- Retinal vs vitreous detachment or hemorrhage can be distinguished using point-of-care ultrasonography (POCUS) in the emergency department (ED).
- The authors emphasize that the results do not suggest replacement for ophthalmology specialist exam but could be an adjunct in the ED to improve care.
Why this matters
- Up to 3% of ED visits involve ocular symptoms, and in many cases, without rapid effective treatment, irreversible vision loss is a risk.
- Editorial calls study well-done with high-quality evidence of the accuracy of POCUS in the ED for these conditions.
- For retinal detachment, POCUS had (95% CIs):
- Sensitivity: 96.9% (80.6%-99.6%); and
- Specificity: 88.1% (81.8%-92.4%).
- For vitreous hemorrhage, POCUS had:
- Sensitivity: 81.9% (63.0%-92.4%); and
- Specificity: 82.3% (75.4%-87.5%).
- For vitreous detachment, POCUS had:
- Sensitivity: 42.5% (24.7%-62.4%); and
- Specificity: 96.0% (91.2%-98.2%).
- Prospective study, 225 patients presenting to 2 academic and 2 county hospital EDs, February 3, 2016 to April 30, 2018.
- Accuracy of POCUS conclusion compared with final ophthalmologist diagnosis.
- Funding: None disclosed.
- Unclear how results would translate to other settings.
- POCUS utility relies on operator experience.