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<meta name="DC.Description" content="Summary: A glaucoma drainage implant was detected on plain skull radiographs before MR imaging examination of the brain. The patient was denied the MR imaging for fear of dislodging the “metallic foreign body.” The Baerveldt glaucoma drainage implant was mistakenly identified as an orbital metallic object based on its radiographic characteristics. Because none of the current glaucoma drainage implants contain ferromagnetic material, patients with these devices can undergo MR imaging without special precaution." />
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<meta name="citation_reference" content="Lagouros PA, Langer BG, Peyman GA, Mafee MF, Spigos DG, Grisolano J. Magnetic resonance imaging and intraocular foreign bodies. Arch Ophthalmol 1987;105:551–553" />
<meta name="citation_reference" content="Williams S, Char DH, Dillon WP, Lincoff N, Moseley M. Ferrous intraocular foreign bodies and magnetic resonance imaging. Am J Ophthalmol 1988;105:398–401" />
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<meta name="og-description" property="og:description" content="Summary: A glaucoma drainage implant was detected on plain skull radiographs before MR imaging examination of the brain. The patient was denied the MR imaging for fear of dislodging the “metallic foreign body.” The Baerveldt glaucoma drainage implant was mistakenly identified as an orbital metallic object based on its radiographic characteristics. Because none of the current glaucoma drainage implants contain ferromagnetic material, patients with these devices can undergo MR imaging without special precaution." />
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      <h1 class="highwire-cite-title" id="page-title">Plain Film Imaging of Baerveldt Glaucoma Drainage Implants</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Elizenda M. Ceballos</span> and <span class="highwire-citation-author" data-delta="1">Richard K. Parrish</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2002,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">23 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">935-937; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-10166--61971494797" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Elizenda M. Ceballos </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Ophthalmology, University of Miami School of Medicine, Miami, FL</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Elizenda%2BM.%2BCeballos%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ceballos%20EM&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AElizenda%2BM.%2BCeballos%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Richard K. Parrish <span class="nlm-suffix">II</span></div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Ophthalmology, University of Miami School of Medicine, Miami, FL</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Richard%2BK.%2BParrish%2B%3Cspan%2Bclass%3D%22nlm-suffix%22%3EII%3C/span%3E" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Parrish%20RK&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ARichard%2BK.%2BParrish%2BII" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><p id="p-1">Summary: A glaucoma drainage implant was detected on plain skull radiographs before MR imaging examination of the brain. The patient was denied the MR imaging for fear of dislodging the “metallic foreign body.” The Baerveldt glaucoma drainage implant was mistakenly identified as an orbital metallic object based on its radiographic characteristics. Because none of the current glaucoma drainage implants contain ferromagnetic material, patients with these devices can undergo MR imaging without special precaution.</p></div><p id="p-2">Drainage implants are increasingly being used for the surgical treatment of glaucoma refractory to medical and standard surgical therapy. Echographic and radiographic findings may suggest the diagnosis of an orbital foreign body if the ophthalmic history is not known.</p><div class="section" id="sec-1"><h2 class="">Case Report</h2><p id="p-3">An asymptomatic 82-year-old female patient with open angle glaucoma presented to her ophthalmologist for evaluation of a “metallic object” in her left orbit (<a id="xref-fig-1-1" class="xref-fig" href="#F1">Fig 1</a>). The object in question was identified as a 350-mm<sup>2</sup> Baerveldt glaucoma drainage implant (Pharmacia Co., Kalamazoo, MI) that had been previously placed to lower intraocular pressure. The smooth convex radiographic profile of the device corresponded to the globe curvature in the superotemporal orbit.</p><div id="F1" class="fig pos-float  odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F1.large.jpg?width=800&amp;height=600&amp;carousel=1" title="Plain film radiographs obtained from an asymptomatic 82-year-old female patient with open angle glaucoma who presented to her ophthalmologist for evaluation of a &#x201C;metallic object&#x201D; in her left orbit. A, Anteroposterior view shows the convex, barium-impregnated plate of the Baerveldt glaucoma drainage implant positioned superotemporally on the globe. B, Lateral view shows the implant." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-432516819" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;Plain film radiographs obtained from an asymptomatic 82-year-old female patient with open angle glaucoma who presented to her ophthalmologist for evaluation of a &#x201C;metallic object&#x201D; in her left orbit. &lt;em&gt;A&lt;/em&gt;, Anteroposterior view shows the convex, barium-impregnated plate of the Baerveldt glaucoma drainage implant positioned superotemporally on the globe. &lt;em&gt;B&lt;/em&gt;, Lateral view shows the implant.&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Fig 1." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F1.medium.gif" width="248" height="440"/><noscript><img class="highwire-fragment fragment-image" alt="Fig 1." src="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F1.medium.gif" width="248" height="440"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F1.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Fig 1." data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F1.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/30531" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="fig-label">F<span class="sc">ig</span> 1.</span> <p id="p-6" class="first-child">Plain film radiographs obtained from an asymptomatic 82-year-old female patient with open angle glaucoma who presented to her ophthalmologist for evaluation of a “metallic object” in her left orbit.</p><p id="p-7"><em>A</em>, Anteroposterior view shows the convex, barium-impregnated plate of the Baerveldt glaucoma drainage implant positioned superotemporally on the globe.</p><p id="p-8"><em>B</em>, Lateral view shows the implant.</p><div class="sb-div caption-clear"></div></div></div></div><div class="section" id="sec-2"><h2 class="">Discussion</h2><p id="p-4">Of the commercially available glaucoma drainage implants, only the Baerveldt glaucoma drainage implant (250, 350, and 425 mm<sup>2</sup>) is radiopaque (<a id="xref-fig-2-1" class="xref-fig" href="#F2">Fig 2</a>). Barium-impregnated silicone used in the fabrication of the Baerveldt plate increases echographic resolution and facilitates radiographic identification. The Krupin-Denver eye valve to disc implant (184 mm<sup>2</sup>) (E. Benson Hood Laboratories, Pembroke, MA), Ahmed glaucoma valve (184 mm<sup>2</sup>) (New World Medical, Rancho Cucamonga, CA), Molteno drainage device (single plate 129 mm<sup>2</sup> and double plate 259 mm<sup>2</sup>) (Molteno Ophthalmic Ltd., Dunedin, New Zealand), and the Joseph valve (Valve Implants Limited, Hertford, England) feature a translucent silicone tube connected to a plate made of rigid plastic or flexible silicone rubber that is fixed to the sclera (<a id="xref-fig-3-1" class="xref-fig" href="#F3">Fig 3</a>). None of these devices contain ferromagnetic material or have been impregnated with a radiopaque substance.</p><div id="F2" class="fig pos-float  odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F2.large.jpg?width=800&amp;height=600&amp;carousel=1" title="Baerveldt glaucoma drainage implants are shown in three sizes with surface areas of 250, 350, and 425 mm2 (left to right)." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-432516819" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;Baerveldt glaucoma drainage implants are shown in three sizes with surface areas of 250, 350, and 425 mm&lt;sup&gt;2&lt;/sup&gt; (&lt;em&gt;left&lt;/em&gt; to &lt;em&gt;right&lt;/em&gt;).&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Fig 2." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F2.medium.gif" width="440" height="293"/><noscript><img class="highwire-fragment fragment-image" alt="Fig 2." src="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F2.medium.gif" width="440" height="293"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F2.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Fig 2." data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F2.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/30512" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption"><span class="fig-label">F<span class="sc">ig</span> 2.</span> <p id="p-9" class="first-child">Baerveldt glaucoma drainage implants are shown in three sizes with surface areas of 250, 350, and 425 mm<sup>2</sup> (<em>left</em> to <em>right</em>).</p><div class="sb-div caption-clear"></div></div></div><div id="F3" class="fig pos-float  odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F3.large.jpg?width=800&amp;height=600&amp;carousel=1" title="Commercially available glaucoma drainage devices are shown. From left to right, they are the Krupin drainage device, Baerveldt drainage implant (350 mm2), Ahmed implant, double plate Molteno device, and single plate Molteno device. (Note that the Joseph valve is not shown)." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-432516819" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;Commercially available glaucoma drainage devices are shown. From &lt;em&gt;left&lt;/em&gt; to &lt;em&gt;right&lt;/em&gt;, they are the Krupin drainage device, Baerveldt drainage implant (350 mm&lt;sup&gt;2&lt;/sup&gt;), Ahmed implant, double plate Molteno device, and single plate Molteno device. (Note that the Joseph valve is not shown).&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Fig 3." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F3.medium.gif" width="440" height="263"/><noscript><img class="highwire-fragment fragment-image" alt="Fig 3." src="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F3.medium.gif" width="440" height="263"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F3.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Fig 3." data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/23/6/935/F3.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/30478" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption"><span class="fig-label">F<span class="sc">ig</span> 3.</span> <p id="p-10" class="first-child">Commercially available glaucoma drainage devices are shown. From <em>left</em> to <em>right</em>, they are the Krupin drainage device, Baerveldt drainage implant (350 mm<sup>2</sup>), Ahmed implant, double plate Molteno device, and single plate Molteno device. (Note that the Joseph valve is not shown).</p><div class="sb-div caption-clear"></div></div></div><p id="p-5">Intraocular pressure is lowered when aqueous humor flows from inside the eye through the tube into the space between the plate that rests on the scleral surface and surrounding fibrous capsule. The adjacent periocular tissues absorb aqueous humor from the reservoir. Although intraocular ferromagnetic foreign bodies have been shown to move during MR imaging (<a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a>–<a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a>), because neither the Baerveldt drainage implant nor any of the other commercially available devices contain ferromagnetic material, inadvertent dislocation of these devices is unlikely.</p></div><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-23.6.935.1" data-doi="10.1001/archopht.1987.01060040121048"><div class="cit-metadata"><cite>Lagouros PA, Langer BG, Peyman GA, Mafee MF, Spigos DG, Grisolano J. <strong>Magnetic resonance imaging and intraocular foreign bodies.</strong> <span class="cit-source">Arch Ophthalmol</span> <span class="cit-pub-date">1987</span>;<span class="cit-vol">105</span>:<span class="cit-fpage">551</span>–553</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/archopht.1987.01060040121048&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=3566612&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F6%2F935.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-23.6.935.2" data-doi="10.1016/0002-9394(88)90305-4"><div class="cit-metadata"><cite>Williams S, Char DH, Dillon WP, Lincoff N, Moseley M. <strong>Ferrous intraocular foreign bodies and magnetic resonance imaging.</strong> <span class="cit-source">Am J Ophthalmol</span> <span class="cit-pub-date">1988</span>;<span class="cit-vol">105</span>:<span class="cit-fpage">398</span>–401</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/0002-9394(88)90305-4&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=3282439&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F6%2F935.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3 in text" id="ref-3">↵</a><div class="cit ref-cit ref-other" id="cit-23.6.935.3" data-doi="10.1016/S0002-9394(99)00435-3"><div class="cit-metadata"><cite>Ta CN, Bowman RW. <strong>Hyphema caused by metallic intraocular foreign body during magnetic resonance imaging.</strong> <span class="cit-source">Am J Ophthalmol</span> <span class="cit-pub-date">2000</span>;<span class="cit-vol">129</span>:<span class="cit-fpage">533</span>–534</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/S0002-9394(99)00435-3&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=10764867&amp;link_type=MED&amp;atom=%2Fajnr%2F23%2F6%2F935.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><ul class="history-list"><li xmlns:hwp="http://schema.highwire.org/Journal" class="received" hwp:start="2001-08-13"><span class="received-label">Received </span>August 13, 2001.</li><li xmlns:hwp="http://schema.highwire.org/Journal" class="accepted" hwp:start="2002-01-28"><span class="accepted-label">Accepted after revision </span>January 28, 2002.</li></ul><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/23/6/935.abstract" class="hw-link hw-link-article-abstract" data-icon-position="" data-hide-link-title="0">View Abstract</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 23</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 6 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jun 2002 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Elizenda M.</span> <span class="nlm-surname">Ceballos</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Richard K.</span> <span class="nlm-surname">Parrish</span></span></span></div>
  
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      <div class="highwire-cite-title">Plain Film Imaging of Baerveldt Glaucoma Drainage Implants</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Elizenda M.</span> <span class="nlm-surname">Ceballos</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Richard K.</span> <span class="nlm-surname">Parrish</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2002, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">23 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">935-937; </span></div>
  
  
  
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