Ultrasound Biomicroscopy in Diagnosis of Anterior Segment Pathology

Introduction Ultrasound biomicroscopy (UBM) is a non-invasive diagnostic procedure, developed in order to achieve better visualization of the anterior segment of the eye. The first clinical images were made in March 1990. The use of UBM at the Institute for Eye Diseases, Clinical Centre of Serbia, began in February 2007. Outline of Cases Due to a drop in visual acuity, the first patient was sent to the Institute for Eye Diseases, Clinical Centre of Serbia. The existence of the ciliary body tumour was suspected, so she underwent a UBM diagnostic procedure. UBM showed fibrin in the anterior chamber of the eye, occlusion of the pupil, and the absence of tumour. The second patient had a part of the chamber angle filled with solid lesion. UBM showed a solid tumour lesion filling the chamber angle in the lower part of the anterior chamber. The origin of the tumour was the ciliary body rather,than the choroid which was shown by the B scan ultrasound. Lipodermoid was found by clinical examination of the third patient. He underwent UBM in order to exclude the involvement of the sclera under the lesion. UBM visualized a subconjunctival lesion lying on the sclera, reaching the limbus of the cornea. The difference in ultrasound reflection of the two tissues helped us to confirm that the sclera was not involved. Our fourth patient underwent an antiglaucomatous procedure, and the assessment of the chamber angle opening was the reason for the UBM examination. Parameters measured in the lower quadrants (6 o'clock) that we managed to obtain were the following: AOD (250 mu m) - 180 mu m, AOD (500 mu m) - 400 mu m, TIA - 34.39 deg., ARA - 0.25 mm(2). Comparing them to normal values, we came to the conclusion that the chamber angle was open in the lower part of the anterior chamber. Conclusion Ultrasound biomicroscopy gives us plenty of useful information when it comes to diagnosing the anterior chamber pathology.