Standardized echography (ultrasonography) for the detection and characterization of retinal detachment

Thirty-five patients with clear media and retinal detachment were studied prospectively to determine the reliability and accuracy of ultrasound in this diagnosis. The extent of detachment was identified correctly within three clock hours in 33 of 35 cases (94.2%). The average height of detachment was 6.12 mm. In 27 of 31 cases (87%), the retinal tear was located within two clock hours of the superior most margin of detachment seen echographically, and in 23 of 31 cases (74%) within two clock hours of the highest elevation of the retina echographically. In 29 of 35 cases (82%) echographic determination of detachment margins was within one clock hour of clinical observation. Retinal detachments greater than 4.5 mm in maximal height appeared clinically bullous. Ultrasound correctly identified 26 of 29 maculae detached before operation (90%). Ultrasound correctly identified all seven cases with advanced massive periretinal proliferation. Mean standardized reflectivity (delta dbs) was 13.9 with 95% confidence levels of 12.7 to 15.2. A stronger correlation existed between height of retinal detachment and reflectivity, than clinical appearance of retina. Based on the findings, it was concluded that standardized echography is a highly reliable technique for the detection and characterization of retinal detachment in eyes with opaque media.