Dataset Information

Objective assessment of a relative afferent pupillary defect by B-mode ultrasound.

ABSTRACT:

Purpose

To evaluate B-mode ultrasound as a novel method for objective and quantitative assessment of a relative afferent pupillary defect (RAPD) in a prospective case-control study.

Methods

Seventeen patients with unilateral optic neuropathy and a clinically detectable RAPD and 17 age and sex matched healthy controls were examined with B-mode ultrasound using an Esaote-Mylab25 system according to current guidelines for orbital insonation. The swinging flashlight test was performed during ultrasound assessment with a standardized light stimulus using a penlight.

Results

B-mode ultrasound RAPD examination was doable in approximately 5 minutes only and was well tolerated by all participants. Compared to the unaffected contralateral eyes, eyes with RAPD showed lower absolute constriction amplitude of the pupillary diameter (mean [SD] 0.8 [0.4] vs. 2.1 [0.4] mm; p = 0.009) and a longer pupillary constriction time after ipsilateral light stimulus (mean [SD] 1240 [180] vs. 710 [200] ms; p = 0.008). In eyes affected by RAPD, visual acuity correlated with the absolute constriction amplitude (r = 0.75, p = 0.001).

Conclusions

B-mode ultrasound enables fast, easy and objective quantification of a RAPD and can thus be applied in clinical practice to document a RAPD.

SUBMITTER: Schmidt FA

PROVIDER: S-EPMC6110480 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Objective assessment of a relative afferent pupillary defect by B-mode ultrasound.

Schmidt Felix A FA Connolly Florian F Maas Matthew B MB Grittner Ulrike U Harms Lutz L Brandt Alexander A Paul Friedemann F Schreiber Stephan S Ruprecht Klemens K

PloS one 20180827 8

<h4>Purpose</h4>To evaluate B-mode ultrasound as a novel method for objective and quantitative assessment of a relative afferent pupillary defect (RAPD) in a prospective case-control study.<h4>Methods</h4>Seventeen patients with unilateral optic neuropathy and a clinically detectable RAPD and 17 age and sex matched healthy controls were examined with B-mode ultrasound using an Esaote-Mylab25 system according to current guidelines for orbital insonation. The swinging flashlight test was performed ...[more]

PMID: 30148895

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Project description:PurposeRecently, some attempts have been made to integrate lung ultrasound (LUS) teaching into medical curricula. However, current education studies of LUS are extremely heterogeneous due to the lack of evidence-based guidelines on LUS education. In particular, the assessment of competencies is poorly standardized and mostly relies on non-validated scales. A new validated tool, the objective structured assessment of lung ultrasound skills (LUS-OSAUS), has the potential to overcome these limitations. Therefore, we adopted the LUS-OSAUS tool to assess the competencies of a group of LUS-trained undergraduates. Existing no prior practical applications of the LUS-OSAUS, our aim was to investigate the practical utility of this tool and its applicability in the evaluation of US-trained medical students.MethodsEight undergraduates (two males, six females) were enrolled on a voluntary basis to receive a theoretical and practical training in LUS. Once completed their training, each student performed an LUS examination on a different patient hospitalized for respiratory symptoms. The same eight patients were also scanned by a senior resident in emergency medicine for a comparison with students' results. Students and the senior resident were tested by an examiner using the LUS-OSAUS tool. We compared the scores obtained by operators in all areas of competence of the LUS-OSAUS, the total scores, and the time needed to complete the sonographic task.ResultsMedian students' score in the single items of the scale was significantly lower than the ones obtained by the senior resident (4.0 [3.3-5.0] vs. 5.0 [5.0-5.0]; p < 0.0001). Students scored significantly lower than the senior resident in each item, except for B-line identification, choice of the correct transducer, and suggested focused questions. Median total score was also lower for students compared to the senior resident (70.5 [61.0-74.8] vs. 84.0 [83.5-84.3] (p = 0.0116). Median time required to complete the examination was significantly higher for students (14.1 [12.8-16.1] vs. 4.7 [3.9-5.2] min, p = 0.0117).ConclusionsThe LUS-OSAUS tool allowed for a standardized and comprehensive assessment of student's competencies in lung ultrasound, and helped to discriminate their level of expertise from that of a more experienced operator. The scale also specifically tests the theoretical knowledge of trainees, thus making redundant the use of questionnaires designed for this purpose.

Dataset Information

Objective assessment of a relative afferent pupillary defect by B-mode ultrasound.

Purpose

Methods

Results

Conclusions

Publications

Objective assessment of a relative afferent pupillary defect by B-mode ultrasound.

Similar Datasets

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