title: B-scan ultrasonography to screen for retinal tears in acute symptomatic age-related posterior vitreous detachment.
abstract: OBJECTIVE
  To evaluate the performance characteristics of B-scan ultrasonography (US) as a diagnostic test for the detection of retinal tears in acute symptomatic age-related posterior vitreous detachment (PVD).
  
  
  METHODS
  Evaluation of a diagnostic test through a cross-sectional study with prospective data collection. The study intended to meet the 14 items proposed by the Quality Assessment of Diagnostic Accuracy Studies panel.
  
  
  METHODS
  Two hundred thirty-nine patients with acute-onset age-related PVD were consecutively enrolled in a nonreferral hospital.
  
  
  METHODS
  Comprehensive eye examination including vitreous and retinal biomicroscopy was performed on an emergency basis followed by blind B-scan kinetic US. Sensitivity, specificity and predictive values of the index test (B-scan US) were analyzed and compared with the standard reference (baseline examination). In cases of disagreement between both diagnostic methods, a new gold standard was established based on the findings of subsequent directed indirect ophthalmoscopy based on the echographic findings. Positive and negative likelihood ratios and a likelihood nomogram with pretest and posttest odds of retinal tears were calculated for B-scan US.
  
  
  METHODS
  Index test performance for the detection of retinal tears secondary to age-related PVD.
  
  
  RESULTS
  Both diagnostic methods performed comparably. The sensitivity of B-scan US for detection of retinal tears was 96% and that of baseline examination was 89%. Both methods had similar negative predictive values of 99%. B-scan US specificity was 98%. The estimated pretest and posttest probability for a positive B-scan US were 10.8% and 89%, respectively.
  
  
  CONCLUSIONS
  Proper B-scan kinetic US is a noninvasive and accurate diagnostic method for the detection of retinal tears that can be reliably used in no view or small pupil cases with symptomatic PVD.
  
  
  BACKGROUND
  The authors have no proprietary or commercial interest in any of the materials discussed in this article.
authors.affiliation: Ophthalmology Department, POVISA Hospital, Vigo, Spain. josel.carrero@yahoo.es
authors.forename: Jose
authors.initials: J
authors.lastname: Lorenzo-Carrero
authors.forename: Ines
authors.initials: I
authors.lastname: Perez-Flores
authors.forename: Monica
authors.initials: M
authors.lastname: Cid-Galano
authors.forename: Marta
authors.initials: M
authors.lastname: Fernandez-Fernandez
authors.forename: Fernando
authors.initials: F
authors.lastname: Heras-Raposo
authors.forename: Ramon
authors.initials: R
authors.lastname: Vazquez-Nuñez
authors.forename: Marta
authors.initials: M
authors.lastname: Lopez-Fuentes
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D012167:Retinal Perforations / Q000000981:diagnostic imaging* / Q000209:etiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D020255:Vitreous Detachment / Q000150:complications / Q000000981:diagnostic imaging*