Diagnostic Accuracy of Ocular Ultrasound in Assessment of Vitreous Hemorrhage and Associated Ocular Diseases

Background: Vitreous hemorrhage (VH) is a significant ophthalmic condition with a yearly incidence ranging from 7.4 to 15.4 per 100,000 people. Its primary causes include proliferative diabetic retinopathy (PDR), ocular trauma, and other retinal vascular disorders. Ocular ultrasound is increasingly utilized as a rapid, non-invasive diagnostic tool to assess vitreous hemorrhage and related ocular conditions. Objective: This study aimed to evaluate the diagnostic accuracy of ocular ultrasound in detecting vitreous hemorrhage and associated ocular diseases in a clinical setting. Methods: A cross-sectional observational study was conducted at the University of Lahore Teaching Hospital from October 09, 2023, to March 21, 2024. The study included 70 symptomatic patients diagnosed with acute age-related vitreous hemorrhage. Detailed ophthalmic examinations were performed using noncontact or three-mirror lenses, slit-lamp vitreous biomicroscopy, and indirect binocular ophthalmoscopy. B-scan ocular ultrasound, with a focused probe of 7.5 MHz and high-sensitivity gain settings, was employed to perform echographic tests. Data on demographic details, medical history, clinical findings, and ultrasound results were collected and analyzed using SPSS version 25. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated to determine the diagnostic efficacy of ocular ultrasound. Results: Out of 70 patients, 43 (61.42%) were males and 27 (38.60%) were females. The age distribution showed 50 patients (71.42%) were under 50 years old, while 20 patients (28.60%) were over 50 years old. The causes of vitreous hemorrhage included proliferative diabetic retinopathy (30%), penetrating trauma (24.3%), post-intraocular surgery (11.42%), and blunt trauma (10%). The diagnostic accuracy of ocular ultrasound for detecting vitreous hemorrhage demonstrated a sensitivity of 77.8%, specificity of 35.3%, PPV of 56.0%, NPV of 60.0%, and an overall accuracy of 57.14%. Conclusion: Ocular ultrasound proved to be a valuable, non-invasive diagnostic tool with high sensitivity for detecting vitreous hemorrhage, though its specificity was moderate. While useful for initial assessments, especially in emergency settings, it should be supplemented with comprehensive ophthalmic examinations for accurate diagnosis and management of vitreous hemorrhage.