Performance of a handheld ultrasound device in detecting retinal detachments

Abstract

Purpose: To assess the accuracy and performance of the Butterfly IQ+ handheld ultrasound (HHUS) in detecting retinal detachments (RDs).

Methods: A cross-sectional observational study of eyes with (n = 20) and without (n = 20) RD imaged using a conventional B-scan ophthalmic ultrasound device Ellex Eye Cubed by Clarion Medical Technologies (Cambridge, ON, CA) and a portable HHUS (Butterfly IQ+). Images were compared between the modalities for qualitative differences. Agreement between the HHUS and standard ultrasonography equipment and with clinical examination was quantified using Cohen's kappa coefficient.

Results: Forty eyes of 33 patients were included in the study. Twenty eyes of 18 patients had RDs, and 20 eyes of 18 patients did not. The observed agreement in RD diagnosis between the Butterfly and the Ellex Eye Cubed was 97.5%., and the Cohen's Kappa was 0.950 (95% CI: 0.85-1.00). The observed agreement in RD diagnosis between the Butterfly IQ+ and diagnosis confirmed by the gold standard of clinical exam was 92.5%, and Cohen's Kappa was 0.850 (95% CI: 0.69-1.00). The sensitivity and specificity of the Butterfly ultrasound in RD diagnosis were 90% (95% CI: 68.3-98.8%) and 95% (95% CI: 83.2-100), respectively.

Conclusion: There was a high degree of agreement between the systems for the identification of RD. The Butterfly IQ's extreme portability and ease of use make it a viable option to screen for RDs in hospital-based consults, emergency departments, or low-resource settings.