B-Scan Ultrasonographic Evaluation of Posterior Segment Pathologies in Dense Cataract: A Prospective Cross-Sectional Study

Abstract

Background: Dense cataracts frequently obscure direct visualization of the posterior segment, making preoperative assessment difficult. Undetected posterior segment abnormalities may adversely influence surgical planning, visual prognosis, and postoperative outcomes. B-scan ultrasonography provides a rapid, non-invasive, and reliable method for evaluating intraocular structures hidden behind opaque ocular media.

Objective: To evaluate the diagnostic role of B-scan ultrasonography in detecting posterior segment abnormalities among patients with dense cataracts undergoing preoperative assessment.

Materials and Methods: A prospective cross-sectional study was conducted in the Department of Radiodiagnosis at Vinayaka Mission's Kirupananda Variyar Medical College and Hospital (VMKV MCH), Salem, Tamil Nadu, India. A total of 185 patients with clinically diagnosed dense cataracts were included after obtaining informed consent. All participants underwent standardized ophthalmic B-scan ultrasonography using high-frequency linear transducers. Patient demographics, laterality, sonographic findings, and associated posterior segment abnormalities were documented and statistically analysed.

Results: Among the 185 patients evaluated, the majority belonged to the 51–60 years age group (43.2%), followed by 61–70 years (33.5%). Males constituted 53% of the study population. Cataracts involved the right eye in 51.9%, left eye in 33.0%, and both eyes in 15.1% of patients. The posterior segment appeared normal in most patients, while the remaining cases demonstrated various abnormalities, including vitreous degeneration, posterior vitreous detachment, vitreous haemorrhage, retinal detachment, choroidal abnormalities, and other vitreoretinal pathologies.

Conclusion: B-scan ultrasonography is an indispensable imaging modality for evaluating the posterior segment in patients with dense cataracts. It facilitates early detection of occult ocular abnormalities, assists ophthalmic surgeons in operative planning, improves prediction of postoperative visual outcomes, and contributes significantly to comprehensive preoperative assessment.