Ophthalmic Ultrasonography: Expert Consult - Online and Print PDF
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Ophthalmic Ultrasonography Arun D. Singh MD Professor of Ophthalmology Director, Department of Ophthalmic Oncology Cole Eye Institute Cleveland Clinic Cleveland, OH, USA Brandy C. Hayden BS CDOS ROUB Director of Ophthalmic Ultrasonography Cole Eye Institute Cleveland Clinic Cleveland, OH, USA For additional online content visit www.expertconsult.com Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2012 SAUNDERS is an imprint of Elsevier Inc. © 2012, Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN: 978-1-4377-2636-7 British Library Cataloguing in Publication Data Singh, Arun D. Ophthalmic ultrasonography. 1. Eye–Ultrasonic imaging. I. Title II. Hayden, Brandy C. 617.7’1543–dc22 Working together to grow libraries in developing countries www.elsevier.com | www.bookaid.org | www.sabre.org Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 Video Table of Contents Video contributors: Arun D Singh and Brandy C Hayden Clip 3.1 Instructional video: Basic Positioning Clip 3.2 Instructional video: Axial Scans Clip 3.3 Instructional video: Longitudinal scans Clip 3.4 Instructional video: Transverse scans Clip 3.5 Instructional video: Five Scan Screening Clip 3.6 Instructional video: Detailed B-scan Examination Clip 3.7 Intraocular mass: Transverse scan Clip 3.8 Intraocular mass: Longitudinal scan Clip 3.9 Vitreous hemorrhage with PVD: Mobility Clip 3.10a Intraocular mass: B-scan: Vascularity Clip 3.10b Intraocular mass: A-scan: Vascularity Clip 3.11 Vitreous hemorrhage with a retinal detachment: B-Scan: Convection Movement Clip 7.1 Instructional video: Biometric A scan Clip 7.2 Contact biometric A-scan: Compression Clip 7.3 Immersion biometric A-scan: Non-compression Clip 7.4 Immersion biometric A-scan: Misalignment Clip 10.1 Vitreous hemorrhage: Dispersed: Mobility Clip 10.2 Vitreous hemorrhage: Layered: Mobility Clip 10.3 Posterior vitreous detachment: Mobility Clip 10.4 Tractional retinal detachment: Mobility Clip 10.5 Open funnel retinal detachment: Mobility Clip 11.1A Choroidal melanoma: Moderate vascularity Clip 11.1B Choroidal melanoma: Marked vascularity Clip 12.1A Vitritis: Mobility Clip 12.1B Vitreous lymphoma: Mobility Clip 16.1 Dislocated crystalline lens: Mobility Preface Ultrasonography has become an important clinical tool Ophthalmic Ultrasonography represents the cumulative in all aspects of ophthalmic practice. Ultrasonography experience of more than 30 contributors, the majority of is routinely used not only for biometry for calculating whom practice with us at the Cole Eye Institute. Despite the power of intraocular lens implants prior to cataract individual styles and preferences, great editorial care has surgery but also in the management of patients with been taken to follow a uniform layout, to avoid overlap, trauma, uveitis, vitreoretinal disorders, and differentia- and to present balanced views. tion of intraocular tumors. The advent of high-resolution ultrasonography of the anterior segment (ultrasound Arun D. Singh, MD biomicroscopy) has added new depth of understanding Department of Ophthalmic Oncology of glaucoma and anterior segment disorders. Digital Cole Eye Institute ultrasound biomicroscopy of the cornea is essential for Cleveland Clinic planning refractive surgery. 9500 Euclid Avenue The contents of Ophthalmic Ultrasonography have been Cleveland, OH 44195, USA chosen with particular attention to recent advances. The pertinent findings in most chapters have been illustrated Brandy C. Hayden, BS CDOS ROUB to improve understanding of key concepts. We have Director of Ophthalmic Ultrasonography included 26 video clips offering details of how to perform Cole Eye Institute (i-10) and interpret ophthalmic ultrasonography. Chapters on Cleveland Clinic Foundation ocular prenatal imaging, laboratory applications, and 9500 Euclid Avenue ultrasound-guided anesthesia broaden the horizons of Cleveland, OH 44195, USA ultrasonography applications in ophthalmology. Concepts currently under investigation are summarized in the chapter on future considerations. ix List of Contributors Norma Allemann MD Daniel T. Ginat MD MS Adjunct Professor of Ophthalmology Radiology Resident Department of Ophthalmology Department of Imaging Sciences Federal University of São Paulo University of Rochester Medical Center Medical Coordinator Rochester, NY, USA Diagnostic Center in Ophthalmology Marine Gobbe MST(Optom) PhD Fleury Medicina e Saúde Research Optometrist São Paulo, Brazil London Vision Clinic Timothy J. Archer MA(Oxon) DipCompSci(Cantab) London, UK Research Manager Brandy C. Hayden BS CDOS ROUB London Vision Clinic Director of Ophthalmic Ultrasonography London, UK Cole Eye Institute Brian K. Armstrong MD Cleveland Clinic Cornea, External Disease and Refractive Surgery Fellow Cleveland, OH, USA Cole Eye Institute Linda Kelley CRA COA ROUB Cleveland Clinic Health Technician Supervisor Cleveland, OH, USA Bruce W Carter Department of Veterans Affairs Medical Center Erin Broaddus MD Miami, FL, USA Radiology Resident Ronald R. Krueger MD MSE Department of Radiology Medical Director, Department of Refractive Surgery Wake Forest University Baptist Medical Center Cole Eye Institute Winston-Salem, NC, USA Professor of Ophthalmology Hajir Dadgostar MD PhD Lerner College of Medicine of Case Western Reserve University Physician, Vitreoretinal Surgery Cleveland Clinic Valley Retina Associates Medical Group Cleveland, OH, USA Encino, CA, USA Breno da Rocha Lima MD Vikram S. Dogra MD Ophthalmology Resident Professor of Radiology Cole Eye Institute Director of Ultrasound Cleveland Clinic Department of Imaging Sciences Cleveland, OH, USA University of Rochester Medical Center Careen Y. Lowder MD PhD Rochester, NY, USA Full Professional Staff William J. Dupps Jr MD PhD Cole Eye Institute Staff, Cornea and Refractive Surgery, Biomedical Engineering Cleveland Clinic and Transplant Cleveland, OH, USA Cleveland Clinic Lisa D. Lystad MD Adjunct Associate Professor of Biomedical Engineering Staff Neuro-Ophthalmology Case Western Reserve University Cole Eye Institute Cleveland, OH, USA Cleveland Clinic Steven Gayer MD MBA Cleveland, OH, USA Professor of Anesthesiology and Ophthalmology Glauco Reggiani Mello MD University of Miami’s Miller School of Medicine Cornea and Refractive Surgery Fellow Bascom Palmer Eye Institute Cole Eye Institute Miami and Palm Beach Gardens, FL, USA Cleveland Clinic Cleveland, OH, USA xi List of Contributors Maria Helena Mandello Carvalhaes Ramos MD Eric Scot Shaw BS Assistant Doctor Research Assistant Diagnostic Center in Ophthalmology Department of Anesthesiology, Perioperative Medicine and Pain Fleury Medicina e Saúde Management São Paulo, Brazil University of Miami, Miller School of Medicine Miami, FL, USA Dan Z. Reinstein MD MA(Cantab) FRCSC FRCOphth Medical Director Ronald H. Silverman PhD London Vision Clinic Professor of Ophthalmic Science London, UK Department of Ophthalmology Department of Ophthalmology Columbia University Medical Center St. Thomas’ Hospital – Kings College New York, NY, USA London, UK Riverside Research Institute Department of Ophthalmology New York, NY, USA Columbia University Medical Center Arun D. Singh MD New York, NY, USA Professor of Ophthalmology Centre Hospitalier National d’Ophtalmologie Director, Department of Ophthalmic Oncology Paris, France Cole Eye Institute Edward J. Rockwood MD Cleveland Clinic Associate Professor of Ophthalmology Cleveland, OH, USA Cleveland Clinic Lerner College of Medicine of Case Western Rishi P. Singh MD Reserve University Assistant Professor of Ophthalmology Cole Eye Institute Cleveland Clinic Lerner College of Medicine Cleveland Clinic Case Western Reserve University Cleveland, OH, USA Staff Physician Reecha Sachdeva MD Cole Eye Institute Ophthalmology Resident Cleveland Clinic Cole Eye Institute Cleveland, OH, USA Cleveland Clinic Nathan C. Steinle MD Cleveland, OH, USA Vitreoretinal Fellow Marcony R. Santhiago MD Cole Eye Institute Cornea and Refractive Surgery Fellow Cleveland Clinic Cole Eye Institute Cleveland, OH, USA Cleveland Clinic Virgínia L L Torres MD Cleveland, OH, USA Post Doctoral Research Fellow Lynn Schoenfield MD Federal University of São Paulo Staff Pathologist São Paulo, Brazil Assistant Professor of Pathology Elias I. Traboulsi MD Cleveland Clinic Head, Department of Pediatric Ophthalmology and Strabismus Cleveland, OH, USA Director, The Center for Genetic Eye Diseases Jonathan E. Sears MD Cole Eye Institute Associate Professor Cleveland Clinic Cleveland Clinic Lerner College of Medicine Cleveland, OH, USA Cole Eye Institute Mary E. Turell MD Cleveland Clinic Clinical Fellow in Ophthalmic Oncology Cleveland, OH, USA Cole Eye Institute Sumit Sharma MD Cleveland Clinic Resident, Ophthalmology Cleveland, OH, USA Cole Eye Institute Amit Vasanji PhD Cleveland Clinic Director, Biomedical Imaging and Analysis Center Cleveland, OH, USA Lerner Research Institute Cleveland Clinic Cleveland, Ohio, USA xii Dedication To my parents who educated me beyond their means, my Timothy Murray for introducing me to academics, and wife Annapurna, and my children, Nakul and Rahul, who J. Douglas Woodrich and Gretchen Arnold Doran for make all my efforts worthwhile (A.D.S.). believing in who I am (B.C.H.). To my parents Michael and Barbara Hayden who have always encouraged me, Judith Abel, Eric Carlson and xiii Acknowledgments We are grateful to Daniel Martin, MD, Chairman, Cole Eye Institute, for his encouragement. We gratefully acknowledge the contributions of Rachael Briggs, Anne Pinter, Karen King, Sharon Allen, Shawn Perry, Jennifer Pertz, and the staff of the imaging department in retriev- ing and preparing the large amount of material used in this book. We could not have completed this project on time without the support of Sharon Nash (Development Editor), Vinod Kumar Iyyappan (Project Manager), and Alison Woodhouse (copy-editor). We are indebted to Russell Gabbedy (Acquisition Editor) for offering us the opportunity to compile this book. Arun D. Singh, MD Department of Ophthalmic Oncology Cole Eye Institute Cleveland Clinic 9500 Euclid Avenue Cleveland, OH 44195, USA Brandy C. Hayden, BS CDOS ROUB Director of Ophthalmic Ultrasonography Cole Eye Institute (i-10) Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland, OH 44195, USA xv
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