Detection of metallic ocular foreign bodies with handheld sonography in a porcine model

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective. Eye conditions are common in emergency departments. Intraocular foreign bodies (IOFBs) are a frequent concern. Orbital computed tomography (CT) is traditionally used for evaluation. We sought to evaluate bedside ocular sonography for detecting metallic IOFBs. Methods. A pig model was chosen. A micrometer was used to create 3 precise metallic fragments: 0.012 × 0.012 × 0.012, 0.025 × 0.025 × 0.012, and 0.05 × 0.05 × 0.012 in. Individual eyes were randomized to the presence or absence of a foreign body. Randomization was also used to determine the specific size of any given IOFB. A standard 18-gauge spinal needle was used to puncture the sciera and introduce the IOFB into the vitreous. Each eye was then evaluated by 2 sonologists for the presence or absence of an IOFB. Results. A total of 28 eyes were used; 12 (43%) were randomized to no IOFB ahd 16 (57%) to the presence of an IOFB. Of the 16 eyes that received IOFBs, 8 (50%) were 0.012 × 0.012 × 0.012 in; 5 (31%) were 0.025 × 0.025 × 0.012 in; and 3 (19%) were 0.05 × 0.05 × 0.012 in. Sensitivity was 87.5% and specificity 95.8%. Positive predictive value (PPV) and negative predictive value (NPV) were 96.5% and 85.2%, respectively. Conclusions. Bedside sonography may identify the presence of metallic IOFBs. The PPV allows a high degree of certainty that an IOFB is actually present if seen and may negate the need for uninfused orbital CT. The NPV was 85.2%. Given the potential grave consequences of a missed IOFB, sonography cannot be used as the definitive test to rule out the presence of a metallic IOFB. In the presence of negative findings, further imaging is warranted.

Original languageEnglish (US)
Pages (from-to)1341-1346
Number of pages6
JournalJournal of Ultrasound in Medicine
Volume24
Issue number10
DOIs
StatePublished - Jan 1 2005

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Eye Foreign Bodies
Foreign Bodies
Ultrasonography
Swine
Tomography

Keywords

  • Emergency medicine
  • Emergency sonography
  • Ocular foreign bodies
  • Ocular sonography
  • Portable sonography
  • Sonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Detection of metallic ocular foreign bodies with handheld sonography in a porcine model. / Shiver, Stephen A; Lyon, Matthew L; Blaivas, Michael.

In: Journal of Ultrasound in Medicine, Vol. 24, No. 10, 01.01.2005, p. 1341-1346.

Research output: Contribution to journalArticle

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title = "Detection of metallic ocular foreign bodies with handheld sonography in a porcine model",
abstract = "Objective. Eye conditions are common in emergency departments. Intraocular foreign bodies (IOFBs) are a frequent concern. Orbital computed tomography (CT) is traditionally used for evaluation. We sought to evaluate bedside ocular sonography for detecting metallic IOFBs. Methods. A pig model was chosen. A micrometer was used to create 3 precise metallic fragments: 0.012 × 0.012 × 0.012, 0.025 × 0.025 × 0.012, and 0.05 × 0.05 × 0.012 in. Individual eyes were randomized to the presence or absence of a foreign body. Randomization was also used to determine the specific size of any given IOFB. A standard 18-gauge spinal needle was used to puncture the sciera and introduce the IOFB into the vitreous. Each eye was then evaluated by 2 sonologists for the presence or absence of an IOFB. Results. A total of 28 eyes were used; 12 (43{\%}) were randomized to no IOFB ahd 16 (57{\%}) to the presence of an IOFB. Of the 16 eyes that received IOFBs, 8 (50{\%}) were 0.012 × 0.012 × 0.012 in; 5 (31{\%}) were 0.025 × 0.025 × 0.012 in; and 3 (19{\%}) were 0.05 × 0.05 × 0.012 in. Sensitivity was 87.5{\%} and specificity 95.8{\%}. Positive predictive value (PPV) and negative predictive value (NPV) were 96.5{\%} and 85.2{\%}, respectively. Conclusions. Bedside sonography may identify the presence of metallic IOFBs. The PPV allows a high degree of certainty that an IOFB is actually present if seen and may negate the need for uninfused orbital CT. The NPV was 85.2{\%}. Given the potential grave consequences of a missed IOFB, sonography cannot be used as the definitive test to rule out the presence of a metallic IOFB. In the presence of negative findings, further imaging is warranted.",
keywords = "Emergency medicine, Emergency sonography, Ocular foreign bodies, Ocular sonography, Portable sonography, Sonography",
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AU - Lyon, Matthew L

AU - Blaivas, Michael

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N2 - Objective. Eye conditions are common in emergency departments. Intraocular foreign bodies (IOFBs) are a frequent concern. Orbital computed tomography (CT) is traditionally used for evaluation. We sought to evaluate bedside ocular sonography for detecting metallic IOFBs. Methods. A pig model was chosen. A micrometer was used to create 3 precise metallic fragments: 0.012 × 0.012 × 0.012, 0.025 × 0.025 × 0.012, and 0.05 × 0.05 × 0.012 in. Individual eyes were randomized to the presence or absence of a foreign body. Randomization was also used to determine the specific size of any given IOFB. A standard 18-gauge spinal needle was used to puncture the sciera and introduce the IOFB into the vitreous. Each eye was then evaluated by 2 sonologists for the presence or absence of an IOFB. Results. A total of 28 eyes were used; 12 (43%) were randomized to no IOFB ahd 16 (57%) to the presence of an IOFB. Of the 16 eyes that received IOFBs, 8 (50%) were 0.012 × 0.012 × 0.012 in; 5 (31%) were 0.025 × 0.025 × 0.012 in; and 3 (19%) were 0.05 × 0.05 × 0.012 in. Sensitivity was 87.5% and specificity 95.8%. Positive predictive value (PPV) and negative predictive value (NPV) were 96.5% and 85.2%, respectively. Conclusions. Bedside sonography may identify the presence of metallic IOFBs. The PPV allows a high degree of certainty that an IOFB is actually present if seen and may negate the need for uninfused orbital CT. The NPV was 85.2%. Given the potential grave consequences of a missed IOFB, sonography cannot be used as the definitive test to rule out the presence of a metallic IOFB. In the presence of negative findings, further imaging is warranted.

AB - Objective. Eye conditions are common in emergency departments. Intraocular foreign bodies (IOFBs) are a frequent concern. Orbital computed tomography (CT) is traditionally used for evaluation. We sought to evaluate bedside ocular sonography for detecting metallic IOFBs. Methods. A pig model was chosen. A micrometer was used to create 3 precise metallic fragments: 0.012 × 0.012 × 0.012, 0.025 × 0.025 × 0.012, and 0.05 × 0.05 × 0.012 in. Individual eyes were randomized to the presence or absence of a foreign body. Randomization was also used to determine the specific size of any given IOFB. A standard 18-gauge spinal needle was used to puncture the sciera and introduce the IOFB into the vitreous. Each eye was then evaluated by 2 sonologists for the presence or absence of an IOFB. Results. A total of 28 eyes were used; 12 (43%) were randomized to no IOFB ahd 16 (57%) to the presence of an IOFB. Of the 16 eyes that received IOFBs, 8 (50%) were 0.012 × 0.012 × 0.012 in; 5 (31%) were 0.025 × 0.025 × 0.012 in; and 3 (19%) were 0.05 × 0.05 × 0.012 in. Sensitivity was 87.5% and specificity 95.8%. Positive predictive value (PPV) and negative predictive value (NPV) were 96.5% and 85.2%, respectively. Conclusions. Bedside sonography may identify the presence of metallic IOFBs. The PPV allows a high degree of certainty that an IOFB is actually present if seen and may negate the need for uninfused orbital CT. The NPV was 85.2%. Given the potential grave consequences of a missed IOFB, sonography cannot be used as the definitive test to rule out the presence of a metallic IOFB. In the presence of negative findings, further imaging is warranted.

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KW - Portable sonography

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