Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

Dong Ho Chang; Pyung Lee; Seung Chan Lee; Kyung Hyun Jin

doi:10.3341/jkos.2010.51.1.106

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Chang, Lee, Lee, and Jin: Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

Original Article

J Korean Ophthalmol Soc 2010;51(1):106-111.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.1.106

Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

Dong Ho Chang, MD¹, Pyung Lee, MD¹, Seung Chan Lee, MD², Kyung Hyun Jin, MD¹

¹Department of Ophthalmology, KyungHee University, College of Medicine, Seoul, Korea

²Department of Ophthalmology, Kangwon University, College of Medicine, Chuncheon, Korea

Address reprint requests to Kyung Hyun Jin, MD Department of Ophthalmology, KyungHee University College of Medicine #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: khjinmd@khmc.or.kr

Received 2 May 2008 Accepted 15 September 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical significance of angle-opening distance 500 (AOD500) using ultrasound biomicroscopy (UBM) in the early stage of traumatic hyphema.

Methods

The participants of this study were 46 hospitalized traumatic hyphema patients. We measured the quantity of initial blood clotting using a slit-lamp and the range of angle recession, AOD500 using UBM and then reviewed the relationship between the two.

Results

The difference of AOD500 in the traumatic and the non-traumatic eye measured by UBM at admission increased significantly in the wider recessed angle group (p=0.008), but did not increase at a statistically significantly level in the larger initial blood clot grade group (≥ Grade 2).

Conclusions

These results suggest that the measurement of the angle-opening distance of both eyes using UBM will aid in evaluating the range of angle recession in patients in the early stage of traumatic hyphema.

Keywords: Angle-opening distance 500 (AOD 500), Traumatic hyphema, Ultrasound biomicroscopy (UBM)

References

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Figure 1.

Ultrasound biomicroscopic image of the anterior chamber and the definition of angle-opening distance at 500 μm from the scleral spur (AOD500).

Figure 2.

The photographs of the anterior segment and ultrasound biomicroscopy (UBM) in 2 traumatic hyphema patients (A, B). The angle recession (short arrow) was seen in UBM photograph at 12 and 3 o'clock (in the middle upper and lower photograph). The blood clot (long arrow) is well-visualized in the UBM photograph at 6 o'clock (in the right upper and lower photograph).

Figure 3.

The grade of angle recession and angle opening distance 500 (AOD500) (μm). The difference of AOD500 in traumatic & nontraumatic eye measured by UBM at admission were increased statistically significantly in larger area recessed angle group (p=0.008).

Table 1.

Patient demographics

Table 2.

Angle-opening distance 500 (μm) in traumatic and nontraumatic eye, and the difference of angle-opening distance 500 (μm) in traumatic and nontraumatic eye (Mean± SD^*)

	AOD 500^† (μm)
Traumatic eye	572.740±244.899
Nontraumatic eye	373.750±115.431
Traumatic eye ^AOD500-	198.997±198.334
Nontraumatic eye ^AOD500	
p-value^‡	0.000

^* SD=standard deviation

^† AOD500=angle-opening distance 500

^‡ p-value=statistical significance evaluated by paired t-test.

Table 3.

The difference of angle-opening distance 500 (μm) in traumatic and nontraumatic eye according to degree of angle recession

The degree of angle recession (˚)	traumatic eye ^AOD500* – nontraumatic eye ^AOD500*	p-value^†
≤1 point of angle recession (+)^‡	158.777±149.269	0.008
≥2 point of angle recession (+)^‡	423.077±291.226	0.008

^* AOD500=angle-opening distance 500

^† p-value=statistical significance evaluated by Mann-Whitney U test

^‡ Angle recession was estimated in the 4 points (12, 3, 6, 9 o'clock) in the UBM.

Table 4.

Angle-opening distance 500 (μm) in traumatic and nontraumatic eye, and the difference of angle-opening distance 500 (μm) in traumatic and nontraumatic eye according to the grade group of initial blood clot

The grade of initial blood clot group	traumatic eye ^AOD500* – nontraumatic eye ^AOD500*	p-value^†
Group 1^‡	192.301±204.933	0.173
Group 2^§	269.231±94.211	0.173

^* AOD500=angle-opening distance 500

^† p-value=statistical significance was evaluated by Mann-Whitney U test

^‡ Group 1=initial blood clot grade 0, Ⅰ

^§ Group 2=initial blood clot grade Ⅱ, Ⅲ, Ⅳ.

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