Ocular Publications

Retinal Detachment

• Gottlieb M, Holladay D, Peksa GD. Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis. Acad Emerg Med. 2019 Aug;26(8):931-939. PMID: 30636351.
• Sensitivity: 94.2% (95% CI 78.4%-98.6%)
• Specificity 96.3% (95% CI 89.2%-98.8%)
• Positive likelihood ratio 25.2 (95% CI 8.1-78.0)
• Negative likelihood ratio 0.06 (95% CI 0.01-0.25).

Optic Nerve

• Teismann N, Lenaghan P, Nolan R, Stein J, Green A. Point-of-care ocular ultrasound to detect optic disc swelling. Acad Emerg Med. 2013 Sep;20(9):920-5. PMID: 24050798.

Blinded, prospective study of 14 patients presenting to a neuroophthalmology clinic at risk for conditions associated with optic disc edema. Two EPs performed PoCUS examinations. Patients then underwent standard clinical assessment by a specialist. Disc swelling on dilated fundoscopic exam occurred in 11 of 28 eyes. Disc height > 0.6 mm on PoCUS predicted optic disc edema on fundoscopic exam with sensitivity of 82% (95% CI 48%-98%) and a specificity of 76% (95% CI 50%-93%). Disc height > 1.0 mm –> sensitivity of 73% (95% CI 39%-94%) and specificity of 100%(95% CI 81%-100%).

• Tessaro MO, Friedman N, Al-Sani F, Gauthey M, Maguire B, Davis A. Pediatric point-of-care ultrasound of optic disc elevation for increased intracranial pressure: A pilot study. Am J Emerg Med. 2021 May 21;49:18-23. PMID: 34051397.

Retrospective review of patients from tertiary pediatric ED who had ocular POCUS and within 48h underwent ICP determination. 76 eyes from 40 patients analyzed; 26 patients had increased ICP. The optimal optic disc elevation cutoff was 0.66 mm, with a sensitivity of 96% (95% CI 79-100%) and a specificity of 93% (95% CI 79-100%). 1/40 (2.5%) of patients with optic disc elevation < 0.66 had increased ICP.

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