Abstract
Ultrasound biomicroscopy (UBM) is the only available option for noninvasive, high-resolution imaging of the intricate iridociliary complex, and for anterior segment imaging with corneal haze or opacity. While these unique features render UBM essential for specific types of trauma, congenital anomalies, and anterior segment tumors, UBM imaging has found clinical utility in a broad spectrum of diseases for structural assessments not limited to the anterior intraocular anatomy, but also for eyelid and orbit anatomy. This imaging tool has a very specific niche in the pediatric population where anterior segment disease can be accompanied by corneal opacity or clouding, and anomalies posterior to the iris may be present. Pediatric patients present additional diagnostic challenges. They are often unable to offer detailed histories or fully cooperate with examination, thus amplifying the need for high-resolution imaging. This purpose of this systematic review is to identify and synthesize the body of literature involving use of UBM to describe, evaluate, diagnose, or optimize treatment of pediatric ocular disease. The collated peer-reviewed research details the utility of this imaging modality, clarifies the structures and diseases most relevant for this tool, and describes quantitative and qualitative features of UBM imaging among pediatric subjects. This summary will include information about the specific applications available to enhance clinical care for pediatric eye disease.
摘要
对于复杂的虹膜睫状体结构以及合并角膜混浊或不透明的眼前节进行非侵入性、高分辨率成像, 超声生物显微镜(UBM)是唯一选择。虽然这些特征使UBM对于特定类型的创伤、先天性畸形和眼前节肿瘤的诊断是必要的, 但人们已经在广泛的疾病谱中, 发现了UBM成像在结构评估中的临床用途。其不仅可用于眼内前节解剖, 也可用于眼睑和眼眶解剖的评估。在儿童群体中, 无论伴有角膜混浊或是云翳的眼前节疾病, 该成像工具都有非常特殊的地位。对于儿科患者的诊断, 医生会面临额外的挑战。儿童通常无法提供详细病史也无法全力配合相关检查, 因此对高分辨率成像的需求更大。本综述的目的是针对涉及应用UBM对儿童眼病进行描述、评估、诊断或优化治疗的文献进行筛选与整合。所筛选出的研究详细说明了这种成像方式的用途, 阐明了最适用于该工具的结构和疾病, 并描述了儿童受试者UBM成像的定量和定性特征。同时, 本文得出的结论将包括可用于加强儿童眼病临床护理的具体应用。
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Funding
JLA has grant support from the UMB ICTR/Clinical Science and Translational Science KL2 Award 1KL2TR003099-01 and R43EY030798-01. JLB has grant support from National Cancer Institute of the NIH Award K08CA232344, Hyundai Hope on Wheels, and The Wright Foundation. JLB has indirect support provided by The Larry and Celia Moh Foundation, The Institute for Families, Inc., Children’s Hospital Los Angeles, an unrestricted departmental grant from Research to Prevent Blindness, The National Institute of Health P30EY029220, The National Cancer Institute P30CA014089.
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Alexander, J.L., Wei, L., Palmer, J. et al. A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology. Eye 35, 265–276 (2021). https://doi.org/10.1038/s41433-020-01184-4
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DOI: https://doi.org/10.1038/s41433-020-01184-4
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