Case #11: 3D Ultrasound of the Disorganized Eye

By Paul T. Finger, MD

History

[10 MHz] 3D Ultrasonography Reveals - *Note* Ultrasonography reveals an open funnel retinal detachment (white arrow). Note the echolucent vitreous humor. The posterior choroidal detachments (black arrows) exhibit variable internal reflectivity consistent with blood. A = anterior, S = superior, T = temporal.
[10 MHz] 3D Ultrasonography Reveals – *Note* Ultrasonography reveals an open funnel retinal detachment (white arrow). Note the echolucent vitreous humor. The posterior choroidal detachments (black arrows) exhibit variable internal reflectivity consistent with blood. A = anterior, S = superior, T = temporal.
3D ultrasound is particularly helpful in evaluation of the disorganized eye. This case of retinal detachment with hemorrhagic choroidals illustrates this advantages of 3D ophthalmic ultrasonography. This 60 year old male hypertensive patient was referred with neovascular glaucoma. Both 2D and 3D ultrasonography were performed.

Unlike static 2D images, a 3D volume can be rotated, oriented, and sectioned. This movie allows the viewer to review 5 (out of hundreds of possible) sections of this 3D ocular volume.

The original 3D block was composed of 90 sequentially acquired 2D images reconstructed into a 9.5 megabyte file. Due to limitations of the Internet, the entire file (volume) is not displayed. While evaluating this animation, you are experiencing a retrospective review of the ultrasound examination and realizing the potential of telemedicine.

Impression

Open Funnel Detachment and Hemorrhagic Choroidals

Comment

This case presents two of the many unique capabilities of 3D ultrasonography:

  1. The ability to quarter the acquired volume and thereby image 3 planes (3 dimensions) simultaneously.
  2. The ability to replay the examination in a remote location (as you are doing in limited form). This capability will allow ultrasound specialists to review and comment on examinations performed in remote locations.

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