Zastosowanie ultrasonografii w okulistyce dziecięcej : diagnostyka chorób oczu u wcześniaków i niemowląt

Background: Ultrasonographic (US) examinations in ophthalmology play a major role as one of the additional examination modes in the diagnostics of orbital diseases, and in cases of changes of a vascular origin it is useful in the evaluation of blood flow velocity. The special value of this examination in the assessment of the opaque optical structures on the fundus of the eye is emphasized. The aim of the study was 1) to present the ultrasonographic images and the efficacy of the method in the evaluation of some congenital and acquired bulbar diseases and 2) on the bases of the advantages of the examination, to determine whether ultrasonography could be included as a screening method in the diagnostics of preterm infants as well as a method of choice in term infants with ophthalmologic diseases. Material/Methods: One thousand sixty-two children between the ages of 3 weeks to 12 months, of whom 1135 were preterm and 27 term infants, with ophthalmologic changes were examined. A real-time ultrasonographic apparatus with color Doppler (5-7.5 MHz sectoral and 7.5-10 MHz linear transducers). The US examinations of preterm infants were conducted four times and in term infants twice. Results: In 105 children (8.99%) and in 184 eyes, premature retinopathy, intra-bulbar tumors, retinal ablation, posttraumatic changes, inflammatory processes in the posterior chamber of the eyeball, and congenital anomalies of the bulbar structures were diagnosed. Conclusions: Bulbar ultrasonography, being a safe, quick, and efficient examination, should be included as an additional screening method in preterm infants. Ultrasonography with color Doppler is an efficient method of choice for diagnosing problematic diseases of the eyeballs of infants

Use of color Doppler ultrasonography in primary vasospastic syndrome and assessment of ocular blood flow in patients with transient monocular blindness

Background: Transient monocular blindness (TMB) may appear as a consequence of vasospasm called the primary vasospastic syndrome. Because of pathogenesis of this disorder it is an essential diagnostic procedure in evaluation of hemodynamic disturbances in eyeball circulation system in group of TMB patients. The aim of this study was to investigate the changes in eyeball circulation in patients with TMB, using colour Doppler ultrasound imaging method (CDI). Material/Methods: 89 patients (59 women and 30 men) aged 34 to 56 (avg. 49.53, sd 3.15) with symptoms of transient blindness were examined using Acuson 128XP apparatus and sector probe frequency of 7.5 MHz. In ophthalmic artery (OA), central retinal artery (CRA) and short posterior temporal ciliary artery (SPTCA), the following parameters of blood flow were determined: peak systolic velocity (PSV, m/s), peak end - diastolic velocity (EDV, m/s), vascular pulsation index (PI) and resistance index (RI). The determined blood flow parameters were compared with the same blood flow indicators in the group of healthy individuals, matched for sex and age with the study group. T-Student test was applied in the statistical analysis of the differences between studied ocular blood flow parameters. In case of lack of normal variance, non - parametric U-Mann-Whitney test was used. Results: Statistical diminishing of average values of PSV (p =0.0001) in CRA and SPTCA; RI (p = 0.0001 in CRA and p = 0.0003 in SPTCA) and PI (in OA p = 0.0005, in CRA p = 0.0001, in SPTCA p = 0.0004) of examined eyes in comparison to healthy subjects was revealed. Peak-diastolic and mean velocities did not indicate statistically relevant difference in the control group. Conclusions: The statistically significant decrease of peak systolic parameters of blood flow velocity, pulsation and resistance indices in eyeball arteries were observed in patients with transient monocular blindness. Color Doppler ultrasonography was an effective and helpful method in assessing blood flow changes of eyeball microcirculation in transient monocular blindness

Zastosowanie ultrasonografii w okulistyce dziecięcej : technika badania i możliwości obrazowania gałki ocznej u wcześniaków i niemowląt

Background: Ultrasonography, a safe, repeatable, and easy examination, is used as the first method in the diagnosis of the ophthalmologic diseases in infants. This examination is also important in visualizing the vitreous body, retina, chorioidea, and the orbit as well as opaque structures of the eyeball. Among the methods using ultrasound waves in pediatric ophthalmology, the most common are real-time ultrasonography and the color Doppler technique. Material/Methods: In 2002-2005, ultrasonographic examinations were performed on 1162 children aged 3 weeks to 12 months, of whom 1135 (97.7%) were preterm and 27 (2.3%) term infants. The real-time ultrasonograhic examination was conducted using a 5-7 MHz sector probe and a 7.5-10.5 MHz linear probe. However, in cases of difficult diagnosis, the color Doppler technique was applied. In all, 4549 ultrasound examinations were performed. Results: In the premature group, the normal image of the eyeball was diagnosed in 1057 (91%) children. In 78 cases (6.7%), typical changes for retinopathy as well as changes in the vitreous body were found. In 27 children (2.3%) eyeball changes were observed as results of other ophthalmic disorders. The normal images of the eyeball in newborns in real-time US as well as in color Doppler US were presented. Conclusions: Ultrasonographic examination, particularly color Doppler, being safe and not time-consuming, could be the method of choice in ophthalmologic diagnostics in infants and, especially, premature newborns

Clinical usefulness of color Doppler imaging in the management of the neck region vessels in patients with intraocular tumors : preliminary report

Background: The purpose of the study was to assess the clinical usefulness of color Doppler ultrasonography (CDU) examinations of the neck vessels in patients with intraocular tumors as well as to establish whether the changes in these vessels had an influence on further ophthalmologic procedures. Material/Methods: Clinical ophthalmological examinations such as visual acuity, anterior segment and ocular fundus, as well as color Doppler ultrasonography of the bulbar and neck region vessels were performed on 38 patients, aged 44-70 years with eyeball tumors. Localization, size, vascularization of the intrabulbar tumors and big vessels of the neck region were analyzed. Results: In 28 patients, choroidal melanoma was identified, and the vascularity of tumor mass was monitored in 10 patients after brachytherapy. Compression or infiltration of jugular veins or carotid artery were not observed. Severe internal carotid artery stenosis due to arteriosclerosis was detected in 5 patients, but no one was suggested to be operated on first in Vascular Surgery Department. Conclusions: Color Doppler ultrasonography should be the first choice technique in the neck vessels and intrabulbar tumors imaging. Visualization of the mass lesions vascularity and the evaluation of amplitude of blood flow velocity allows to monitor the effectiveness of their therapy. It was found that this technique is useful in deciding upon the method of treatment in patients with coexisting arteriosclerosis

Sodium Iodate Selectively Injuries the Posterior Pole of the Retina in a Dose-Dependent Manner: Morphological and Electrophysiological Study

Sequential morphological and functional features of retinal damage in mice exposed to different doses (40 vs. 20 mg/kg) of sodium iodate (NaIO3) were analyzed. Retinal morphology, apoptosis (TUNEL assay), and function (electroretinography; ERG) were examined at several time points after NaIO3 administration. The higher dose of NaIO3 caused progressive degeneration of the whole retinal area and total suppression of scotopic and photopic ERG. In contrast, the lower dose induced much less severe degeneration in peripheral part of retina along with a moderate decline of b- and a-wave amplitudes in ERG, corroborating the presence of regions within retina that retain their function. The peak of photoreceptor apoptosis was found on the 3rd day, but the lower dose induced more intense reaction within the central retina than in its peripheral region. In conclusion, these results indicate that peripheral area of the retina reveals better resistance to NaIO3 injury than its central part