Ultrasound biomicroscopy qualitative and quantitative signs of phacoantigenic uveitis

Background/objective

To describe the ultrasound biomicroscopy (UBM) diagnostic features in patients suspected of experiencing chronic inflammation due to phacoantigenic uveitis

Subjects/methods

This single-center study enrolled patients referred to the Uveitis Department of Cleveland Clinic Abu Dhabi for chronic anterior uveitis and traumatic cataract. Patients’ demographics, causes and dates of the inciting traumatic event, and ophthalmic findings were recorded. 20-MHz UBM assessment of the status of the anterior capsule and the crystalline lens was performed. Then, cataract surgery was performed using a single technique. Comparison of the anterior capsule and lens status by clinical, UBM, and intraoperative evaluation.

Results

Forty eyes with phacoantigenic uveitis were considered. The slit-lamp examination could identify interruption of the anterior capsule in 20% of the eyes and liquefied sinking lens material in 10%. An intra-operative defect in the anterior capsule was documented in 87.5% of eyes. UBM imaging showed anterior capsule irregularity in 63.3% of eyes and confirmed the presence of anterior capsule defects in 47.5% and lens matter herniating into the anterior chamber in 15%. Hypoechogenic lacunae within the cataractous lens were detected in 12.5% of eyes. For UBM, sensitivity and specificity values were 82.86% (95% CI: 66.35–93.44) and 100% (95% CI: 47.82–100), respectively. Positive and negative predictive values for UBM were 100% (95% CI: 88.06–100) and 45.45% (95% CI: 28.69–63.32), respectively. The overall diagnostic accuracy of UBM was 85% [95% CI: 70.16–94.29].

Conclusion

Ultrasound Biomicroscopy (UBM) is essential for assessing suspected anterior capsule ruptures in phacoantigenic uveitis cases.