Sir,
Thank you for the well-written response and review of the current B-scan ultrasonography literature. B-scan ultrasonography, certainly, has a role in treating diabetic patients with vitreous hemorrhage and a poor funduscopic view. Ultrasonography gives the ophthalmologist a useful tool in his or her armamentarium to make an appropriate medical or surgical decision. It is important to note that the references in the above letter do not deal with only patients who have diabetic retinopathy, but a variety of patients with other vitreoretinal disorders as well that lead to vitreous hemorrhage. The different pathogenesis of the diseases such as in a hemorrhagic posterior vitreous detachment where one wants to rule out a retinal detachment can confound the data and management decisions of the studies cited. Diabetic patients are typically more difficult to evaluate as they often have multiple tractional bands that can simulate posterior hyaloid or retina on B-scan ultrasonography. Even if there is an area of peripheral retinal detachment, vitrectomy is not always required. We appreciate your contributions and insight into this important imaging modality in diabetic patients.
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