Open AccessThe use of ocular ultrasound for the diagnosis of retinal detachment in a local accident and emergency department
Author(s) -
Chu Ho Cheung,
Chan Ming Yin,
Chau Cheuk Wai Jeffrey,
Wong Chi Pang,
Chan Hok Hang,
Wong Tai Wai
Publication year - 2017
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/1024907917735085
Subject(s) - medicine , retinal detachment , emergency department , confidence interval , ultrasound , ophthalmology , emergency ultrasound , retinal , radiology , psychiatry
Objectives: This study aimed to assess the accuracy of ocular ultrasound performed by emergency physicians for diagnosis of retinal detachment. Methods: This was a prospective single‐center observational study conducted between September 2013 and February 2015. All adult patients presenting to the emergency department with acute onset of visual changes were eligible to participate. Patients who met one of the following criteria were excluded: a diagnosis of retinal detachment had already been made by an ophthalmologist prior to attendance; pre‐existing retinal detachment currently under treatment; hemodynamically unstable; suspected rupture eyeball; and unable to give consent. Six emergency physicians performed emergency ocular ultrasound using a linear 10‐MHz ultrasound probe. An abnormal lifting of the retina or the presence of a retinal flap was considered diagnostic of retinal detachment. The final diagnosis of the ophthalmologist who was blinded to the study was used as the gold standard. Results: Among the 139 patients evaluated, 16 (12%) had retinal detachments and 14 of them were correctly identified (true positives). Of the 123 patients (88%) without retinal detachment, 107 patients were correctly identified (true negatives). The sensitivity and specificity of emergency ocular ultrasound for retinal detachment were 88% (95% confidence interval = 60 to 98) and 87% (95% confidence interval = 79 to 92), respectively. Conclusion: Emergency ocular ultrasound is a useful adjunct for the diagnosis of retinal detachment.