B-scan ultrasonography for the detection of macular thickening.

PURPOSE To report the sensitivity and specificity of B-scan ultrasonography to detect macular thickening. DESIGN Observational case series. METHODS Seventy-seven eyes of 40 consecutive patients (age range, 7-80 years) in a retinal specialty practice were examined. A single masked ultrasound operator performed B-scan ultrasonography on all eyes and graded macular thickening. The final assessment of macular thickening was based on biomicroscopy findings combined with fluorescein angiography (FA) and optical coherence tomography (OCT). The presence or absence of macular thickening as determined by B-scan ultrasonography was compared with the final clinical assessment, FA findings, and OCT measurements. RESULTS B-scan ultrasonography detected macular thickening with a high degree of sensitivity (91%) and specificity (96%). There was a high degree of agreement between findings on ultrasonography and FA (kappa = 0.80). Ultrasonographic diagnosis correlated with OCT measurements for both central macular thickness (r =.65, P <.001) and volume (r =.56, P <.001). CONCLUSIONS Ultrasonographic detection of macular thickening correlates with findings on slit-lamp biomicroscopy, FA, and OCT. B-scan ultrasonography is a potentially useful technique for assessing macular thickness when biomicroscopy is impossible or when patients cannot tolerate FA or OCT.