Is Tegaderm beneficial for improving image quality and patient discomfort in ocular ultrasound?

Studies on ocular point-of-care ultrasound differ on whether gel should be applied directly to the eye or on top of an adhesive membrane (i.e., Tegaderm). However, there needs to be data concerning which approach has the better image quality and the impact of patient preference. In the study conducted by Amy Marks, Rush University Medical Center, Chicago, IL, United States of America, and colleagues, the team sought to address this gap through the assessment of the difference in image quality and patient preference between Tegaderm compared to no Tegaderm for ocular ultrasound in the emergency department.

For this purpose, the patients were randomized to Tegaderm placed on either right or left eye. The other eye served as a control with no Tegaderm. Ultrasound was conducted on the right eye, followed by the left eye in all cases. After performing each ultrasound, patients were asked to rate their maximal discomfort from the ultrasound of that eye by utilizing g a Likert scale (0 = no discomfort; 10 = severe discomfort). The patients were then asked about their preferred side (Tegaderm vs no Tegaderm). Finally, an experienced ultrasound fellowship-trained sonographer reviewed the images and rated them from 1 to 5. Descriptive statistics were used for the analysis of continuous data.

The study led to the following findings:

• The mean image score was significantly worse with Tegaderm compared with no Tegaderm (mean difference: 0.94/5.00). This was consistent in both the transverse and the sagittal plane subgroups.
• The percentage of acceptable images was also higher in the no Tegaderm™ group compared with the Tegaderm™ group (97.8% versus 82.8%).
• The researchers did not observe a statistically significant difference in patient discomfort with the Tegaderm™ versus the no Tegaderm™ group.
• When asked to compare the two approaches, 54.4% of patients preferred Tegaderm™, 30.0% preferred no Tegaderm™, and 15.6% had no preference.

"Tegaderm use reduced image quality, and no significant difference was seen in patient discomfort for ocular ultrasound, suggesting that ocular ultrasound may be performed better without Tegaderm use," the researchers wrote in their study. "Future studies should assess the impact of Tegaderm versus no Tegaderm in more novice users."

Reference:

Marks A, Patel D, Chottiner M, Kayarian F, Peksa GD, Gottlieb M. Covered or uncovered: A randomized control trial of Tegaderm versus no Tegaderm for ocular ultrasound. Am J Emerg Med. 2022 Nov;61:87-89. doi: 10.1016/j.ajem.2022.08.044. Epub 2022 Aug 28. PMID: 36057214.