New York Hospital Queens, Department of Emergency Medicine.
West J Emerg Med. 2009 Nov;10(4):263-6.
Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye.
This study evaluated the ability of emergency physicians to detect a ruptured globe in an ex-vivo porcine model.
Following a brief training lecture, 15 emergency medicine residents and 4 emergency medicine attending physicians used ultrasonography to evaluate 18 porcine eyes, randomized as normal, ruptured, or completely devoid of vitreous humor. The consequences of ultrasound applanation with this method were evaluated by measuring intraocular pressure changes with and without a 1mm clear plastic shield.
Our study participants were able to identify abnormal eyes with a sensitivity of 79% (95% CI 73% to 84%) and a specificity of 51% (95% CI 41% to 61%). Intraocular pressure increased 5% with ultrasound applanation, though with a 1mm thick plastic shield there was no measurable change.
Ultrasound imaging may be a future modality to be used by trained emergency physicians to expedite the identification of a rupture globe, but it is unlikely to replace more definitive imaging techniques. The use of a clear plastic barrier in this porcine model prevents an increase in intra-ocular pressure without affecting image quality, and should be used in any future studies on this method.
最近的病例报告表明，超声检查可用于在紧急情况下诊断眼部病变。当眼眶周围水肿和疼痛影响对创伤后眼睛的检查时，超声检查可能特别有用。
本研究评估了急诊医师在离体猪模型中检测眼球破裂的能力。
在简短的培训讲座后，15 名急诊医学住院医师和 4 名急诊医学主治医生使用超声检查评估了 18 只猪眼，随机分为正常、破裂或完全缺乏玻璃体。通过测量有和没有 1mm 厚透明塑料片时眼压的变化，评估了这种方法的超声压平的后果。
我们的研究参与者能够以 79%（95%置信区间 73%至 84%）的敏感性和 51%（95%置信区间 41%至 61%）的特异性识别异常眼。超声压平使眼压升高 5%，但使用 1mm 厚的塑料片时眼压没有可测量的变化。
超声成像可能是未来一种由经过培训的急诊医师使用的方法，以加快对眼球破裂的识别，但不太可能取代更明确的成像技术。在这种猪模型中使用透明塑料屏障可以在不影响图像质量的情况下防止眼压升高，并且应在任何关于这种方法的未来研究中使用。
