A Study of Posterior Segment Pathology in Cataractous Eyes Using B-scan Ultrasonography

Mohammed Abdalla Shakour, Caroline E. Ayad, Samih Kajoak, Hamid Osman, E. Rahim

International Journal of Biomedicine. 2021;11(1):78-81.
DOI: 10.21103/Article11(1)_OA13
Originally published March 5, 2021


Background: Ultrasonography (US) is a valuable diagnostic modality for detecting posterior segment eye diseases (PSEDs) in patients with cataractous eyes. This imaging modality can better facilitate planning surgery and predicting prognosis. The purpose of this study was to determine the role of B-scan US in evaluating posterior segment abnormalities of eyes in cataract patients pre-operatively to limit complications and visual impairment.
Methods and Results: A prospective, cross‑sectional study to assess cataracts by US, as well as to detect posterior segment abnormalities of eyes in cataract patients, was conducted in Sudan at Albasar International Foundation (Makah Eye Complex in Omdurman) between December 2018 and December 2019.
All patients (n=380; 48% males and 52% females; a mean age of 63±12.57 years) with non-visualization of the fundus, regardless of age and gender, were involved and were assumed to have orbital pathologies. Patients with high-risk extrusion of intraocular contents and a previous history of ocular surgery were excluded from the present study. All patients with dense cataracts were evaluated using standard US machines (Echoscan US-4000; NIDEK CO., LTD.) equipped with a real-time high-frequency probe.
The typical age of the patients complaining of cataracts was between 61 and 70 years, which constituted 35% of cases, followed by age >70 years, which constituted 24.2% of cases. About 47.63% patients had ocular pathology in the posterior segment of the eye. The most common PSEDs were vitreous abnormalities (46.2%). Among vitreous abnormalities, most abnormal eyes had vitreous changes (36.1%), followed by VD (3.7%); 1.3% of patients had retinal detachment.
Conclusion: Ocular US should be the first screening modality in the evaluation of posterior segment pathologies in cataractous eyes and should be performed in cataract patients pre-operatively for better surgical planning and predicting post-operative visual prognosis.

B-scan ultrasonography • cataract • posterior segment eye diseases

1. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012 May;96(5):614-8. doi: 10.1136/bjophthalmol-2011-300539. 
2. Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB, Keeffe J, Kempen JH, Leasher J, Limburg H, Naidoo K, Pesudovs K, Resnikoff S, Silvester A, Stevens GA, Tahhan N, Wong TY, Taylor HR; Vision Loss Expert Group. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017 Sep;5(9):e888-e897. doi: 10.1016/S2214-109X(17)30293-0. 
3. World Health Organization. (‎2007)‎. Global Initiative for the Elimination of Avoidable Blindness: action plan 2006-2011. Geneva: World Health Organization. https://apps.who.int/iris/handle/10665/43754
4. Sushil K, Ruchi G. Diagnostic ultrasonography of the eye. All India Ophthalmological Society.  AIOS, CME series. 2011; 24:17–9.
5. Skandesh BM, Mohan Kumar, Sreenivasa Raju N. Role of high resolution sonography (B-SCAN) in the evaluation of posterior segment lesions of the eye. International Journal of Contemporary Medicine Surgery and Radiology. 2018;3(3):C11-C16.
6. Byrne SF, Green RL. Ultrasound of the eye and orbit. 2nd ed. St. Louis: Mosby; 2002
7. Agrawal D, Ahirwal D. A study of role of B scan ultrasound in posterior segment pathology of eye. Int J Med Res Rev. 2015;3(9):969–74.
8. Sharma OP. Orbital sonography with its clinicosurgical correlation. Indian J Radiol Imaging. 2005;15:537–54.
9. Meenakshi V, Jyothirmayi T, Sree B. Role of B-Scan Ultrasonography in cataract patients in a tertiary care centre. J Evol Med Dent Sci. 2015;4(83):14525–30. doi: 10.14260/jemds/2015/2066.
10. Qureshi MA, Laghari K. Role of B-scan ultrasonography in pre-operative cataract patients. Int J Health Sci (Qassim). 2010 Jan;4(1):31-7. 
11. Shen Z, Duan X, Wang F, Wang N, Peng Y, Liu DT, Peng X, Li S, Liang Y. Prevalence and risk factors of posterior vitreous detachment in a Chinese adult population: the Handan eye study. BMC Ophthalmol. 2013 Jul 16;13(1):33. doi: 10.1186/1471-2415-13-33. 
12. Allen D, Vasavada A. Cataract and surgery for cataract. BMJ. 2006 Jul 15;333(7559):128-32. doi: 10.1136/bmj.333.7559.128. 
13. De La Hoz Polo M, Torramilans Lluís A, Pozuelo Segura O, Anguera Bosque A, Esmerado Appiani C, Caminal Mitjana JM. Ocular ultrasonography focused on the posterior eye segment: what radiologists should know. Insights Imaging. 2016 Jun;7(3):351-64. doi: 10.1007/s13244-016-0471-z.
14. Chanchlani M, Chanchlani R. A study of posterior segment evaluation by B-Scan in hyper mature cataract. J Clini Exp Ophthalmol. 2016;7:1. doi: https://doi.org/10.4172/2155-9570.1000516.
15. McLeod D, Restori M. Ultrasonic examination in severe diabetic eye disease. Br J Ophthalmol. 1979 Aug;63(8):533-8. doi: 10.1136/bjo.63.8.533. 
16. Richter GM, Torres M, Choudhury F, Azen SP, Varma R; Los Angeles Latino Eye Study Group. Risk factors for cortical, nuclear, posterior subcapsular, and mixed lens opacities: the Los Angeles Latino Eye Study. Ophthalmology. 2012 Mar;119(3):547-54. doi: 10.1016/j.ophtha.2011.09.005. 
17. Salman A, Parmar P, Vanila CG, Thomas PA, Jesudasan CA. Is ultrasonography essential before surgery in eyes with advanced cataracts? J Postgrad Med. 2006 Jan-Mar;52(1):19-22.
18. Mendes MH, Betinjane AJ, Cavalcante Ade S, Cheng CT, Kara-José N. Ultrasonographic findings in patients examined in cataract detection-and-treatment campaigns: a retrospective study. Clinics (Sao Paulo). 2009;64(7):637-40. doi: 10.1590/S1807-59322009000700005.
19. Jain A, Gauba N, Kaur I, Singh S, Jaswal H. Role of B-Scan in cataract patients. Indian J Appl Radiol. 2017;3(1):110.
20. Ali SI, Rehman H. Role of B-scan in preoperative detection of posterior segment pathologies in cataract patients. Pak J Ophthalmol. 1997;13:108-12.
21. Shaikh FU, Narsani AK, Jatoi SM, Shaikh ZA. Preoperative posterior segment evaluation by ultrasonography in dense cataract. Pak J Ophthalmol. 2009;25(3):135.

Download Article
Received December 30, 2020.
Accepted February 8, 2021.
©2021 International Medical Research and Development Corporation.