Clinical Ophthalmology (Jan 2025)

The “Triangle” Sign: A Novel Ultrasound Marker for Diagnosing Total Choroidal Detachment and Total Suprachoroidal Hemorrhage

  • Bhatt VD,
  • Bhatt DC,
  • Bhatt KD,
  • Dabir S,
  • Berendschot TTJM,
  • Erckens RJ,
  • Webers CAB

Journal volume & issue
Vol. Volume 19
pp. 261 – 268

Abstract

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Vaidehi D Bhatt,1 Deepak C Bhatt,1 Kalpana D Bhatt,1 Supriya Dabir,2 Tos TJM Berendschot,3 Roel J Erckens,3 Carroll AB Webers3 1UBM Institute, Mumbai, India; 2Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 3University Eye Clinic Maastricht, Maastricht, the NetherlandsCorrespondence: Vaidehi D Bhatt, UBM Institute, A/1 Ganesh Baug, Dadar, Mumbai, 400019, India, Tel +91-9821525810, Email [email protected]: This study aims to explore the diagnostic utility of ultrasound B-scan while introducing the “Triangle” sign as a novel indicator. It also validates the sign’s efficacy in distinguishing between choroidal detachment (CD) and suprachoroidal hemorrhage (SCH) from retinal detachment (RD) and vitreous hemorrhage (VH).Patients and Methods: Retrospective analysis of consecutive cases of total CD and SCH undergoing B-scan at a single tertiary imaging center. The study examined the presence of the “Triangle” sign (a hypoechoic/anechoic triangular shape of vitreous noted anterior to the optic disc) in total CD & SCH, categorized cases by subtype and etiology, and its role in differentiating from RD and VH.Results: Thirty-six eyes with a total CD and SCH were analyzed. Amongst the cases of total SCH 31 (86.1%), (58.1%) were linked to intraocular surgery, and (41.9%) were linked to post-traumatic events. The “Triangle” sign was consistently present in all 36 eyes, with additional findings indicating concurrent VH (52.8%) or RD (5.6%). Among the 31 eyes with total SCH, 58.3% initially had detectable choroidal membrane seen on B scan, while 41.7% did not. Despite this, the “Triangle” sign was consistently visible in all 36 eyes, and monitoring with B-scans revealed choroidal membrane as the hemorrhage resolved.Conclusion: The “Triangle” sign is a distinctive and reliable ultrasound feature for total CD and SCH diagnosis, offering clarity in challenging cases where traditional methods face limitations.Keywords: choroidal detachment, suprachoroidal hemorrhage, ultrasound B-scan

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