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Ultrasound of the eye, or ophthalmoechography, is a diagnostic method that is widely used by ophthalmologists and allows one to identify various abnormalities. For some diseases, this method is the only possible one, moreover, it is safe, informative and non-invasive.

Ultrasound of the eyeball is most informative for eye diseases that are accompanied by clouding of its media. During the procedure, the doctor assesses the condition of the eye muscles and optic nerve, identifies abnormalities in the development of the eye, and determines the normal parameters of the eyeball.

Often this diagnosis is accompanied by Doppler ultrasound, which allows you to evaluate a number of additional parameters:

• blood flow speed;
• blood flow volume;
• vascular patency.

It is Doppler sonography that makes it possible to detect vascular diseases of the eye at early, preclinical stages.

There are two main modes of performing ultrasound examination of the eye:

• A-mode, which is performed with the eye open. To do this, the patient is given superficial anesthesia to keep the eye motionless.
• B-mode is performed with the eyelid closed. There is no anesthesia, but a special gel is applied to the eyelid.
• Combination of these two techniques.

The described methods are two-dimensional modes, however, thanks to the development of modern computer technologies in medicine, it has become possible to perform three-dimensional ultrasound.

Indications for ultrasound examination of the eye:

• measurement of physiological parameters of the orbit, optical media;
• detection of tumor formations;
• eye damage;
• clouding of the eye media;
• presence of foreign bodies;
• cataract;
• glaucoma;
• myopia;
• lens luxation;
• retinal disinsertion;
• pathology of the optic nerve;
• changes in the vitreous body;
• presence of hemorrhages;
• exophthalmos;
• abnormalities of eye development;
• control of the postoperative period;
• the presence of somatic pathology that gives complications to the eye: diabetes mellitus, hypertension, kidney disease.

In addition to the above reasons, ultrasound of the eyeball is prescribed to assess the dynamics of myopia, when planning lens replacement surgery, before cataract removal.

This study provides maximum information for the doctor, is inexpensive, accessible, non-invasive, painless, has virtually no contraindications, and is safe. Another reason why many specialists prefer to do ultrasound is the lack of special training. The procedure can be performed immediately on the day of treatment, and the patient does not have to change his usual lifestyle.

Contraindications

There are no contraindications for eye ultrasound. This procedure can be performed on any category of patients: pregnant, breastfeeding, cancer patients, those with an open form of tuberculosis, or those with concomitant somatic pathology.

Local changes may be a temporary limitation to the diagnosis of the eye:

• penetrating eye injury;
• acute inflammatory process;
• corneal ulcers.

Examination of the eyeball using ultrasound has no age restrictions and takes 15-20 minutes. After the study, the patient can immediately return to their usual lifestyle.

Ultrasound of the eyeball with Dopplerography of blood vessels

Ultrasound of the eyeball with Doppler sonography is the most informative and accessible research method, while other methods do not always allow one to assess the state of blood flow. With direct ophthalmoscopy, it is possible to carry out only an indirect assessment of the retinal vessels, as well as to identify gross changes.

For some diseases, ultrasound of the eye is the main diagnostic method: diabetes mellitus and hypertension. According to the recommendations, such patients are required to undergo testing at least once a year, and in case of frequent exacerbations of the underlying disease - twice a year. Based on the diagnostic results, the doctor can predict the further development of the disease, up to complete blindness.

Modern computer technologies contribute to the further development of Dopplerography of the eye. Currently, there are more informative methods: convergent Doppler, power Doppler, color Doppler mapping. At the Kutuzovsky Children's Center, patients with eye diseases are examined using all modern techniques, focusing on the severity and severity of clinical symptoms.

Ultrasound of the eye– a method for diagnosing ophthalmological diseases, visualizing the structure of the eye, the condition of the optic nerves, muscles and blood vessels, lens, and retina. It is used as part of a comprehensive diagnosis of myopia, farsightedness, astigmatism, retinal dystrophy, cataracts, glaucoma, eye tumors, injuries, vascular pathologies, neuritis. Several variants of the procedure are common: one-dimensional (A), two-dimensional (B), three-dimensional (AB) scanning, Doppler ultrasound/ultrasound scanning of vessels. The cost depends on the selected ultrasound mode.

Preparation

Ultrasound of the eye does not require advance preparation. Immediately before the procedure, it is necessary to remove eye makeup and remove contact lenses. If the presence of a foreign body in the ocular tissues is suspected, an x-ray of the eye is performed before the ultrasound examination. If a tumor of any etiology develops, a preliminary diaphanoscopy or X-ray examination is recommended.

What does it show

The result of eye ultrasound in A-mode scanning is a one-dimensional image, the resulting parameters are used to calculate the power of the intraocular lens before cataract surgery. With B-mode, a two-dimensional image of the orbits and eyeballs is obtained, the study reveals corneal opacities, cataracts, hemorrhages, foreign bodies, and neoplasms in the eye. With comprehensive AB mode, the structures of the eye are displayed in three dimensions. Vascular examination reflects the characteristics of blood flow in real time through graphical and quantitative indicators. Ultrasound of the eye can detect the following pathologies:

• Myopia, hypermetropia. The length of the anteroposterior axis of the eyeball is measured. With congenital myopia it is greater than normal, with farsightedness it is less.
• Cataract. Normally, this structure is transparent and is not visible on the monitor. When clouded, the lens thickens and begins to reflect ultrasound waves - it becomes visible.
• Degenerative-dystrophic diseases. Retinal degeneration, optic nerve atrophy, glaucoma, keratopathy, conjunctival dystrophy are accompanied by thinning and cell death. On ultrasound images, the affected areas become less bright - from white and light gray to gray, barely detectable.
• Neoplasms, foreign body. The study allows you to determine the size and location of the tumor, a foreign object in the eye. On ultrasound they appear as areas of increased and high echo activity.
• Pathologies of the optic nerves. Assessment of the state of the optic nerve fibers is necessary for retrobulbar neuritis, neurogenic tumors, glaucoma, and traumatic lesions. The change in the thickness of the nerve sheath and disc, the expansion of certain parts of it, and the blurring of boundaries are determined.
• Vascular pathologies of the eye. Ultrasound of the ocular vessels is used to analyze blood flow during age-related, diabetic, and atherosclerotic changes. The study reveals thrombosis of small and large vessels, non-perfused microvessels, vascular malformations, narrowing of the lumen, paucity of branching, slowing of blood flow, tortuous and wave-like course of vessels.

In addition to the above, ultrasound of the eye is prescribed to identify congenital abnormalities of the organ of vision, diseases of the lacrimal glands and lacrimal sac. Despite the high information content, ultrasound results cannot be the only confirmation of the diagnosis. They are used in conjunction with data from a clinical interview, medical history, ophthalmological examination, radiography and other instrumental methods.

Advantages

Currently, ultrasound of the eye is the most informative and accessible method for the early diagnosis of ophthalmological pathologies. The advantages of the method include harmlessness: the absence of radiation exposure and invasive intervention allows examination of children, the elderly, pregnant and nursing mothers. The short duration of the examination procedure and relatively low cost make ultrasound one of the most common methods for screening eye diseases. The disadvantage of ultrasound examination of the eye is that image clarity is limited by the sensor area; the resolution is lower than with MRI and CT.

Ultrasound of the eye (or ophthalmoechography) is a safe, simple, painless and highly informative method for studying the structures of the eye, allowing them to be imaged on a computer monitor as a result of the reflection of high-frequency ultrasonic waves from the tissues of the eye. If such a study is supplemented by the use of color Doppler mapping of the vessels of the eye (or color doppler mapping), then the specialist can assess the state of blood flow in them.

In this article we will provide information about the essence of the method and its varieties, indications, contraindications, methods of preparing and performing ultrasound of the eye. This data will help you understand the principle of this diagnostic method, and you will be able to ask your ophthalmologist any questions you may have.

Ultrasound of the eye can be prescribed both to identify many ophthalmological pathologies (even at the initial stages of their development), and to assess the condition of the eye structures after surgical operations (for example, after replacing the lens). In addition, this procedure makes it possible to monitor the dynamics of the development of chronic ophthalmological diseases.

The essence and types of the method

Ultrasound of the eye is a simple and at the same time highly informative method for diagnosing eye diseases.

The principle of ophthalmoechography is based on the ability of ultrasonic waves emitted by the sensor to be reflected from organ tissues and converted into an image displayed on a computer monitor. Thanks to this, the doctor can obtain the following information about the eyeball:

• measure the size of the eyeball as a whole;
• assess the extent of the vitreous;
• measure the thickness of the inner membranes and lens;
• assess the extent and condition of retrobulbar tissues;
• determine the size or identify tumors of the ciliary region;
• study the parameters of the retina and choroid;
• identify and evaluate characteristics (if it is impossible to determine these changes during);
• differentiate primary retinal detachment from secondary, which was caused by an increase in tumors of the choroid;
• detect foreign bodies in the eyeball;
• determine the presence of opacities, exudate or blood clots in the vitreous body;
• identify .

Such a study can be performed even with opacities in the optical media of the eye, which can complicate diagnosis using other methods of ophthalmological examination.

Usually, ophthalmoechography is supplemented by Dopplerography, which allows one to assess the condition and patency of the vessels of the eyeball, the speed and direction of blood flow in them. This part of the study makes it possible to detect abnormalities in blood circulation even at the initial stages.

To perform an ultrasound of the eye, the following types of this technique can be used:

1. One-dimensional echography (or mode A). This research method is used to determine the size of the eye or its individual structures and assess the condition of the orbits. When carrying out this technique, a solution is instilled into the patient's eye and the device's sensor is installed directly on the eyeball. As a result of the examination, a graph is obtained that displays the eye parameters necessary for diagnosis.
2. Two-dimensional echography (or mode B). This method allows you to obtain a two-dimensional picture and characteristics of the structure of the internal structures of the eyeball. To perform it, no special preparation of the eye is required, and the ultrasound device sensor is installed on the closed eyelid of the subject. The study itself takes no more than 15 minutes.
3. Combination of modes A and B. This combination of the above methods makes it possible to obtain a more detailed picture of the condition of the eyeball and increases the information content of the diagnosis.
4. Ultrasound biomicroscopy. This method involves digital processing of echo signals received by the device. As a result, the quality of the image displayed on the monitor increases several times.

Doppler examination of the vessels of the eye is performed using the following methods:

1. Three-dimensional echography. This research method makes it possible to obtain a three-dimensional image of the structures of the eye and its vessels. Some modern devices allow you to obtain a picture in real time.
2. Power Dopplerography. Thanks to this technique, a specialist can study the condition of blood vessels and assess the amplitude and speed of blood flow in them.
3. Pulsed wave dopplerography. This research method analyzes the noise that occurs during blood flow. As a result, the doctor can more accurately assess its speed and direction.

Duplex ultrasound scanning combines all the capabilities of both conventional ultrasound and Doppler examination. This examination method simultaneously provides data not only on the size and structure of the eye, but also on the condition of its blood vessels.

Indications

Ultrasound of the eye is one of the diagnostic methods recommended for patients with myopia or farsightedness.

Ultrasound of the eye may be prescribed in the following cases:

• high degrees or farsightedness;
• glaucoma;
• retinal disinsertion;
• pathologies of the eye muscles;
• suspicion of a foreign body;
• optic nerve diseases;
• injuries;
• vascular pathologies of the eyes;
• congenital abnormalities of the structure of the visual organs;
• chronic diseases that can lead to the appearance of ophthalmological pathologies: kidney diseases accompanied by hypertension;
• monitoring the effectiveness of treatment of eye cancer pathologies;
• monitoring the effectiveness of therapy for vascular changes in the eyeball;
• assessment of the effectiveness of ophthalmological operations performed.

Doppler ultrasound of the eye is indicated for the following pathologies:

• spasm or obstruction of the retinal artery;
• thrombosis of the ophthalmic veins;
• narrowing of the carotid artery, leading to impaired blood flow in the ophthalmic arteries.

Contraindications

Ultrasound of the eye is an absolutely safe procedure and has no contraindications.

Patient preparation

Carrying out ophthalmoechography does not require special preparation of the patient. When prescribing it, the doctor must explain to the patient the essence and necessity of performing this diagnostic test. Particular attention is paid to the psychological preparation of young children - the child must know that this procedure will not cause him pain, and behave correctly during an ultrasound scan.

If it is necessary to use mode A during the study, before the examination, the doctor must check with the patient about the presence of an allergic reaction to local anesthetics and select a drug that is safe for the patient.

Ultrasound of the eye can be performed both in a clinic and in a hospital. The patient must take with him a referral for examination and the results of previously performed ophthalmoechography. Women should not use eye makeup before the procedure, as gel will be applied to the upper eyelid during the examination.

How the research is carried out

Ophthalmoechography is performed in a specially equipped room as follows:

1. The patient sits on a chair in front of the doctor.
2. If mode A is used for the examination, a solution of local anesthetic is instilled into the patient's eye. After its action begins, the doctor carefully places the device’s sensor directly on the surface of the eyeball and moves it as necessary.
3. If the study is performed in mode B or Doppler sonography is performed, then anesthetic drops are not used. The patient closes his eyes and the gel is applied to his upper eyelids. The doctor places the sensor on the patient's eyelid and performs the examination for 10-15 minutes. After this, the gel is removed from the eyelids with a napkin.

After the procedure, the ultrasound diagnostic specialist draws up a conclusion and hands it to the patient or sends it to the attending physician.

Normal indicators

The results of ophthalmoechography are interpreted by an ultrasound diagnostic specialist and the patient’s attending physician. To do this, the results obtained are compared with the norm:

• the vitreous body is transparent and has no inclusions;
• the volume of the vitreous body is about 4 ml;
• anterior-posterior axis of the vitreous body – about 16.5 mm;
• the lens is transparent, invisible, its posterior capsule is clearly visible;
• eye axis length – 22.4-27.3 mm;
• thickness of the internal shells – 0.7-1 mm;
• the width of the hypoechoic structure of the optic nerve is 2-2.5 mm;
• refractive power of the eye with emmetropia is 52.6-64.21 D.

Which doctor should I contact?

An eye ultrasound may be prescribed by an ophthalmologist. For some chronic diseases that cause changes in the condition of the eyeball and fundus, this procedure may be recommended by doctors of other specializations: a therapist, neurologist, nephrologist or cardiologist.

Ultrasound of the eye is a highly informative, non-invasive, safe, painless and easy-to-perform diagnostic procedure that helps make the correct diagnosis for many ophthalmological pathologies. If necessary, this study can be repeated many times and does not require any breaks. To conduct an ultrasound of the eye, the patient does not need to undergo special preparation and there are no contraindications or age restrictions for prescribing such an examination.

Catad_tema Functional and laboratory diagnostic methods - articles

Catad_tema Eye diseases - articles

Hemodynamics of the vessels of the eye and orbit in patients with different types of clinical refraction according to convergent Doppler ultrasound

V.S. Rykun, O.A. Kuritsyna, O.V. Solyannikova, A.Yu. Kinzersky, E.B. Konovalova
Rykun V.S., Kuritsina O.A., Solyannikova O.V., Kinzerskiy A.Yu., Konovalova Ye.V.

Chelyabinsk State Medical Academy, Ural State Medical Academy of Additional Education, Chelyabinsk
Chelyabinsk State Medical Academy, Urals State Medical Academy for Advanced Training, Chelyabinsk

In order to identify hemodynamic features in the vessels of the eye and orbit in patients with various types of clinical refraction, convergent Dopplerography (a combination of color Doppler mapping and power Doppler) of the ophthalmic artery, central retinal artery, posterior short and long ciliary arteries, central retinal vein and superior ophthalmic vein was performed in 32 healthy volunteers (64 eyes) aged 18 to 55 years. A significant deterioration in hemodynamic parameters was found in individuals with high myopia, especially pronounced in the posterior short ciliary arteries and the central retinal artery. The data obtained explain some aspects of the pathogenesis of the occurrence of atrophic and dystrophic changes in the structures of the fundus and optic nerve in patients with high myopia.

Convergent Doppler ultrasonography (combination of Color Doppler Imaging and Energy Doppler) of the ophthalmic artery, central retinal artery, posterior short and long ciliary arteries, central retinal vein and superior ophthalmic vein was performed in 32 normal volunteers (64 eyes) aged 18 to 55 years in order to identify the hemodynamic characteristics of eye and orbit vessels in patients with different clinical refraction. An appreciable deterioration of the hemodynamic parameters was discovered in subjects with high grade myopia. It was especially pronounced in the posterior short ciliary arteries and central retinal artery. The data obtained explain some aspects of the pathogenesis of atrophic and dystrophic lesions in the eye fundus and optic nerve in patients with high grade myopia. ("Imaging in the Clinic", 2001, 18: 4-6)

Keywords: convergent dopplerography, vessels of the eye and orbit, clinical refraction.

Key words: convergent Doppler ultrasonography, eye and orbit vessels, clinical refraction.

The study of hemodynamic features in the vessels of the eye and orbit in individuals with various types of clinical refraction is of undoubted interest due to the fact that patients with myopia more often develop peripheral vitreochorioretinal dystrophy, which can be complicated by retinal detachment; Their glaucoma also develops differently. In the nineties, the study of hemodynamics in the ophthalmic artery basin began to be carried out using gray scale scanning, color Doppler mapping (CDC) and pulsed wave Dopplerography. There is information about the hemodynamic characteristics of the ophthalmic artery (OA), central retinal artery (CRA), posterior short ciliary arteries (PSCA) in healthy individuals of various age groups, as well as changes in hemodynamics in these vessels in some eye diseases. We came across only one work in which the authors studied hemodynamics in patients with different refractions using color circulation only in the CAS and noted a significant decrease in the blood flow velocity in it in people with high myopia.

Currently, the most modern sensitive method for studying the architectonics and hemodynamic characteristics of the vascular system of the eye and orbit is the convergent Doppler mode - a combination of color Doppler mapping and power Doppler - in which blood flows are simultaneously encoded by speed and kinetic energy and their images are summed up.

We have not found any information on hemodynamic studies in the HA, CAS, CCCA, posterior long ciliary arteries (PLCA), central retinal vein (CRV), superior orbital vein (SOV) in patients with different clinical refractions, performed using convergent Dopplerography in the available literature .

Material and methods

The studies were carried out on the Acuson Aspen multi-purpose diagnostic system using an electronic linear sensor with an operating frequency of 7.5 MHz. Scanning of the eyeball was carried out with the patient lying down, through the upper eyelid, using a regular contact gel for ultrasound examinations.

At the beginning, the posterior pole of the eyeball and the contents of the orbit with the optic nerve were visualized in gray scale mode. Then, in the Color Doppler mode, using the convergent Doppler channel, the location of the vessel under study, the direction of blood flow in it were determined, and using pulsed wave Dopplerography, hemodynamic characteristics were recorded in the arteries: maximum systolic blood flow velocity (Vmax), end diastolic blood flow velocity (Vmin), maximum average cardiac cycle blood flow velocity (Vmed) in cm/s, resistance index (RI), pulsatility index (PI), systole-diastolic ratio (Ratio), coded blood flow width (W) in mm. Hemodynamic characteristics were determined in the GA, CAC, ZCCA, and PDCA. In the veins (CVS and IHV), Vmax and W were determined.

The studies were carried out on 32 healthy volunteers (64 eyes) aged from 18 to 55 years (25 women and 7 men). Emmetropic refraction was present in 30 eyes, weak or moderate myopia in 22 eyes, and high myopia in 12 eyes.

Statistical processing of the results was carried out using Microsoft Excel and Statistica software packages. Differences at p<0,05.

Results and its discussion

The obtained data (M+/-m) are presented in tables 1-3.

As can be seen from table. 1, differences in hemodynamic parameters in GA in patients with different types of clinical refraction are few and insignificant. We recorded an increase in Vmin and a decrease in W in patients with mild and moderate myopia compared to emmetropes. At the same time, in the CAS there was a significant decrease in Vmax, Vmed and W in patients with high myopia in comparison with groups with emmetropia and low and moderate myopia, which is consistent with literature data.

Table 1. Hemodynamic parameters in the ophthalmic artery and central retinal artery for various types of clinical refraction

Index	Orbital artery			Central retinal artery
	Emmetropia	Myopia is weak and medium degree	High myopia degrees	Emmetropia	Myopia is weak and medium degree	High myopia degrees
Vmax, cm/s	35,5+/-1,7	38,9+/-2,2	40,0+/-3,3	12,1+/-0,8 (2)	11,0+/-0,6 (3)	8,5+/-0,6 (2, 3)
Vmin, cm/s	9,0+/-0,5 (1)	11,3+/-1,2 (1)	11,2+/-1,3	3,1+/-0,4	2,9+/-0,6	2,6+/-0,4
Vmed, cm/s	18,3+/-0,9	20,2+/-1,2	21,2+/-2,1	6,3+/-0,5 (2)	6,0+/-0,4 (3)	4,6+/-0,4 (2, 3)
R.I.	0,74+/-0,01	0,71+/-0,02	0,72+/-0,02	0,74+/-0,02	0,74+/-0,02	0,71+/-0,03
PI	1,78+/-0,07	1,43+/-0,12	1,42+/-0,10	1,47+/-0,07	1,45+/-0,11	1,39+/-0,11
Ratio	4,41+/-2,14	3,80+/-0,29	3,84+/-0,29	4,33+/-0,33	4,76+/-0,52	4,11+/-0,61
W, mm	1,78+/-0,09 (1)	1,31+/-0,07 (1)	1,47+/-0,09	1,47+/-0,08 (1, 2)	1,48+/-0,06 (1)	1,36+/-0,12 (2)

Note: here and in tables 2, 3:
(1) - values ​​​​are noted that are statistically significantly different for emmetropia and myopia of weak and moderate degrees
(2) - values ​​that are statistically significantly different for emmetropia and high myopia are noted
(3) - values ​​that are statistically significantly different for low and moderate myopia and high myopia are noted.

The most interesting are the changes we recorded in hemodynamic parameters in the CCCA (Table 2). With high myopia, apparently due to an increase in the length of the anterior-posterior axis of the eyeball and stretching of its membranes, there is a sharp decrease in Vmax, Vmin Vmed and an increase in RI, PI, and Ratio, which indicates a significant increase in vascular resistance in the area of ​​the CPCA and decreased blood supply to the choroid, the vascular network of which is formed by these arteries.

In the PDCA with high myopia, we noted only a decrease in W.

Table 2. Hemodynamic parameters in the posterior short and posterior long ciliary arteries for various types of clinical refraction

Index	ZKCA			ZDCA
	Emmetropia	Myopia is weak and medium degree	High myopia degrees	Emmetropia	Myopia is weak and medium degree	High myopia degrees
Vmax, cm/s	31,1+/-0,8 (2)	11,6+/-0,7	9,9+/-0,7 (2)	16,0+/-0,8	15,8+/-1,5	16,4+/-1,5
Vmin, cm/s	4,4+/-0,4 (2)	4,2+/-0,3 (3)	2,9+/-0,3 (2, 3)	5,7+/-0,4	5,9+/-0,6	6,5+/-0,7
Vmed, cm/s	7,7+/-0,6 (2)	7,0+/-0,4 (3)	5,5+/-0,4 (2, 3)	9,8+/-0,5	9,9+/-1,0	9,2+/-1,1
R.I.	0,67+/-0,02	0,64+/-0,02 (3)	0,70+/-0,02 (3)	0,64+/-0,02	0,62+/-0,02	0,60+/-0,03
PI	1,18+/-0,05	1,07+/-0,04 (3)	1,28+/-0,08 (3)	1,07+/-0,04	1,01+/-0,07	0,96+/-0,07
Ratio	3,32+/-0,21	2,89+/-0,13 (3)	3,59+/-0,29 (3)	3,04+/-0,18	2,74+/-0,16	2,97+/-0,42
W, mm	0,77+/-0,04 (1, 2)	0,59+/-0,04 (1)	0,68+/-0,06 (2)	0,91+/-0,04 (2)	0,80+/-0,04	0,75+/-0,05

In table Figure 3 presents the hemodynamic characteristics of CVT and HBV in our patients. We found smaller values ​​of Vmax and W in the central CVS in individuals with myopic refraction compared to emmetropes and a decrease in W in the CVV in those examined with high myopia compared to patients with low and moderate myopia.

Table 3. Hemodynamic parameters in the central retinal vein and superior ophthalmic vein for various types of clinical refraction

Conclusion

Using convergent Doppler sonography, we detected a significant decrease in blood flow velocities not only in the CAC, but also in the CCCA in individuals with high myopia. Moreover, an increase in RI, PI, Ratio in the CCCA indicates a significant obstruction of blood flow in the choroid proper in this category of patients.

The deterioration of hemodynamic parameters we recorded explains the vascular aspects of the pathogenesis of the occurrence of atrophic and dystrophic changes in the structures of the fundus (maculopathy, false staphyloma, some types of vitreochorioretinal dystrophy) and the optic nerve in individuals with high myopia.

Literature

1. Plotnikova Yu.A., Chuprov A.D., Tarlovsky A.K. Analysis of the results of Dopplerography of the central retinal artery in normal conditions and in various ocular pathologies. Bulletin of Ophthalmology, 1999, 9: 17.
2. Rykun V.S., Katkova E.A., Solyannikova O.V., Peutina N.V. Age-related changes in blood flow in the vessels of the eye and orbit according to complex ultrasound examination. Imaging in Clinic, 2000, 16:28.
3. Kharlap S.I., Shershnev V.V. Color Doppler mapping of the central retinal artery, central retinal vein and orbital arteries. Imaging in Clinic, 1992, 1: 19.
4. Baxter G.M., Williamson T.N. Color Doppler imaging of the eye: normal ranges, reproducibility and observer variation. J. Ultrasound Med., 1995, 14(2): 91-96.
5. Kaiser H.J., Schotxau A., Flammer J. Blood-now velocities in the extraocular vessels in normal volunteers. Am. J. Ophthalmol, 1996, 122(3): 364-370.
6. Liu C.J., Chou Y.H., Chou J.C. Retrobulbar haemodynamic changes studied by color Doppler imaging in glaucoma. Eye, 1997, 11 (Pt 6): 818-826.
7. Mendivil A., Cuartero V., Mendivil M.P Color Doppler imaging of the ocular vessels. Graefes Archive for Clinical & Experimental Ophthalmology, 1995, 233(3): 135-139.
8. Pichot O., Gonzalvez V., Franco A. et al. Color Doppler ultrasonography in the study of orbital and ocular vascular diseases. J.Fr. Ophtalmol., 1996, 19 (1): 19-31.
9. Venturini M., Zaganelli E., Angeli E. et al. Ocular color Doppler echography: the examination technique, identification and flowmetry of the orbital vessels. Radiologia Medica, 1996, 91(1-2): 60-65.

To assess the thin and fragile tissues of the eye, as well as its vessels, it is necessary to use a special technique - ultrasound with Doppler. Today, this is practically the only way in which it is possible to fully see, without causing any harm to the patient, how correctly the vessels of the eye work and how blood flows in them.

General characteristics of the examination

The blood supply to the eyes comes from the internal carotid artery. It is divided into the central retinal artery, the orbital artery and some others. The functional state of the eyes, as well as visual acuity, are very dependent on the blood supply, and its disruption can be the cause of many pathologies.

A study of blood vessels using Doppler ultrasound will determine whether there is a violation of blood flow in the eyes. This is an accessible, non-invasive, safe and painless diagnostic method, which is also highly informative.

can be used both for the primary diagnosis of blood flow pathologies in the ocular vessels, and for continuous monitoring of the condition.

Diseases for which the procedure is indicated

Dopplerography of the eye (what such a study reveals will be described below) is usually prescribed as a clarifying procedure if the patient has certain diseases.

Hypertonic disease

Since it is the heart that is responsible for the quality of blood flow in general, in case of hypertension it is recommended to perform Doppler ultrasound of the ophthalmic arteries to understand whether the underlying disease affects their function and visual acuity. It is especially important to carry out this diagnosis if the patient complains of a feeling of a veil before the eyes or decreased visual ability.

Diabetes

Diabetes mellitus is a disease that can negatively affect the functionality of almost any organ, including the eyes. Elevated blood sugar leads to fragility of the eye vessels, as a result of which periodic microbleeds occur in the retina, and vision steadily declines. To keep the condition of the eye vessels under control, it is recommended to periodically undergo ultrasound examination.

Glaucoma

Glaucoma is a whole group of eye pathologies in which there is a constant or periodic increase in intraocular pressure. As glaucoma develops, the patient begins to experience a decrease in visual acuity due to optic nerve atrophy and visual field defects.

By performing Doppler ultrasound of the vessels of the eye, you can not only confirm or refute glaucoma, but also determine its type. For example, the open-angle form is characterized by a decrease in peak systolic blood flow velocity, end-diastolic blood flow velocity and an increase in the resistance index.

Stroke

During and after a stroke, along with impaired cerebral circulation, impaired blood flow in the vessels of the eyes can also be observed. Therefore, doctors recommend examining them using Doppler ultrasound.

Myopia and hypermetropia

When myopia (myopia) and farsightedness (hypermetropia) begin to actively progress, it is worth undergoing an ultrasound of the eye vessels with Doppler to understand whether this is due to impaired blood flow.

Indications for ultrasound scanning include:

Sudden loss of vision

The indication for an urgent examination and ultrasound examination of the eye vessels (what it is is described above) is the patient’s complaint of a sudden loss of vision or a decrease in its acuity. The cause of this problem may be a violation of blood flow in the vessels of the eyes. Also, loss of vision can be caused by eye injury; in this case, it is also recommended to undergo an ultrasound with Doppler to understand how damaged the circulatory system is.

Feeling of fullness in the eyes

A feeling of fullness in the eyes, which is also accompanied by a headache, may be a symptom of intracranial hypertension, spasm or dilatation of cerebral vessels. Damage to the eye vessels themselves is also possible. An ultrasound with Doppler will help you figure this out.

Frequent headaches radiating to the eyes

When a headache “radiates” to the eyes, doctors recommend undergoing an ultrasound with Doppler and examining not only cerebral circulation, but also blood flow in the eye vessels. Perhaps we are talking about a pre-stroke condition, which can be identified using this diagnosis and then effective treatment can be prescribed.

Loss of visual fields

Loss of visual fields is a decrease in the coverage of visible space with a fixed gaze. The cause of this pathology may be a cerebrovascular accident or a stroke. As a rule, in such situations, Doppler ultrasound of the vessels of the eye is prescribed (what such an examination will show will be explained in detail by the attending physician).

How is an ultrasound scan of the vessels of the eye and orbit done?

To undergo the examination, the patient must lie on the couch and close his eyes. A thick gel is applied to the eyelids to improve contact with the sensor. The duration of the procedure is approximately 20-30 minutes for both eyes. The main vessels of the eye are examined: the orbital artery, the posterior short ciliary arteries, the central retinal artery, the central retinal vein, the superior ophthalmic vein.

Interpretation of results

During the ultrasound examination, several indicators are determined, the values ​​of which are then compared with the norm:

• max systolic blood flow velocity in the vessels of the eye;
• min diastolic blood flow velocity in the vessels of the eye;
• resistance index;
• pulsation index;
• the ratio of systolic and diastolic blood flow velocity.

Most often, vascular pathology is discussed when there is a decrease in the values ​​of all of the listed indicators.