2012 Radiology Exam - Ultrasound Case 2

HISTORY: Adult rabbit. Presented with acute blindness. No other clinical signs.

IMAGING STUDY: Ultrasound of the eye.

OBSERVATION:

• Increased echogenicity in the lens (rostral and caudal)
• Increased echogenicity in the  vitreous chamber (okay if did not comment)
• Elevation of the retina from the sclera resulting in a seagull sign
• No retrobulbar disease

SYNTHESIS:

• Cataract
• Retinal detachment
• Vitreal degeneration, hemorrhage, (okay if did not comment)

PLAN:

• Cataract surgery will not likely restore vision
• ERG
• Check for blood pressure and evaluate for causes of systemic hypertension
• US other eye to check for bilateral disease (not for comparison)

General Comments:

The majority of candidates answered this question very well.  The most common error was failure to identify the the cataract which resulted in failure of the case.  Candidates often expressed that the lens was probably normal for a rabbit but the US appearance of the lens is the same in regardless of the species.  Candidates also frequently requested and US of the other eye for comparison to determine if these changes where symmetric and therefore appropriate for this species. However, in this case the rabbit was blind indicating that both eyes were likely to be affected so similar changes in the other eye would most likely be due to bilateral disease rather than normal for the species.  Some candidates also indicated they would like a fundic exam to confirm the retinal detachment however the cataract would inhibit the fundic exam.