Diapositiva 1

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FURTHER IMPROVEMENT IN HIGH FREQUENCY OPHTHALMIC
ULTRASONOGRAPHY FOR OCULAR ONCOLOGY- THE CLOSED
PROBE SYSTEM Vincenzina Mazzeo Simonini
Studio Zavarini, Ferrara, Italy Weill
Medical College, Cornell University, New York,
NY, USA Laura Lodi U.O. di
Oculistica, Ospedale Maggiore, Bologna, Italy
INTERNATIONAL SOCIETY of OCULAR
ONCOLOGY MEETING
SIENNA- Italy 26-30 June
2007 Final Programme and
Abstracts Book, p. 278
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A the anterior segment probes are sealed into a
plastic cylinder closed by a biocompatible
polyethylene film. The transducer is immersed in
distilled water.
A
B on the left the 25 MHz probe (nominal
frequency) to examine the posterior pole on the
right the 35 MHz probe to examine the anterior
segment. The first one has to be used on the
conjunctiva, the second one may be used both on
conjunctiva or on the lid. To be noticed the
different distance of the transducer from the
position of the polyethylene film
Mini immerse technique, the plastic cup is full
of balanced salt solution or metil cellulose. Not
to be used in perforated and/or hypotonic eyes,
difficult to use in young children and
uncooperative patients.
B
Examination of the inferior
peripheral aspect of the eye in an adult patient
and in a paediatric one.
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Peripheral Choroidal Malignant Melanoma at 6
ok. a mini immerse tech. 50MHz. The lesion is
incomplete b-c 35 MHz probe, the mushroom shape
is better displayed along with the base, both on
a
b
c
d
a
the longitudinal (b) and transversal sections
(c). d image at 10 scanning angle
20 M H z and 35
As a
As b
As c
Dome shaped CMM

Normal ciliary body
Normal CB peripheral CMM. Longitudinal section
on the left, transversal on the right. To be
noticed the very clear posterior boundary of the
lesion (arrow) an the liquid bleb on its top
(star)
Barely visible (arrows) Peripheral CMM
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Mushroom shaped CMM (20
and 35 MHz)
Part of the base of the lesion. Image obtained
with a scanning angle of 10
The lesion shows an irregular internal structure
c
The base of the lesion is scanned in different
sections in this case the closed system is put
over the conjunctiva directly, mo sound
attenuation. Different tumour areas display areas
of different reflectivity. The last image display
an infiltration (thin arrow) under the ciliary
body (thick arrow)
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Secondary vasoproliferative retinal tumour
(20 and 35 MHz)
a
b
c
a Solid lesion mimicking a mushroom shape, any
pathognomonic echographic feature b the lesion
shows some highly reflective punctiform lesions
compatible with some jaline bodies c exudative
area
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The same lesion is scanned at 35 MHz with the
probe over the lid skin in correspondence of its
base. The images are rotated by post processing
to correspond to the other images on display.
Choroidal undetermined pigmented lesion at the
inferior quadrant. Transverse sections at 20 and
25 MHz respectively. The lesion is highly
reflective, at 25 MHz the posterior limit is
visible (arrows) in comparison to the 20MHz image
By increasing the frequency the lesion becomes
less reflective. The sound attenuation through
the skin may play a role in this finding through
sound attenuation. In the longitudinal section
(image on the right)
a
b
Choroidal undetermined pigmented lesion in the
nasal periphery. The posterior lens surface is
visible (white arrow). The lesion is less
reflective than the previous one.
b
On the left the longitudinal section the ciliary
body is visible (white arrow)
20, 25 and 35 MHz
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Choroidal undetermined pigmented lesion showing a
shallow undulate surface, high reflectivity both
at 20 and 25 MHz (on the right). The black arrows
show the posterior surface of the lesion.
Choroidal undetermined pigmented
lesion followed since 1994. Dome shape, at 25 MHz
three tiny hollows became visible (
vascular lacunae? Cystic spaces?)
(20 and 25 MHz)
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Proliferative diabetic retinopathy and
undetermined pigmented lesion adjacent to the
nasal side of the disk ( thin arrows)
undetermined pigmented lesion, low internal
reflectivity both at 20 and 25 MHz
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Choroidal Malignat Melanoma treated by external
proton beam ratiotheraphy. Irreguar surface and
shallow serous bleb better visible at 25 MHz
(thin arrow) the tantalum ring produces an
acoustic shadowing (thick arrows).
Choroidal Malignat Melanoma covering the disk
with secondary retinal detachment (thin arrows) a
layer of fluid is also present over the lesion
but is visible at 25 MHz only (red arrow).
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Thank You for your attention