapid B-scanning of the vitreous

Ultrasonic examination is an essential investigation in most patients awaiting vitrectomy. Rapid B-scanning of the vitreous is described utilising a new system capable of high resolution and good tonal quality. Several patterns of haemorrhagic invasion of the vitreous cavity are illustrated, together with detachment, collapse, and retraction of the vitreous gel.