G Addabbo

Imaging Techniques in the Diagnosis of Lacrimal Sac Diverticulum

Lacrimal sac diverticulum is a rare condition characterized by a cystic structure communicating with the sac. This abnormality may be directly demonstrated by dacryocystography only in a few cases; in the remaining cases, preoperative diagnosis may be arduous. We report 3 cases of lacrimal sac diverticulum. In all patients, symptoms were represented by a palpable mass in the lacrimal sac region, associated with permanent (case 1) or episodic (cases 2 and 3) epiphora. In the first case, CT-dacryocystography revealed an apparently solid mass causing inferior lacrimal obstruction, and ultrasonography disclosed a cystic space, not communicating with the sac. At surgery, a sac diverticulum was identified and excised. In the second patient, CT showed a homogeneous rounded mass, whereas a cystic character was revealed by T1-weighted MRI. Dacryocystography showed a lateral impression on the lateral wall of the sac. Ultrasonography revealed a cystic space communicating with the lacrimal sac. In the third case, ultrasonography demonstrated a diverticulum. CT is often unable to discriminate tumors from lacrimal cysts, both showing a parenchymal density. MRI can differentiate lacrimal cystic spaces from solid tumors by T1 intensity and by demonstration of their walls, but it is nonspecific for diverticula. Only dacryocystography and B-scan ultrasonography can reveal the narrow communication between the sac and the diverticulum. Observation is the recommended management for asymptomatic cases.

Standardized echography, pattern electroretinography and visual-evoked potential and automated perimetry in the early diagnosis of Graves' neuropathy

Twenty-four patients (47 eyes) affected by Graves’ disease were enrolled to evaluate the role of standardized echography, pattern electroretinogram (P-ERG), visual evoked potentials (P-VEPs) and automated perimetry in the early diagnosis of the compressive optic neuropathy (CON). The P-ERG amplitude reduction was the most sensitive parameter to demonstrate an early impairment of the optic nerve (ON) function. We found a significant negative correlation between the ON diameter and the P-ERG amplitude. VEPs responses were also altered, but their ability in detecting an early ON damage was less sensitive and specific than P-ERG. The visual field damage was often aspecific and delayed with respect to electrophysiological alterations.

Alterations of the Internal Reflectivity of Extra-Ocular Muscles Associated with Several Clinical Stages of Graves’ Ophthalmopathy

In the period between February 1992 and June 1996, the authors performed extra-ocular muscle echobiometry on 163 patients with Graves’ disease. The aim of this study is the evaluation of changes occurring in several clinical stages. The authors noted an increase in internal muscular reflectivity in the advanced phases and an irregular structure in the early stages. Controversial results in the literature warrant mastery of the method and further research.

Power Doppler Ultrasonography in Ocular and Orbital Diseases

Purpose: The authors present a preliminary report to test the usefulness of a new technique called power Doppler ultrasonography (PD) in the study of orbital vessels. Material and Methods: The ophthalmic artery and vein as well as the central retinal artery and vein have been examined in 10 patients with a General Electric Logiq 5000 that allows the examination with both color Doppler ultrasonography (CD) and PD. Results: PD does not alias, is relatively angle independent and is able to better detect the pathways of these vessels. Conclusions: PD is a new promising technique that may be superior to CD in detecting orbital and ocular vessels.

Posterior scleritis : Ultrasound findings in two cases

Two cases of posterior inflammatory scleritis are described. The authors show the echographic findings, pointing out the helpfulness of diagnostic ultrasound and the crucial role in monitoring these diseases with A scan examinations to obtain clear results of therapy, even if subjective symptoms disappear.

Echographic study of the vitreoretinal interface in giant retinal tears.

Vitreous and vitreoretinal interface changes were evaluated in giant retinal tears in order to plan surgical approach. Vitreal sineresis was evident in patients affected by primary giant retinal tears; in patients affected by retinal disinsertion the vitreous was adherent to the edge of the posterior flap, and in giant retinal tears secondary to IOL implantation, posterior vitreous detachment but no sineresis was displayed.

Graves’ Disease: Measurement of the Extraocular Muscle Thickness with the Echobiometer

The authors measured extraocular muscle thickness in normal subjects and in patients affected by Graves’ disease, using a Sonomed A-2000 echobiometer (probe with 10-MHz frequency); Hertel’s exophthalmometry was also performed. Statistically significant differences in muscle thickness between normals and patients were found. This technique seems to be sufficiently useful and reliable in extraocular thickness evaluation, showing data similar to those of the recent literature.

Ultrasonographic Features and Patterns of Regression after Conservative Treatment of Retinoblastoma

The authors analyze the echographic features relative to some cases of retinoblastoma treated with conservative therapy in order to monitor the regression of the tumor consequent to the treatment.

Orbital Metastases: Echographic Findings Our Experience

In this paper the authors examine the echographic findings in 20 patients with metastatic and secondary tumors of the orbit observed at the University Eye Clinic of Ferrara (Italy) between January 1985 and August 1995. The aim of this study is to identify some typical echographic characteristics in these forms and to underline the diagnostic role of orbital echography.

Pediatric Ultrasound: A Personal Experience during the Period 1991–1994

The ultrasound examination of the eye with A and B scan has become one of the principal diagnostic methods for detecting ocular abnormalities in children because it is a non invasive technique and can be performed without resorting to general anesthesia. The authors report the most unusual and interesting cases from 1,226 examinations performed in the Department of Ophthalmology, Istituto G. Gaslini, Genova, Italy, between January 1991 and December 1994.The ultrasound examination of the eye with A and B scan has become one of the principal diagnostic methods for detecting ocular abnormalities in children because it is a non invasive technique and can be performed without resorting to general anesthesia. The authors report the most unusual and interesting cases from 1,226 examinations performed in the Department of Ophthalmology, Istituto G. Gaslini, Genova, Italy, between January 1991 and December 1994.