Value of high-frequency ultrasound biomicroscopy in uveitis

Purpose To determine the use of high-frequency ultrasound biomicroscopy (UB M) in the assessment of inflammatory lesions of the iris, ciliary body, par s plana and peripheral vitreous, and in particular to determine the proport ion of cases for which UBM contributed significant additional, hitherto ina ccessible, information. Methods Charts of patients seen in the uveitis clinic at University Eye Hos pital from November 1994 to September 1999 for whom a UBM investigation had been performed were analysed. UBM was performed in a standard manner, usin g a Humphrey UBM 840 system. The clinical relevance of the UBM findings was determined for the whole series and for the following six subgroups of pat ients arbitrarily established according to the type and location of patholo gy: hypotony, pseudophakic uveitis, iris and ciliary body pathology excludi ng hypotony, pars plana pathology, scleritis and Toxocara uveitis. Findings were classified as positive when they confirmed a suspected diagnosis of l esional process or when they gave essential information. Findings were clas sified as essential when they led to the diagnosis or when they modified th erapeutic intervention. Results During the study period 111 eyes of 77 patients were included. UBM findings contributed essential information that allowed a diagnosis to be r eached or that influenced treatment in 43% of cases. It yielded positive fi ndings in 91% of cases, enabling assessment of morphological changes in the iris, ciliary body, and retroiridal and peripheral vitreous induced by int raocular inflammatory or pseudo-inflammatory disorders. Specific UBM signs, present in all patients, were identified in Toxocara uveitis. The groups o f patients that benefited most from UBM examination were those with hypoton y (83% essential findings) and opaque media (100% essential findings). Conclusion For uveitis patients with an inflammatory process situated in th e iris/ ciliary body/pars plana/retroiridal vitreous areas, UBM was of grea t clinical value and improved the management in a significant manner.