Media Type: Textbook

Synopsis: Despite the development over the past 10 years of many modern imaging techniques for the posterior segment, ophthalmic ultrasound has retained its critical role in the management of retina patients. Although many excellent textbooks have been published on ultrasound, Dynamic Ophthalmic Ultrasonography is unique in its extensive use of video clips in order to explain the complex art of dynamic B-scan in a completely new way. It fills a void in the ultrasound literature very nicely, and when paired with an online account used to view the videos, will serve as an excellent shelf reference. For those technicians or ophthalmologists seeing patients in real time who require a reference standard to aid with a challenging case, this book will prove to be very useful.

Target Audience: Ophthalmologists and ophthalmic technicians

Review: Dr Julian Pancho S. Garcia has compiled an impressive collection of video clips over an 8-year career experience at the well-regarded New York Eye and Ear Infirmary. Ultrasound is a complex skill and takes years to master, and Dr Pancho has demonstrated his superior skills and deep understanding of the modality with the creation of this text.

The chapters, rather than being organized by disease process, are organized according to the different types of important dynamic movements that can be observed on B-scan (convection, gravity-dependent movement, reflex motion, vascularity, aftermovement of the vitreous, hyaloid, retina and choroid). Each still image presented in the hard copy book is paired with a video clip online. The clips are well-organized by chapter and image number, making it easy to navigate back and forth between the book and the website database. A useful addition at the end of the book is a series of 6 challenging cases which can be used to test the reader on his/her skills and to review particularly important teaching points.

Throughout the text, important tips are noted in large text boxes at the bottom of the page and are repeated for emphasis. The text of the tips is written clearly, and the content of the tips is relevant and central to basic B-scan teaching. For example, there are many images and videos to aid in the classic ultrasonographic dilemma faced by the ophthalmic technician or resident in which a patient has a vitreous hemorrhage and the status of the retina is not known (PVD or RD? RRD or TRD?).

The limitations of the book are minor. As the author states in the preface, the text is not intended to replace a comprehensive classic ultrasound text. The technique section in the introduction is limited and would not be adequate for a technician or ophthalmic resident just learning ultrasound for the first time. Furthermore, not all disease states are represented. However, the videos provided by the author provide a unique and never-before-seen approach to diagnostic dilemmas. These videos will undoubtedly aid in delineation of the anatomy in real time in the clinic of even the most challenging of cases. In this way, the book contains a wealth of clinical information not obtainable from any other source.

In summary, this text fills a void in the ultrasound literature very nicely. Any technician or ophthalmologist in training or in practice who often finds him or herself in common ultrasonographic diagnostic situations will find the presence of this book invaluable. Furthermore, the lessons taught in this book are timeless – even as ultrasound probes become more advanced and higher resolution images are available, the behavior of ophthalmic tissues as seen in these videos will always be constant and will remain diagnostically critical.