Image quality for Tegaderm™ vs. No Tegaderm for ocular ultrasound

Tegaderm™ is sometimes applied to protect the eye during ocular ultrasound (US), but limited research has assessed whether this reduces image quality for physicians without advanced US training. We compared ocular US image quality with and without Tegaderm. Prospective randomized crossover study at a teaching facility. Residents and faculty without RDMS or fellowship training obtained ocular US images (short- and long-axis) of healthy volunteers. Tegaderm placement was randomized by side. Participants rated their images using ACEP Emergency US Standard Reporting Guidelines (1–5). Images were also scored by a faculty reviewer with advanced US training (raters). Mixed-effects regression modeled image quality in relation to Tegaderm and participant factors. Fifty emergency physicians participated (22% PGY-1, 20% PGY-2, 42% PGY-3, 16% faculty; 74% male). Overall mean score was 3.67. Images without Tegaderm scored higher than with Tegaderm (4.04 vs 3.29, p < 0.01). Advanced reviewers gave lower scores than non-advanced physicians (3.29 vs 4.04, p < 0.01). No significant differences were noted by gender, PGY year, side, or view. In multivariate analysis, Tegaderm use (−0.75; p < 0.01) and raters (−0.75; p < 0.01) predicted lower scores. Ocular US image quality was significantly reduced with Tegaderm. Faculty with advanced US training provided more critical assessments.