ULTRASOUND BIOMICROSCOPY Essay Submitted for the partial fulfillment of Master Degree in Ophthalmology By Hanaa Hamdi Rashad M.B.,B.Ch Faculty of Medicine,Ain Shams University Supervised by Prof.Dr./Mahmoud Hamdi Ibrahim Professor of Ophthalmology Faculty of Medicine,Ain shams University Dr./Dina Ezzat Lecturer of Opthalmology Faculty of Medicine, Ain shams University Faculty of Medicine Ain Shams University Cairo 2007 Ultrasound Biomicroscopy Imaging of the eye and orbit is facilitated by the use of ophthalmic ultrasound (5-10MHz).Palvin , etal (1990) developed the high frequency (50-100MHz) biomicroscopic ultrasound) , using the high frequency transducters to provide high resolution in vivo imaging of the anterior segment - .Ultasound biomicroscopy (UBM) is a high resolution , non invasive high frequency ultrasound ( HFU) technique that allows assessment of the anterior segment and peripheral retina ( Garcia - Feijoo, etal , 2003 ) . The UBM technology is based on incorporation of 50-100 MHz transducers in a β mode echography clinical scanner . Different transducer frequencies can be used depending on the ocular tissue to be imaged . In general , increasing the transducer frequency improves the image resolution but limits the depth of tissue penetration , so may be useful in refractive surgery Conversely a decrease in transducer frequency increases the penetration depth but decreases tissue resolution . Tissue penetration is approximately 4 – 5 mm and the scanner produces a 5× 5mm field with 256 vertical imaged lines ( or A – Scans ) at a scan rate of eight frames per second . Palvin etal (1991) describe and quantify the normal values for anterior segment quantitative assessment of its relationships UBM is a new ultrasound diagnostic procedure that provides high definition image of the anterior segment including retroirideal structure and the angle region . The structures surrounding the posterior chamber , including the ciliary body , iridolenticular relation-ship and zonular apparatus of zinn , previously hidden from clinical observation , can be imaged and their normal anatomic relation –ship assessed (Tello etal, 2000) . UBM is independent on the clarity of the optical media . In cases with corneal opacity visualization of the anterior chamber and gonioscopy becomes unfeasible , ( Abd El- Razek etal , 2006 ). UBM is a useful tool for evaluating patients with anterior segment problems like glaucoma including congenital type as it can demonstrate associated congenital anomalies and differentiating different functional and type of primary congenital glaucoma . ( Attia etal ;2004 ) UBM measurements of the anterior chamber depth as well as ciliary body surface area is beneficial in evaluation of accommodative intra - ocular lens (Hofy etal ;2006) Aim of work The aim of our work is to demonstrate UBM diagnostic values in anterior segment different pathology . References 1 – Abd El – Razek – R , El- Katib – A , El – Essawy – R and Metwaly _M . In " UBM in congenital glaucoma : what information can it provide? " .Bull .ophthalmol . Soc . EGYPT , 2006 ; vol. 99 , Number 6 , P.873 – 879 . 2 – Attia – HE , El –cheweich – HM , El – Basty – MK and El –Kady – SK . In " UBM evaluation of trabeculectomy filtering blebs with and without mitomycin " .Bull .ophthalmol . Soc .EGYPT . 2004, vol 97, No . 3, 419 – 424 . 3 – El – Hofy – O , Abou – steit – M , Salah – Y , Hassan – NA , El – Sanabary – Z and Aseem – M . In " Ultrasound Biomicroscopy in Evaluation of Accommodative Intra – ocular lens " . Bull . Ophthalmol . Soc . EGYPT , 2006 ; vol 99 , Number 2 , P .183 – 188 4 – Fayed – AA .In " Traditional Ultrasound graphy and UBM finding in small size Eye " . Bull ophthalmol . Soc . EGYPT 2006 , vol .99,Number 6 . 5– Garcia – Feijoo – J , Jimenez Alfaro – I and Cuina – Sardina – R . In " Ultrasound biomicroscopy examination of posterior chamber phakic intraocular lens position " . ophthalmology . 2003;110:163 – 172 . 6– Hanafy _ M . In " Assessment of limbal lesions by Ultrasound Biomicroscopy ( UBM )' . Bull . Ophthalmol . Soc . EGYPT , 2001 , vol . 94 , Number 1 , 55 -62 . 7 - Palvin – CJ , Harasiewicz –K and Sherar – MD . In " clinical use of ultrasound biomicroscopy " .Ophthalmology . 98 : 287 – 295 , 1991 . 8 – Palvin – CJ , Sherar – MD and Foster – FS . In " Subsurface ultrasound microscopic imaging of intact eye " . Ophthalmology, 1990 ; 97; 244 – 250 . 9 – Shalaby – MH and El – Gendy – HA . In " Ultrasound Biomiroscopy ( UBM ) Guided secondary Implantation in Aphakic children ". Bull . Ophthalmol . Soc . EGYPT , 2006 , vol 99 , Number 6 , P.913 – 919 . 10 – Tello –C , Rothman – R , Ishikawa – H and Ritch – R . In " Differential Diagnosis of the angle closure glauco ma". ophthalmology clinics of North America ; volume 13 , No 3 , 2000 . plane of the work : 1-Introduction: A -Ultrasonograghy in general. B- History of ultrasound biomicroscopy (UBM). 2-Physical properties. 3-Discription of the apparatus. 4-Mode of the use (Methods of examination). 5-Clinical applications and benefits in the : A-Cornea. B-Anterior chamber. C-Angle of the anterior chamber. D- Ciliary body. E-Posterior chamber. F-Surgeries of glaucoma. G-Crytalline lens. H-Intra-ocular lens surgeries.