Color Doppler ultrasonography of the eye and orbit

Color Doppler imaging is the recent development in ultrasonography that allows simultaneous two-dimensional structural imaging in Doppler evaluation of blood flow. With this technique, it is possible for the first time to indirectly display the fine orbital vessels such as the ophthalmic artery and its branches, the central retinal artery, the posterior ciliary artery, and the lacrimal artery. Also, the display of venous structures such as the superior ophthalmic vein, the vortex vein, and the central retinal vein is possible. In addition to the qualitative display of those vessels, the hemodynamics in those vessels can be quantitatively assessed by looking at the Doppler spectrum and deter…

Optic Nerve Decompression Improves Hemodynamic Parameters in Papilledema

Purpose: The purpose of this study is to examine changes in color Doppler imaging parameters before and after optic nerve sheath decompression (ONSD) for chronic papilledema caused by pseudotumor cerebri (PTC). Methods: Color Doppler imaging was performed within 48 hours before surgery and within 48 hours after the procedure using a color Doppler unit with a 7.5-MHz phased linear transducer. Pulsed Doppler spectrum analyses were recorded digitally on videotape from the ophthalmic, central retinal, and short posterior ciliary arteries, using a 0.4 × 0.6-mm sample volume. Results: Blood flow velocities in the ophthalmic, short posterior ciliary, and central retinal arteries of 24 eyes were si…

Ophthalmologic Imaging Methods

Sonography and computed tomography in the diagnosis of orbitocranial malformations and tumors

Standardized sonography and CT scanning have distinct advantages and disadvantages in the evaluation of patients with orbital diseases. Echography provides an efficient screening examination in patients presenting with signs and symptoms of orbital pathology. It allows the detection, localization, measurement and in almost 80% differentiation of orbital lesions. High resolution CT scanning gives an excellent topographic display of masses in the orbit. In visualization of intracranial causes of orbital processes and demonstration of changes in the posterior third of the orbit, in the orbital bones and the periorbital sinuses it is superior to ultrasonography.

Color Doppler Imaging of Arterial Blood Flow in Central Retinal Vein Occlusion

Purpose: The hemodynamics of the retrobulbar arterial circulation of patients with central retinal vein occlusion were evaluated in order to better understand the pathophysiology of this disease. Methods: Color Doppler imaging was used to measure the peak systolic velocity and vascular resistance (pulsatility index) in the retrobulbar arteries of involved eyes and clinically healthy fellow eyes of patients with central retinal vein occlusion and in the control eyes of age- and sex-matched healthy volunteers. Results: Average peak systolic velocity was significantly lower and average vascular resistance was significantly higher in the central retinal artery of involved eyes of patients with …

Color Doppler Hemodynamics of Giant Cell Arteritis

Objectives: To determine quantitative and qualitative hemodynamic alterations within the ophthalmic, central retinal, and short posterior ciliary arteries in patients with giant cell arteritis (GCA) proved by biopsy specimen. Design, Patients, and Setting: A consecutive case series of patients with GCA referred to an urban eye hospital who were evaluated with color Doppler imaging that was used to analyze orbital blood flow velocities and vascular resistance in 22 consecutive patients with GCA compared with age and sex-matched controls. Results: Patients with GCA all demonstrated significantly reduced central retinal and short posterior ciliary arterial mean flow velocities as well as signi…

Color Doppler imaging of the eye and orbit A synopsis of a 400 case experience

Color Doppler imaging (CDI) is a recent advance in ultrasonography that allows simultaneous two-dimensional imaging of structure and blood flow. Doppler information is superimposed in color over a conventional gray-scale ultrasound image. Using this technique we have examined 400 eyes. The central retinal artery, posterior ciliary arteries, ophthalmic artery, the central retinal vein and the vortex veins could be located in all normal eyes. Using the color image as a guide, Doppler spectral analysis is used for quantitative assessment of blood flow velocity in these vessels. We also studied patients with intraocular tumors, arterial and venous retinal occlusions, orbital vascular anomalies …

Myxoma of the orbit: a clinicopathologic report.

A 27-year-old white man developed proptosis of his left eye over a period of 2 years. It was associated with vertical diplopia and displacement of the left globe down and laterally. Ultrasonography showed a cystic mass in the superior orbital region. Computed tomography (CT) demonstrated a solid, well-defined lesion behind the globe displacing the optic nerve medially. A transfrontal craniotomy revealed a nodular mass in the posterior and superior orbit, which extended anteriorly up to the globe. Histopathology, immunohistochemistry, and transmission electron microscopy proved the tumor to be a myxoma.

Epiphora Secondary to Blockage of the Lacrimal System: The Role of Endonasal Dacryocystorhinostomy

Stenosis of the lacrimal system may occur secondary to tumor, infection, trauma, and congenital etiologies. Attempts to remedy this problem often include irrigation and probing. However, if these fail, external or internal dacryocystorhinostomy (DCR) with or without stenting may be performed. The purpose of this article is to detail our experience with a microscopic endonasal approach to DCR utilized in 23 patients. This is a modification of an older accepted procedure which utilizes the modern techniques of endonasal sinus surgery. This approach has allowed for immediate restoration of drainage in 22 of 23 cases. In one case, the procedure was repeated because of restenosis at the level o…

Color Doppler Imaging of the Ocular Ischemic Syndrome

Purpose: This study describes hemodynamic characteristics of the ophthalmic, central retinal, and posterior ciliary arteries in 16 eyes of 11 patients with the ocular ischemic syndrome. Understanding the hemodynamic characteristics of the retrobulbar circulation may elucidate the natural history and pathophysiology of the ocular ischemic syndrome and perhaps form the basis for rational treatment of this condition. Methods: Color Doppler imaging, a procedure that permits rapid noninvasive imaging of the ophthalmic, central retinal, and posterior ciliary arteries, was used to quantitate peak systolic blood flow velocities and vascular resistance (pulsatility index) within these vessels in stu…