By the same token the author wishes to acknowledge the tremendous merits of two electronic engineers who made the development and continuous perfection of Instrumentation for Standardized Echography possible through their enormous knowledge of, and skills in, the field of diagnostic ultrasound, and through their readiness and capability to accept and accommodate clinical necessities:

 (1) Ing. Bernhard of Kretztechnik (Zipf, Austria);  with his help the Kretz 7000 instrument of the II. Eye Department of the University in Vienna (Austria) was modified to become the prototype for all subsequent standardized A-scan instruments by 1964, and with his help the author developed the first commercially available immersion tomograph Kretztechnik 7900 S (combined standardized A-scan and B-scan) in 1966 as well as the Kretz 7200 MA by 1970 (the only standardized A-scan unit available throughout the 1970's and early 1980's).

(2) Jean Abascal of Biophysic Medical, later of Biovision International [BVI] (all in Clermont-Ferrand, France), and lastly of Quantel Medical (Bozeman, MT, USA and Clermont-Fd / Paris, France); together with Jean Abascal the author developed the Ophthascan S in the 1980's, the Mini-A-scan in the  late 1980's, the B-scan S in the late 1990's, and most recently, its successor, the Cine-scan S (all with progressively increasing digital capabilities and more numerous and powerful software programs).

 

The results of a collaborative international melanoma and retinoblastoma studies undertaken for publication during the International Congress of Ophthalmology in San Francisco in 1982 [93] demonstrate the effectiveness of Standardized Echography performed by a great number of echographers worldwide (all had been trained at the Universities of Iowa, USA or Vienna, Austria):

The diagnosis of malignant melanomas of the choroid and ciliary body accomplished with Standardized Echography by a total of 92 different examiners () in 33 different centers worldwide in a total of 1629 histological confirmed cases carried the unique sensitivity of 99% and a specificity of 97.9%.

Likewise the diagnosis of retinoblastomas achieved by 56 different echographers in 23 different centers worldwide in a total of 319 histological proven cases carried a sensitivity of 98.1% and a specificity of 97.8%.

 

Since the mid 1970's measurements of the optic nerve [64, 66, 69, 70, 150] and the extraocular muscles [63, 64, 69, 70, 74] were added to the armamentarium of Standardized Echography and were perfected during the following years [75, 87, 93, 94, 97, 104, 150]. The usage of the "30 degree test" [86, 87, 150] to distinguish between solid and fluid optic nerve sheath widening and the even more important technique of "exercising " the optic nerve to distinguish between intracranial hypertension and optic nerve compression [150, 173, 174, 175] were well accepted. Most reliable diagnoses of diseases affecting the optic nerve (e.g., gliomas, meningiomas, AION, PION, optic neuritis, optic atrophy, papilledema vs. dry optic nerve swelling, intracranial hypertension, compressive optic neuropathy) [150], and of diseases affecting any of the 6 extraocular muscles (e.g., Graves orbitopathy, orbital myositis, hyperemia, hematomas, neoplasms [94, 97, 101, 104, 131, 155, 167, 176, 197, 200] were added to the widening scope of useful diagnostic application of Standardized Echography.

The following case illustrates the applicability and great sensitivity and accuracy of the acoustic differential criteria that have evolved over the years for each of these ocular and orbital conditions and which can reliably be applied because they are based on the optimal and standardized instrument parameters and techniques of Standardized Echography:

A 53-year old white male patient had been referred to the Echography Service in the Eye Department at the University Hospitals in Iowa City in 1990 with the (clinical and CT-scan) diagnosis of Graves' orbitopathy. He had undergone a previous ptosis operation OS, which was only temporally effective. The echograms obtained with a standardized Ascan device (Mini-A-scan) set at Tissue Sensitivity indicated medium to low reflectivity, internal vascularity and a large angle kappa of several tumors located within the sheaths of extraocular muscles in both orbits of this patient (Fig.1). On the basis of these criteria the author made the diagnosis of metastatic carcinoid, which was later confirmed by histopathology.

This diagnosis was made without having experienced this extremely rare kind of tumor within the sheaths of an extraocular muscle before, on the following three accounts: (1) the echographic findings in one case of carcinoid metastatic to the right lacrimal fossa of a 70-year old white female experienced 10 years earlier; her tumor echograms had shown an angle kappa of identical size, but a slightly higher internal reflectivity [92]. (2) The knowledge that tumors located within the sheaths of the extraocular muscles present with a slightly but clearly lower reflectivity than their counterparts located within orbital fat tissues. (3) That no other tumor tissue was known to produce the echographic features recorded in this male patient.

 

Figure 1 A: Patient with the clinical (CT) diagnosis of Graves' orbitopathy

 

Figure 1 B : Standardized A-scan (photograph of frozen image) at Tissue Sensitivity shows medium to low reflectivity and a large angle kappa of the left superior rectus muscle

 

Figure 1 C : Standardized A-scan (photograph of live image) showing segment of the right lateral rectus muscle ( T + 2.6 db, zoom); the blurred  spikes indicate blood flow in the tumor vessels

Figure 1 D: Histopathologic examina- tion confirmed echographic diagnosis of (metastic) carcinoi

 


During phase II Standardized Echography evolved into the most potent, effective, reliable, accurate and diversified ultrasonographic method in ophthalmology offering the best results in detection, localization, measurement and differentiation of intraocular, orbital and periorbital lesions. This method allows, for instance, the differentiation of more than 75 intraocular, and of more than 65 orbital and periorbital, lesions. For many of these differential diagnoses Standardized Echography provides a sensitivity as well as specificity ranging above 95%, in several instances close to 100%.

 

 

3.      Phase III

 

Since the mid 1990's a digital revolution began to drastically change the situation of Standardized Echography. Though some tasks of Standardized Echography always have been easy and quick, many of the differential diagnoses which made this method so superior to other echographic approaches required much time, skills and experience on the part of the echographers. Likewise the training for Standardized Echography was lengthy and training opportunities were lacking. This situation slowed the spread of this unique method.

With the advent of digitization and the development of powerful software programs the situation of Standardized Echography has changed drastically allowing for quick, easy, but still more reliable, more objective and more accurate diagnoses to be accomplished by less trained and less experienced echographers. This trend is just starting for Standardized Echography and promises a bright future for this diagnostic method.

A good example for this development is presented by the author in another contribution to SIDUO XVIII (see Ossoinig KC: "Computer-assisted Echographic Tissue Diagnoses: differentiation between retinal and membranous surfaces"): The A1 sign described there had been found to be the single most reliable and accurate acoustic criterium for differentiating retinal detachments from dense fibrovascular membranes. It's application was fairly quick for a well trained and skilled echographer. With new software already contained in the software package 2000 for the B-scan S instrument, the A1 evaluation has become so quick and easy that untrained participants in a recent workshop on Standardized Echography accomplished the correct diagnosis of a retinal detachment without exception within 5 to 15 seconds.

Other  features of the software package 2000 are: an automatic setting of the Tissue Sensitivity, automatic calculations and digital readouts of the reflectivity and sound absorption of tumor tissues. For the first time this sound absorption can be measured and displayed in db/ mm tissue by simply setting two electronic gates at both opposite surface signals of the tissue or marking any section within the tissue echogram. The associated angle kappa is measured and displayed digitally in degrees and can be displayed schematically (Fig. 2).

This rapidly developing user-friendly automation of differential diagnoses and measurements has begun to rejuvenate Standardized Echography preparing it for a much wider usage in the years to come.


Figure 2 A : Standardized A-scan from strongly absorbing tissue (Tissue Sensitivity). Electronic markers set on each end of the tissue echogram. Angle kappa (51.2 o) and absorption (1.7 db / mm tissue) measured and displayed


Figure 2 B : Same echogram shown in Figure 2 A with schematic display of the angle kappa

 

5.      Conclusion

 

This paper starts with the definition of the term "Standardized Echography" (Introduction). The history of the origin of Standardized Echography in early 1963, its successes and worldwide expansion and its radical changes following the digital revolution, which started in the early 1990 and continue with increasing speed at the present, are narrated in Chapter 1 (Historical Background). Chapters 2-4 describe the special characteristics of each of the three stages in the evolution of Standardized Echography. 

In the four decades of its existence, Standardized Echography has become the most potent and effective echographic method. Powerful software programs developed during the past few years and being added continuously begin to turn this sophisticated method into a quick and easy and ever so more reliable, objective and accurate diagnostic tool in ophthalmology, which will require much less training and experience than in the past.

 

 

6.    Bibliography

 

A selection from the vast literature on Standardized Echography (scientific papers, book chapters, and books) is presented here including publications reporting instrumentation, techniques and specific diagnoses for the first time or confirming previous reports with more details or greater patient volumes, and publications containing concise and relevant bibliographical or summarizing reviews.

 

 

Scientific Papers & Book Chapters:

 

1.   Ossoinig KC   Ultrasonic Diagnosis of Tumors in the Eye and Orbit  - experimental and clinical examinations with the A-scan method [German]  in: Diagnostica Ultrasonica in ophthalmologia (Proceedings of SIDUO I, Berlin 1964, Buschmann W and Hildebrandt I, eds) pp 185-191, Math. Naturwiss. Reihe XIV der Humboldt-Universität Berlin, 1965

 

2.   Ossoinig KC and Steiner H   Standardization in Ultrasonic Diagnosis  - a tissue model for the diagnosis of intraocular tumors [German]   in: Diagnostica Ultrasonica in Ophthalmologia (Proceedings of SIDUO I, Berlin 1964, Buschmann W and Hildebrandt I, eds) pp 129-133, Math. Naturwiss. Reihe XIV der Humboldt-Universität Berlin, 1965

 

3.    Ossoinig KC  Ultrasonic Diagnosis in Ophthalmology [German]   9. Verhandl Österr Ophthal Ges  pp. 11-27, 1965

 

4.     Ossoinig KC  Acoustic Diagnosis of Ocular Tumors - Experimental and Clinical Examinations with the A-scan Method  [German]  Klin. Monatsbl. Augenheilk., 146:321-337, 1965

 

5.    Ossoinig KC   Echography of Intraocular Foreign Bodies [German]   Ber 67. Zus Deutsch Ophthal Ges

       Heidelberg67:288-294, 1965

     

6.   Ossoinig KC  Ultrasonic Diagnosis of Intraocular Foreign Bodies [German]  Ber. Deutsch. Ophth. Ges. 67:288-296, 1966

 

7.     Ossoinig KC  Ultrasonic Diagnosis of the Eye - an Aid for the Clinic (Review)   in: Ultrasonics in Ophthalmology (proceedings of Symposium Münster 1966; Oksala A. and Gernet, H.,eds ),  pp.116-133, Karger Basel / New York 1967

 

8.     Ossoinig KC  Evaluation of Kinetic Properties of Echograms [German]   in: Ultrasonics in Ophthalmology (proceedings of Symposium Münster 1966; Oksala A. and Gernet, H.,eds ),  pp. 88-96, Karger Basel / New York 1967

 

9.     Ossoinig KC  A new Instrument for Clinical Echo-Ophthalmography [German]  Graefe's Arch. Ophthalmol. 171:312-317, 1967

 

10.   Ossoinig KC  Ultrasonic Diagnosis of Orbital Tumors (A-scan and B-scan examinations) [German]  Graefe's Arch. Klin. Exp.Ophthal. 172:364-382, 1967

 

11.    Ossoinig KC and Seher K   Some Findings about the Histological Basis of Echograms [German]   in: Ultrasonics in Ophthalmology (Proceedings of Münster Symposium 1966,      Oksala A and Gernet H, eds) pp 88-96, Karger  1967

12.    Ossoinig KC and Seher K   Results in the Echography of Orbital Tumors [German]   Klin Mbl Augenheilk 151:519-524, 1967

13.     Ossoinig KC and Valencak E  Echo-tomography - a Method for the Diagnosis of Orbital Tumors [French}  In: Neuro-Chir (Paris), 13:899-905, 1967

14.   Ossoinig KC   The Echographic Picture presented by Healthy Orbita (A-scan echograms)   In: Diagnostica Ultrasonica in Ophthalmologia (proceedings of SIDUO II, 1967, Vanýsek, J, ed), Acta Fac. Med. Univ.Brunensis 35, pp. 101- 107, Brno 1968

 

15.     Ossoinig KC  Techniques of Echo-tomography of the Eye and Orbit [German]  In: Diagnostica Ultrasonica in Ophthalmologia (proceedings of SIDUO II, 1967, Vanýsek, J, ed), Acta Fac. Med. Univ.Brunensis 35, pp. 117-123, Brno 1968

 

16.     Ossoinig KC  Echography in Ophthalmology [German]    Wien.Med. Wschr. (Proceedings sterr. Ophthalmol. Ges. 1965) 118:362-367, 1968

 

17.   Valencak E and Ossoinig KC   A- and B-scan Echography of orbital A-V Fistulas [French]   in: Neuro-Chirurgie, Paris,

        14:951-956, 1968

18.  Böck J and Ossoinig KC   Relationship between Histological Structures and Echograms  as the Basis for Non-traumatic Tissue Differentiation [German]   Klin Mbl Augenheilk 155:687-695  1969

 

19.   Ossoinig KC   Routine Ultrasonography of the Orbit    in: Ultrasonography in Ophthalmology, International Ophthalmology Clinics 9/3:613-642, Little, Brown and Company 1969

 

20.    Ossoinig KC   Basics, Methods, and Results of Ultrasonography used in the Diagnosis of

Intraocular Tumors  in: Ophthalmic Ultrasound (Proceedings of International Symposium in Philadelphia 1968, Gitter KA, Keeney AH, Sarin LK, and Meyer D, eds) pp 282-293, The CV Mosby Company, St.Louis, 1969

 

21.   Ossoinig KC  and Seher K  Ultrasonic Diagnosis of Intraocular Foreign Bodies  in: Ophthalmic Ultrasound (Proceedings of International Symposium in Philadelphia 1968, Gitter KA, Keeney AH, Sarin LK, and Meyer D, eds) pp. 311-320, The CV Mosby Company, St.Louis, 1969

       

22.     Ossoinig KC and Till P  Methods and Results of Ultrasonography in Diagnosing Intraocular Tumors  in: Ophthalmic Ultrasound (Proceedings of International Symposium in Philadelphia 1968, Gitter KA, Keeney AH, Sarin LK, and Meyer D, eds) pp294-300, The CV Mosby Company, St.Louis, 1969

 

23.   Ossoinig KC and Till P   Echo-Ophthalmography [German]    Ber dtsch ophthal Ges 70:605-613, 1969

 

24.   Ossoinig KC   Echography of the Orbit  -  Method of Choice for the Diagnosis in Unilateral Exophthalmus [German]  

        Schweiz Med Wochenschr 99:1033-1039, 1969

 

25.   Ossoinig KC  and Valencak E  Ultrasonography and Other Diagnostic Methods: Importance in Orbital Tumors  in: Ophthalmic Ultrasound (Proceedings of International Symposium in Philadelphia 1968, Gitter KA, Keeney AH, Sarin LK, and Meyer D, eds) pp 301-305, The CV Mosby Company, St.Louis, 1969

 

26.   Till P and Ossoinig KC   Echographic Diagnosis of Retinoblastomas [German]   Ber Dtsch Ophthalmol Ges  69:203-209, 1969

 

27.   Ossoinig KC   Enophthalmus - a Sign of an orbital Tumor[German]   Ber. Deutsch Ophthal Ges Heidelberg 1969, JF Bergmann Verlag, München, 1970

 

28.   Gerstner R. and Ossoinig KC  A New High-frequency Ultrasonic Instrument for the Diagnosis and Differential Diagnosis of  abnormal Tissues [German]  in: Ultrasonographia Medica (Proceedings of 1st World Congress on Ultrasonic Diagnostics in Medicine and SIDUO III, Vienna 1969 (Böck J and Ossoinig KC, eds) Vol I, pp. 55-60, published by Wien. Med. Akad., Wien 1971.

 

29.   Ossoinig KC  Basics of Clinical Echo-Ophthalmography. Part IV: Clinical Standardization of Instrument and Examination Techniques [German]   in: Ultrasonographia Medica (Proceedings of 1st World Congress on Ultrasonic Diagnostics in Medicine and SIDUO III, Vienna 1969 (Böck J and Ossoinig KC, eds) Vol II, pp. 83-118, published by Wien. Med. Akad., Wien 1971

 

30.   Ossoinig KC   Ultrasonic Diagnosis of Orbital Vascular Lesions [German]   Klin Mbl Augenheilk 158:526-533  1971

 

31.   Ossoinig KC   Echo-Orbitography  -  a reliable method for the Differential Diagnosis of Endocrine Exophthalmus   in: Further Advances in Thyroid Research (Proc of Vienna Conference on Endocrine Disorders 1968, Fellinger K and Höfer R, eds) pp 871-877,  Verlag Wiener Med Akad, Vienna 1971

       

32.   Till P  Echography of Retrobulbar Hematomas [German]  Klin Mbl. Augenheilk 158:723,   1971

 

33.   Till P and Neumann A   Reliability of Biological Standards [German] ]   in: Ultrasonographia Medica (Proceedings of 1st World Congress on Ultrasonic Diagnostics in Medicine and SIDUO III, Vienna 1969 (Böck J and Ossoinig KC, eds) Vol II, pp. 119-124, published by Wien. Med. Akad., Wien 1971

 

34.     Bronson NR  Development of a Simple B-scan Ultrasonoscope. Trans. Amer. Ophthal. Soc. 70: 365-408, 1972

 

35.   Ossoinig KC   Clinical Echo-Ophthalmography   in: Current Concepts in Ophthalmology (Blodi FC, ed) 8:101-130,

        The CV Mosby Company, 1972

 

36.    Ossoinig KC   The Clinical Value of Echography in Traumatic Retinal Detachments [German]   Mod Probl Ophthal

         10:437-442, 1972

 

37.   Till P and Ossoinig KC   Echography in the Evaluation of periorbital Carcinomas invading the Orbit [German]   Msch

        Ohrh pp 442-448, 1972

 

38.   Till P and Ossoinig KC   Echographic Findings in Retinopathia Proliferans   Klin Mbl Augenh 161: 297-301,

        1972

 

39.     Freyler H   Echography in Hemorrhagic Choroidal Detachments [German] ]  in: Diagnostica Ultrasonica in Ophthalmologia (Proceedings of SIDUO IV, Paris 1971; Massin M. and Poujol J., eds) pp. 189-193,  published by Centre National d'Ophtalmologie des Quinze-Vingts, Paris 1973

 

40.     Ossoinig KC  A New Instrument for Clinical Echo-Ophthalmography (proposals for the standardization of important instrument parameters) [German]  in: Diagnostica Ultrasonica in Ophthalmologia (Proceedings of SIDUO IV, Paris 1971; Massin M. and Poujol J., eds) pp. 131-137,  published by Centre National d'Ophtalmologie des Quinze-Vingts, Paris 1973

 

41.    Ossoinig KC   Discussion of "Reliability of Ocular Tumor Diagnosis with Ultrasound" by Coleman DJ   Trans Amer

        Acad Ophthalmol Otolaryngol 77/5 OP: 684-686, 1973

 

42.     Till P and Abel JO   Results of Echography in Cases with Detached Retina  [German]   in: Diagnostica Ultrasonica in Ophthalmologia (Proceedings of SIDUO IV, Paris 1971; Massin M. and Poujol J., eds) pp.195-198,  published by Centre National d'Ophtalmologie des Quinze-Vingts, Paris 1973

 

43.   Ossoinig KC   Preoperative Differential Diagnosis of Tumors with Echography. I. Physical Principles and Morphological Background of Tissue Echograms   In: Current Concepts in Ophthalmology (Blodi FC ed) 4:264-280. CV Mosby, St.Louis  1974

 

44.   Ossoinig KC   Preoperative Differential Diagnosis of Tumors with Echography. II. Instrumentation and Examination Techniques  In: Current Concepts in Ophthalmology (Blodi FC ed) 4:280-296. CV Mosby, St.Louis  1974

 

45.   Ossoinig KC   Quantitative Echography - An Important Aid for the Acoustic Differentiation of Tissues   in: Ultrasonics in Medicine (Proceedings of 2nd World Congress on Ultrasonics in Medicine, Rotterdam 1973, de Vlieger M, White DN and McCready VR, eds) pp 49-54, Excerpta Medica, Amsterdam 1974

 

46.    Ossoinig KC   Quantitative Echography - the basis of tissue differentiation   J Clinical Ultrasound 2/1: 33-46, 1974

       

47.   Ossoinig KC and Blodi FC   Preoperative Differential Diagnosis of Tumors with Echography.  III Diagnosis of Intraocular Tumors  In: Current Concepts in Ophthalmology (Blodi FC ed) 4:296-313. CV Mosby, St.Louis  1974

 

48.   Ossoinig KC and Blodi FC   Preoperative Differential Diagnosis of Tumors with Echography . IV. Diagnosis of Orbital Tumors  In: Current Concepts in Ophthalmology (Blodi FC ed) 4:313-341. CV Mosby, St.Louis  1974

 

49.   Till P and Lessel MR   Doppler-Sonography and Echo-Ophthalmography off Orbital Vascular Processes   in: SIDUO Round Table 1974 (Massin M and Poujol J, eds) pp 51-58, Centre Nat d'Ophtalmol des Quinze-Vingts, Paris 1974

 

50.   Freyler H and Arnfelser H   Relation between Histological Structure and Ultrasonogram in Malignant Melanoma of the Choroid   in: Ultrasonography in Ophthalmology  (Proceedings of SIDUO V, Francois J and Goes F, eds) pp 163-171,  S Karger 1975

 

51.   Ossoinig KC   A-scan Echography and Orbital Disease   in: Modern Problems in Ophthalmology (Proceedings 2nd  Int Symposium on Orbital Disorders, Amsterdam 1973 (Streiff EB, ed) Vol 14, pp 203-235, Karger 1975

 

52.   Ossoinig KC, Bigar F and Kaefring S   Malignant Melanoma of the Choroidand Ciliary Body. A differential diagnosis in Clinical Echography   in: Ultrasonography in Ophthalmology  (Proceedings of SIDUO V, Francois J and Goes F, eds) pp141-154,  S Karger  1975

 

53.   Ossoinig KC, Bigar F, Kaefring S and McNutt L   Echographic Detection and Localization of BB Shots in the Eye and Orbit   in: Ultrasonography in Ophthalmology  (Proceedings of SIDUO V, Francois J and Goes F, eds) pp 109-118, S Karger  1975

 

54.   Ossoinig KC, Keenan TP and Bigar F   Cavernous Hemangioma of the Orbit   in: Ultrasonography in Ophthalmology  (Proceedings of SIDUO V, Francois J and Goes F, eds) pp 236-244,  S Karger 1975

 

55.   Ossoinig KC and Till P   Ten-year Study on Clinical Echography in Orbital Disease   Bibl Ophthalmol 83:200  1975

 

56.   Ossoinig KC and Till P   Clinical Echography of Tumors in the Eye and Orbit [German]   in: Krebsbehandlung als Interdisziplinäre Aufgabe, Kärcher KH ed, pp 249-270, Springer Verlag 1975

 

57.   Till P  Echography in Rhinogenic Orbital Conditions  in: Modern Problems in Ophthalmology: Orbital Disorders (Bleeker GM et al, eds) Vol 14, p 273, Karger (Basel) 1975

 

58.   Till P and Ossoinig K   Ten-year Study on Clinical Echography in Intraocular Disease   Bibl Ophthalmol 83:49  1975

 

59.   Wüstenberg L and Kohlhase R   Echographic Findings in Unilateral Exophthalmus [German]   in: Ultrasonography in Ophthalmology  (Proceedings of SIDUO V, Francois J and Goes F, eds) pp 217-223,  S Karger 1975

 

60.   Ossoinig KC   Clinical Echography of Orbital Tumors   in: proc Sympos Amer Soc Plast Reconstr Surgeons, Dallas 1974, Tessier P, Callahan A, Mustarde JC and Salyer KE, eds; 12:307-315, CV Mosby 1976

 

61.   Till P   Solid Tissue Model for the Standardization of the Echo-Ophthalmograph 7200 MA (Kretztechnik)   Docum Ophthalmol 41:205  1976

 

62.   Hodes BC Standardized A-scan Echographic Diagnosis of Choroidal Malignant Melanomas   Arch.Ophthal 95:593-597,  1977

 

63.   McNutt LC, Kaefring SL, and Ossoinig KC  Echographic Measurement of Extraocular Muscles  in: Ultrasound in Medicine, Vol 3A (Proceedings of 1st Triennial Meeting [2nd World Congress] of the World Federation for Ultrasound in Medicine and Biology and SIDUO VI, San Francisco, 1976,  White D. and Brown RE, eds) pp. 927-932,  Plenum Press, New York 1977

 

64.   Ossoinig KC   Echography of the Eye, Orbit and Periorbital Region   in: Orbit Roentgenology (Arger PH, ed), 224-269, John Wiley and Sons, New York  1977

 

65.   Ossoinig KC   Special Echographic Techniques for the Evaluation of Ocular Foreign Bodies  [German]   in: proc of "Intraokulärer Fremdkörper und Metallose", Symp DOG Köln 1976, Neubauer H,
Rüssman W and Kilp H, eds; pp 247-257, JF Bergmann Verlag, München 1977    

 

66.     Ossoinig KC, Kaefring SL, McNutt LC, and Weinstock SJ  Echographic Measurement of the Optic Nerve  in: Ultrasound in Medicine, Vol 3A (Proceedings of 1st Triennial Meeting [2nd World Congress] of the World Federation for Ultrasound in Medicine and Biology and SIDUO VI, San Francisco, 1976,  White D. and Brown RE, eds) pp. 1065-1066,  Plenum Press, New York 1977

 

67.    Ossoinig KC, Frazier S, Watzke RC and Diamond JG   Combined A-scan and B-scan Echography as a Diagnostic

        Aid for Vitreoretinal Surgery   in: New and Controversial Aspects of Vitreoretinal Surgery, Houston 1975, McPherson

        A, ed; pp106-125, CV Mosby 1977

 

68.  Till P and Ossoinig KC   First Experiences with a Solid Tissue Model for the Standardization of A- and B-scan

Instruments in Tissue Diagnosis   in: Ultrasound in Medicine (Proceedings of SIDUO VI, 1976, White D and Brown

RE, eds) Vol 3B, pp 2167-2174, Plenum Publishing Corp, 1977

 

69.   Ossoinig KC   Echography of Orbital Disorders  in: Clinical Handbook of Ultrasound (M de Vlieger, ed) pp 881-904, John Wiley and Sons, Inc. (New York)  1978

 

70.   Ossoinig KC   The Role of Clinical Echography in Modern Diagnosis of Periorbital and Orbital Lesions   in: Proceedings of 3rd Int Symposium on Orbital Disorders, Amsterdam 1977 Bleeker GM, ed) pp 496-540, Dr.W.Junk Publishers, The Hague 1978

 

71.   Fuller DG, Snyder WB, Hutton WL and Vaiser A   Ultrasonographic Features of Choroidal Malignant Melanomas   Arch Ophthalmol 97:1465-1472, 1979

 

72.   Hauff W  and Till P   Echographic Findings in Orbital Mucoceles   in: Diagnostica Ultrasonica in Ophthalmologia  (Proceedings of SIDUO VII, Gernet H., ed) pp 151-154, R.A.Remy - Verlag, Münster 1979      

 

73.   Mazzeo V and Scorrano R   Our Echographic Experience about Choroidal Melanomas   in: Diagnostica Ultrasonica in Ophthalmologia  (Proceedings of SIDUO VII, Gernet H., ed) pp 119-122, R.A.Remy - Verlag, Münster 1979

 

74.   Ossoinig KC   The Technique of Measuring Extraocular Muscles   in: Diagnostica Ultrasonica in Ophthalmologia  (Proceedings of SIDUO VII, Gernet H., ed) pp 166-172, R.A.Remy - Verlag, Münster 1979

 

75.  Ossoinig KC  Standardized Echography: Basic Principles, Clinical Applications, and Results

        In: Ophthalmic Ultrasonography: Comparative Techniques (RL Dallow, editor), International Ophthalmology Clinics 19:No.4, pp.127-210, 1979

 

76.   Scott W, Fabre J and Ossoinig KC   Congenital Mucocele of the Lacrimal Sac   Arch Ophthal 9/1, pp 1656-1658  1979

 

77.   Till P   Echography in Intraocular Tumors   in: Diagnostica Ultrasonica in Ophthalmologia  (Proceedings of SIDUO VII, Gernet H., ed) R.A.Remy - Verlag, Münster 1979

 

78.   Dagher G, Anderson R, Ossoinig KC and Baker J   Adenoid Cystic Carcinoma of the Lacrimal Gland in a Child   Arch Ophthal 98:1098-1100, 1980

 

79.   Ossoinig KC and Blodi FC   The Role of Echography in the Diagnosis of Orbital Disorders   Palestra Oftalm Panamericana 4:12-19, 1980

 

80.   Till P   Testing of Ultrasonic Probes and their Suitability for Tissue Differentiation with the help of the Solid Tissue

        Model [German]   Klin Mbl Augenheilk 176: 337-340, 1980

 

81.   Gallenga PE, Dalia T, Bellone G, Cennamo G, Mazzeo V and Rossi A   The Role of Echography in the Conservative

       Treatment of endobulbar Tumors    in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 117-122,  Dr. W. Junk Publishers 1981

 

82.   Hauff  W and Till P   Echography in Unusual Orbital Complications of Parasinusal Diseases   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 317-322,  Dr. W. Junk Publishers 1981

 

83.   Nishimoto Y, Baba Y, Shibata H and Sawada A   Combination of Echography with Coronal CT in the Diagnosis of Orbital Disorders   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 301-316,  Dr. W. Junk Publishers 1981

 

84.   Ossoinig KC   Echographic Differentiation of Vascular Tumors in the Orbit   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 283-291,  Dr. W. Junk Publishers 1981

 

85.    Ossoinig KC   The Significance of the S-shaped Amplifier characteristics in Echographic Tissue Diagnosis    in:

         Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek

         AM, eds) pp 441-443,  Dr. W. Junk Publishers 1981

 

86.    Ossoinig KC   The Significance of Standardized Echography for Neuro-ophthalmology   in: "Aktuelle Ophthalmologische Probleme (Remke H, ed) pp 61-75, Ferdinand Enke Verlag, Stuttgart 1981

 

87.   Ossoinig KC, Cennamo G and Byrne SF   Echographic Differential Diagnosis of Optic-Nerve Lesions   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 327-332,  Dr. W. Junk Publishers 1981

 

88.   Ossoinig KC, Cennamo G, Green RL and Weyer, NL   Echographic Results in the Diagnosis of Retinoblastoma   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 103-107, Dr. W. Junk Publishers 1981

 

89.   Till P and Hauff W   Differential Diagnostic Results of Clinical Echography in Intraocular Tumors   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 91-95, Dr. W. Junk Publishers 1981

       

90.   Till P and Hauff W   Differential Diagnostic Results of Clinical Echography in Orbital Tumors   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 277-282,  Dr. W. Junk Publishers 1981

       

91.   Till P and Scheiber V   Reliability and Accuracy of TM (Tissue Model) for Calibration of Standardized A-scan Instrumentation   in: Ultrasonography in Ophthalmology  (Documenta Ophthalmologica Proceedings Series 29, Thijssen JM and Verbeek AM, eds) pp 457-461,  Dr. W. Junk Publishers 1981

 

92.    Divine RD, Anderson RL and Ossoinig KC   Metastatic Carcinoid Unresponsive to Radiation Therapy presenting asa Lacrimal Fossa Mass   Ophthalmology 89:516-520, 1982

 

93.   Ossoinig KC  Advances in Diagnostic Ultrasound  in: Acta:XXIV International Congress of Ophthalmology, San Francisco1982 (Paul Henkind, ed.), J.B.Lippincott Comp., Vol1, pp.89-114, 1982.

 

94.   Ossoinig KC  A New Echographic Sign for a Reliable Differential Diagnosis of Graves' Orbitopathy [German]   Klin Mbl Augenheilk  180:189-197, 1982

 

95.   Phelps C, Thompson S and Ossoinig KC   The Diagnosis and Prognosis of Atypical Carotid-Cavernous Fistula (Red-Eyed Shunt Syndrome)   AJO 93:423-436, 1982