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超声生物显微镜在白内障相关葡萄膜炎的定性和定量征象。

Ultrasound biomicroscopy qualitative and quantitative signs of phacoantigenic uveitis.

机构信息

Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Eye (Lond). 2024 Dec;38(17):3368-3373. doi: 10.1038/s41433-024-03317-5. Epub 2024 Sep 13.

Abstract

BACKGROUND/OBJECTIVE: To describe the ultrasound biomicroscopy (UBM) diagnostic features in patients suspected of experiencing chronic inflammation due to phacoantigenic uveitis SUBJECTS/METHODS: This single-center study enrolled patients referred to the Uveitis Department of Cleveland Clinic Abu Dhabi for chronic anterior uveitis and traumatic cataract. Patients' demographics, causes and dates of the inciting traumatic event, and ophthalmic findings were recorded. 20-MHz UBM assessment of the status of the anterior capsule and the crystalline lens was performed. Then, cataract surgery was performed using a single technique. Comparison of the anterior capsule and lens status by clinical, UBM, and intraoperative evaluation.

RESULTS

Forty eyes with phacoantigenic uveitis were considered. The slit-lamp examination could identify interruption of the anterior capsule in 20% of the eyes and liquefied sinking lens material in 10%. An intra-operative defect in the anterior capsule was documented in 87.5% of eyes. UBM imaging showed anterior capsule irregularity in 63.3% of eyes and confirmed the presence of anterior capsule defects in 47.5% and lens matter herniating into the anterior chamber in 15%. Hypoechogenic lacunae within the cataractous lens were detected in 12.5% of eyes. For UBM, sensitivity and specificity values were 82.86% (95% CI: 66.35-93.44) and 100% (95% CI: 47.82-100), respectively. Positive and negative predictive values for UBM were 100% (95% CI: 88.06-100) and 45.45% (95% CI: 28.69-63.32), respectively. The overall diagnostic accuracy of UBM was 85% [95% CI: 70.16-94.29].

CONCLUSION

Ultrasound Biomicroscopy (UBM) is essential for assessing suspected anterior capsule ruptures in phacoantigenic uveitis cases.

摘要

背景/目的:描述疑似因白内障相关抗原性葡萄膜炎而发生慢性炎症的患者的超声生物显微镜(UBM)诊断特征。

受试者/方法:本单中心研究纳入了因慢性前葡萄膜炎和外伤性白内障而被转诊至克利夫兰诊所阿布扎比的葡萄膜炎科的患者。记录患者的人口统计学特征、诱发创伤性事件的原因和日期,以及眼科检查结果。对前囊和晶状体的状态进行 20MHzUBM 评估。然后,使用单一技术进行白内障手术。比较临床、UBM 和术中评估的前囊和晶状体状态。

结果

共考虑了 40 只患有白内障相关抗原性葡萄膜炎的眼睛。裂隙灯检查可在 20%的眼中识别前囊中断,在 10%的眼中识别液化下沉的晶状体物质。术中记录到 87.5%的眼睛前囊有缺陷。UBM 成像显示 63.3%的眼中前囊不规则,并证实 47.5%的眼中存在前囊缺陷和 15%的眼中晶状体物质疝入前房。在 12.5%的眼中检测到白内障晶状体内的低回声腔。UBM 的灵敏度和特异性值分别为 82.86%(95%CI:66.35-93.44)和 100%(95%CI:47.82-100)。UBM 的阳性和阴性预测值分别为 100%(95%CI:88.06-100)和 45.45%(95%CI:28.69-63.32)。UBM 的总体诊断准确性为 85%[95%CI:70.16-94.29]。

结论

超声生物显微镜(UBM)对于评估白内障相关抗原性葡萄膜炎病例中疑似前囊破裂至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/730b/11584626/a301bd7510cd/41433_2024_3317_Fig1_HTML.jpg

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