Design Prospective study. Purpose To evaluate real-time duplex colour Doppler examination with colour and pulse Doppler ultrasonography (US) (colour Doppler imaging (CDI)) for detection of the retinal detachment from membranous structures in the posterior segment. Materials and methods In 33 consecutive patients with ophthalmoscopically invisible eyes (34 eyes), CDI was performed to detect the presence or absence of retinal detachment. The diagnostic criterion for retinal detachment was whether or not spectral waveforms were detected in membranous structures with colour and pulse Doppler US. In all cases, the absence or presence of retinal detachment was confirmed by surgery. Results In 27 of 34 eyes, membranes and/or opacities were observed in the vitreous cavity with CDI. In 12 of these 27 eyes, blood flow in those structures was detected by CDI. In all of these 12 eyes, retinal detachment was confirmed at surgery, and in 14 of the 15 eyes in which blood flow was not detected by CDI, absence of retinal detachment was confirmed at surgery. When a diagnosis confirmed by surgery was used as the definitive finding, CDI had a sensitivity of 92.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 93.3%, and an accuracy in the detection of retinal detachment from membranes and/or opacities in the vitreous cavity of 96.3%. Conclusion Real-time duplex colour Doppler examination with colour and pulse Doppler US (CDI) is a noninvasive method useful for the detection of retinal detachment from vitreous opacity and/or membrane in the posterior segment.

Elderly patients with acute obstructive suppurative cholangitis (AOSC) have a very poor prognosis due both to the gradual development of symptoms and to acute exacerbation, resulting in a condition that is both severe and irreversible. In this study, we evaluated the clinical characteristics and effects of biliary drainage in patients with AOSC treated in our department, with special attention being focused on patients aged 70 years or more. Of 21 patients with AOSC, 7 (33.3%) were more than 70 years of age. All 7 had choledocholithiasis. In all patients with choledocholithiasis, in this study. AOSC was observed in 23.3% of those who were more than 70 years of age (7/30). In elderly patients with AOSC, typical symptoms are often absent, and the severity of the disease is difficult to determine based on the results of examination alone. Since early diagnosis of AOSC and appropriate biliary drainage from the onset of AOSC are extremely important, clinical findings should be examined with the utmost care.

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