A clinical study of orbital lesions in a tertiary health center of central India: Sonological Evaluation

Author(s): Vidhya Verma, Mahesh Verma

Purpose: To evaluate the role of B- scan Ultrasonography and color Doppler in orbital diseases, in differentiating ocular and extraocular diseases. Further to assess tumor location, configuration, extent and relationship to an adjacent structure and to establish the etiology of proptosis.

Methods: 100 eyes of 85 patients were examined with B- scan ultrasonography and colour Doppler flow imaging using linear high frequency probe (5 to 17 MHz) of the ultrasound system. The final diagnosis was made based on clinical findings with laboratory parameters or imaging with higher cross-sectional modality or surgery with histopathology (as applicable).

Results: The distinction between ocular and extraocular pathologies was made in 100% of cases. The overall sensitivity, specificity, (Positive Predictive Value) PPV, (Negative Predictive Value) NPV and accuracy of ultrasonography for the diagnosis of ocular pathologies were 94.2%, 98.8%, 99.1%, 92.2% and 94.9% (p-value < 0.0001) compared to 62.5%, 98.8%, 98.7%, 64.8% and 62.7% for ophthalmoscopic examination respectively. The sensitivity, specificity, PPV, NPV and accuracy of ultrasound for the diagnosis of extraocular pathologies were 94.2%, 99.2%, 98.8%, 95.9% and 95.2% respectively with a p-value < 0.0001.

Conclusion: B-scan Ultrasonography was the initial imaging modality opted for in most the cases as it was a readily available, simple, costeffective, nonionizing, noninvasive and reliable modality. It superseded the accuracy of ophthalmoscopic diagnosis with a significant difference (p-value < 0.0001) in the diagnosis of ocular pathologies.

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