Guidelines for ultrasound examination in ophthalmology. Part III: Color Doppler ultrasonography

Abstract

The aim of this article was to present the possibilities of use and application of color-coded Doppler ultrasonography in the diagnosis of various diseases of the eyeball and orbit which result from vascular disorders. Color-coded Doppler ultrasonography is recommended for the assessment of blood flow velocity in the retrobulbar arteries. That is why the article contains current recommendations for Doppler imaging in ophthalmology. The paper provides detailed recommendations for patient’s preparation for the examination, presents the scanning technique and safety of the examination, and lists ophthalmological diseases of vascular origin for which color-coded Doppler ultrasonography can be applied. Furthermore, the article also presents other techniques applied in clinical practice for the assessment of blood flow or imaging of vasculature of a given eyeball structure, inter alia: power Doppler ultrasonography, 3D and 4D ultrasonography, magnetic resonance angiography, spiral computer tomography, transcranial ultrasonography and modern microvascular imaging. The authors emphasize the usefulness of color-coded Doppler ultrasonography in the diagnosis of diseases which result from blood flow disorders within the eyeball, such as amaurosis fugax, ocular ischemic syndrome, insufficiency in vessels supplying the carotid and vertebral arteries, posterior ischemic optic neuropathy, glaucoma, age-related macular degeneration, vascular vision disorders, vascular malformations, such as arteriovenous fistula, orbital varices, systemic connective tissue diseases in retinopathy of prematurity, diabetes, thyroid disorders or strabismus. The application of color-coded Doppler ultrasonography is especially important in the assessment of the vasculature of intrabulbar tumorous lesions and in the differential diagnosis of intrabulbar tumors.

Retrobulbar Short Posterior Ciliary Artery Hemodynamics in Patients with Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma

“…The Pourcelot index, also known as the RI, indirectly determines vascular resistance and is based on the analysis of PSV and EDV. 18 …”

ORBITAL Ultrasonography a diagnosis tool in early cellulitis

“…The application of color-coded Doppler ultrasonography is especially important in the assessment of the vasculature of retrobulbar tumorous lesions and in the differential diagnosis of intraocular tumors. (20) The goal of 3D imaging is to reconstruct the orbit into a threedimensional image using multiple two-dimensional B-scans. While it is difficult to understand what every image represents when piecing the two-dimensional B-scan pictures to reconstruct the eye and orbit in 3 dimensions, there are several approaches and individual methods to the examination, the secret to which is to make sure there is an organized, repeatable approach to evaluating the complete orbit and globe.…”

Ocular ultrasonography for detection of posterior segment pathology in adult patients presenting with blurred vision

“…In order to prevent retrobulbar pressure (RBP), the placement of the probe should be carried out in a situation the upper eyelid is covered with gel with the lowest amount of pressure on the eyeball. 8 In addition, the examination of the eye needs to be in a dynamic method in which the eye should be moved from left to right side and from upper to lower for better visualization of the globe. Furthermore, the color Doppler examination is also carried out as part of the study.…”