A. Retinal Detachment
(1) Presentation:
•
Acute onset of unilateral floaters and/or pinpoint flashing lights (photopsias)
•
Can have visual loss or visual field cuts
(2) Note
: 외상에 의해 발생할 수도 있지만 더 흔하게는 자발적으로 발생하거나 전신적 질병 (예; vasculopathies)에 이차적으로 발생한다.
(3) Findings
: Posterior chamber에 hyperechoic한 linear 구조물이 posterir choroid와 분리되어 관찰됨
: 분리된 구조물은 중심으로는 optic nerve에 붙어 있음 (retina는 optic nerve의 연장이다)
(4) 진단 정확도
Sensitivity 75%, Specificity 94%, Positive Likelihood Ratio 12.4, Negative Likelihood Ratio 0.27 (Kim 2019, PMID: 29774966)
B. Vitreous Detachment
(1) Presentation
•
급성으로 비문증(visualization of floaters)이 한쪽으로 발생
•
Can have visual loss or visual field cuts
(2) Note
This is a common cause of retinal detachment
(3) Findings
: Hyperechoic linear floating structure often with increased echogenicity between the structure and the posterior surface of the globe
(4) Note
: Similar in appearance to retinal detachment but will not be tethered to the optic disc
(5) 진단정확도
Vitreous Detachment – Source: Dr. Matt Riscinti and Dr. Bryan Flores,http://www.thepocusatlas.com/orbital
C. Vitreous Hemorrhage
(1) Presentation
•
Sudden painless visual loss or visual “haze”
•
Can be spontaneous or secondary to trauma
(2) Findings
: Swirling, slightly hyperechoic, “washing machine” appearing material in the posterior chamber
(3) Note
: You may have to increase the gain to adequately visualize. Prompting the patient to move the eye side to side will demonstrate swirling
(4) 진단 정확도
• Note: Each of these ocular pathologies can appear alone or in combination and can be difficult to differentiate. All three will require ophthalmologic consultation.
Source WikiEM https://wikem.org/w/images/Image.png
