title: Test characteristics of point-of-care ultrasonography for the diagnosis of acute posterior ocular pathology.
abstract: OBJECTIVE
  The objective of this study was to determine the test characteristics of point-of-care ultrasonography (POCUS) for the diagnosis of retinal tear (RT), retinal detachment (RD), posterior vitreous detachment (PVD), and vitreous hemorrhage (VH).
  
  
  METHODS
  A prospective observation study on a convenience sample of patients presenting to a tertiary care emergency general ophthalmology clinic was performed.
  
  
  METHODS
  Adult patients with acute flashes/floaters or new visual field defects were included (n = 62).
  
  
  METHODS
  POCUS was performed by a study sonographer and compared with a retina specialist examination without sonography imaging. Sonographers were masked to clinical information. Follow-up was performed by a 6-week health records review. The primary outcome was the diagnosis of RD/RT, PVD, and VH. Analyses included descriptive statistics and test characteristics.
  
  
  RESULTS
  A total of 62 patients with a mean age of 60.8 years were enrolled; 62.9% were female. The mean time to scan required was 7.4 minutes. There was no change in diagnosis at 6 weeks. The sensitivities and specificities, respectively, are as follows: any pathology (n = 60) 88.3% (95% CI 86.8%-89.9%) and 50% (95% CI 2.7%-97.3%); RD (n = 6) 100% (95% CI 53.9%-100%) and 67.9% (95% CI 62.9%-67.9%); RD/RT (n = 23) 47.8% (95% CI 30.8%-62.2%) and 82.1% (95% CI 72.0%-90.6%); PVD (n = 47) 80.9% (95% CI 74.7%-88.0%) and 33.3% (95% CI 14.0%-55.7%); and VH (n = 14) 43.0% (95% CI 21.4%-58.0%) and 93.8% (95% CI 87.5%-98.2%).
  
  
  CONCLUSIONS
  Ocular POCUS detected all RDs but has limited use for the diagnosis of RTs. Patients with suspected acute ocular posterior pathology should be referred to ophthalmology independent of ocular POCUS.
authors: Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont; Ottawa Hospital Research Institute, Ottawa, Ont. Electronic address: mwoo@toh.on.ca.
authors: Michael Y
authors: MY
authors: Woo
authors: Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont.
authors: Nathan
authors: N
authors: Hecht
authors: Department of Ophthalmology, University of Ottawa Eye Institute at the Ottawa Hospital.
authors: Bernard
authors: B
authors: Hurley
authors: Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont.
authors: David
authors: D
authors: Stitt
authors: Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont; Ottawa Hospital Research Institute, Ottawa, Ont; Department of Epidemiology and Community Medicine.
authors: Venkatesh
authors: V
authors: Thiruganasambandamoorthy
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D057972:Posterior Eye Segment / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012163:Retinal Detachment / Q000000981:diagnostic imaging*; D012167:Retinal Perforations / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D016683:Supine Position; D014463:Ultrasonography; D020255:Vitreous Detachment / Q000000981:diagnostic imaging*; D014823:Vitreous Hemorrhage / Q000000981:diagnostic imaging*