The use of point‐of‐care ultrasound for detection of retinal detachment in emergency department

Abstract

Abstract Introduction Retinal detachment (RD) is an ocular emergency commonly encountered in the emergency department (ED). Point‐of‐care ultrasound (POCUS) has been proposed to rapidly identify the diagnosis. This study aimed to assess the accuracy of POCUS for detection of RD by a group of emergency physicians (EP) who had no prior experience in ocular POCUS. Methods This was a retrospective single‐center cohort study conducted between July 2023 and April 2024. All EP without any experience of POCUS in the department were invited to participate voluntarily in the study. They received a structured training session prior to the commencement of study which included a 30‐min lecture followed by a 30‐min supervised hands‐on practice on healthy individuals. All adult patients presenting to ED with acute onset flashes, floaters, and monocular visual loss were included. Patients who met one of the following criteria were excluded: pre‐existing or known RD, suspected ruptured eyeball, and unable to communicate in either Chinese or English. The final diagnosis by ophthalmologists were used as the gold standard for comparison. Results A total of 12 EP participated in the study and 89 patients were identified. Fourteen of them received the diagnosis of RD by ophthalmologists. Overall, the sensitivity of ocular POCUS was 93% (95% confidence interval (CI = 66%–100%). Specificity was 89% (95% CI = 80%–95%). The positive predictive value was 62% (95% CI = 45%–76%) and the negative predictive value was 98% (95% CI = 91%–100%). Conclusion Ocular POCUS has high sensitivity and negative predictive value for detection of RD. It is a useful and readily available diagnostic tool in ED even for EP without prior experience.

Keywords

• emergency department
• POCUS
• retinal detachment