Ocular and Periocular Ultrasound Elastography in Diabetic Retinopathy
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1 Ocular and Periocular Ultrasound Elastography in Diabetic Retinopathy Poster No.: C-0305 Congress: ECR 2014 Type: Scientific Exhibit Authors: G. Pekel 1, K. AGLADIOGLU 2, S. Acer 1, R. Yagci 1, A. Kasikci 1 ; 1 2 Denizli/TR, ANKARA/TR Keywords: DOI: Outcomes, Treatment effects, Elastography, Eyes /ecr2014/C-0305 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 5
2 Aims and objectives In this study, we performed ultrasound elastography (USE) in diabetic patients. It would be expected that after argon laser pan-retinal photocoagulation (PRP), fibrosis occurs and this might cause tissue hardness. We wanted to reveal the effects of PRP in terms of tissue elasticity. The rationale of this study was that ocular USE might have enough sensitivity to detect the hardness occurred due to PRP. Our aim was to evaluate the effects of argon laser panretinal photocoagulation on ocular and periocular ultrasound elastography values in diabetic retinopathy. Also, we wanted to test the applicability of ultrasound elastography in ophthalmological practice. Methods and materials This is a prospective cross-sectional study comparing proliferative diabetic retinopathy patients (study group) who had undergone panretinal photocoagulation and nonproliferative diabetic retinopathy patients (control group). There were 15 participants (11 males, 4 females) in the study group and 16 participants (10 males, 6 females) in the control group. All subjects underwent an ophthalmic examination including visual acuity assessment (Snellen chart), biomicroscopy, air-puff tonometer, indirect retinoscopy, and the US elastography. The USE measurements were done with LOG#Q E9 Ultrasound Elastography (General Electric Company, USA). PRP had been applied with Zeiss Visulas argon laser system (Carl Zeiss Meditec, Germany). The time interval between PRP and the examination was at least one month for the study group. For statistical analysis, SPSS 14.0 software for Windows (SPSS Inc., Chicago, IL, USA) was used to analyze outcomes. 'P' values lower than 0.05 were considered to be statistically significant. Results The elastography values of vitreus, retrobulbar fat and optic nerve were similar in both groups (p>0.05). But, the mean retina-choroid-scleral elastography value of the study group was higher than that of the control group, which indicates increased hardness (p=0.002). Page 2 of 5
3 Images for this section: Fig. 1: This shows the B-mode ultrasonography image (on the left side) and the related elastography image (on the right side) of sclera-choroid-retina complex versus retrobulbar fat of one of our patients. The circles indicate the places where the elastographic measurements were done. Page 3 of 5
4 Fig. 2: This shows the B-mode ultrasonography image (on the left side) and the related elastography image (on the right side) of anterior vitreus vs. posterior vitreus. The circles indicate the places where the elastographic measurements were done. Fig. 3: This shows the B-mode ultrasonography image (on the left side) and the related elastography image (on the right side) of optic nerve head vs. retrobulbar optic nerve. The circles indicate the places where the elastographic measurements were done. Page 4 of 5
5 Conclusion In conclusion, USE could be used effectively in ophthalmological practice. It is a rapid, noninvasive, and reproducible imaging technique. It is also painless and has little risk of complications. It is revealed that panretinal photocoagulation decreases the elasticity of retina-choroid-sclera in diabetic retinopathy. This presentation may encourage the researchers to perform USE in various ocular and periocular diseases such as degenerative myopia, thyroid orbitopathy and pseudotumor orbita, in order to give better insight for the disease mechanisms. Personal information References 1. Garra BS. Elastography: current status, future prospects, and making it work for you. Ultrasound Q. 2011;27: Detorakis ET, Drakonaki EE, Tsilimbaris MK, Pallikaris IG, Giarmenitis S. Real-Time Ultrasound Elastographic Imaging of Ocular and Periocular Tissues: A Feasibility Study. Ophthalmic Surg Lasers Imaging. 2010;41: Ophir J, Alam SK, Garra BS, Kallel F, Konofagou EE, Krouskop T, et al. Elastography: Imaging the Elastic Properties of Soft Tissues with Ultrasound. J Med Ultrasonics. 2002;29: Garra BS. Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q. 2007;23: Drakonaki EE, Allen GM, Wilson DJ. Ultrasound elastography for musculoskeletal applications. The British Journal of Radiology. 2012;85: Garra BS. Elastography: current status, future prospects, and making it work for you. Ultrasound Q. 2011;27: Detorakis ET, Pallikaris IG. Ocular rigidity: biomechanical role, in vivomeasurements and clinical significance. Clin Experiment Ophthalmol. 2013;41: Page 5 of 5
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