S. Nikolov 1, E. Titianova 1,2, S. Cherninkova 3, S. Karakaneva 2, P. Popov 1,2, K. Genova 4
1 Faculty of Medicine, Sofia University St. Kliment Ohridski – Sofia,
2 Clinic of Functional Diagnostics of Nervous System, Military Medical Academy – Sofia,
3 Clinic of Neurology, Alexandrovska University Hospital – Sofia,
4 M-TEX Imaging Laboratory, University Emergency Hospital Pirogov – Sofia, Bulgaria

Objective: To demonstrate the diagnostic abilities of multimodal 2D/3D/4D ultrasound imaging of chronic blast eye trauma associated with full blindness.

Material and Methods: A 31-year-old man with amaurosis after eye blast trauma at the age of 17, underwent multiple operations and different eye-procedures (including a silicon vitreous filling) was studied by parallel application of multimodal 2D/3D/4D ultrasound eye-imaging, electroencephalography, visual and auditory evoked potentials, CT and MRI.

Results: Neuro-ophthalmological status showed chronic traumatic damage of both eyes with complete blindness. The right eye was with pars plana vitrectomy and corneal leucoma and the left bulb was with phthisis. Ocular fundus was not visible on both sides. The 2D/3D/4D eye images showed severe deformation of the left eye with chronic retinal detachment and optic nerve atrophy. The right bulb was fully anechoic, with a normal shape but no images of the lens, optic disc and optic nerve were obtained due to silicon filling of the vitreous. Both ophthalmic arteries and veins had normal ultrasound pattern. The EEG repetitive visual stimulation and visual evoked potentials were associated with color hallucinations during and after the investigation (Charles Bonnet syndrome). These findings correlated with neuroimaging studies where normal occipital cortex, optic nerve atrophy and severe eye deformation were found.

Discussion: The multimodal ultrasound eye imaging can be used as a reliable non-invasive method for screening and topic diagnosis of chronic eye injury.

Key words: blast eye trauma, Charles Bonnet syndrome, ultrasound.

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