Leanne M Clevenger, Jessica L Cao, Megan S Steinkerchner, Amy S Nowacki, Alex Yuan
{"title":"眼外伤成人患者的人口统计学特征、表现特征和治疗效果。","authors":"Leanne M Clevenger, Jessica L Cao, Megan S Steinkerchner, Amy S Nowacki, Alex Yuan","doi":"10.1155/2024/8871776","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Ocular trauma is a common cause of permanent vision loss in adults. The combination of an accurate clinical examination and imaging offers the best prognostic indicators for patients and helps to navigate treatment modalities. This is a retrospective chart review of examination and imaging findings for ocular trauma and how they correlate with treatment course and visual acuity (VA) outcomes.</p><p><strong>Methods: </strong>Adult patients with ocular trauma presenting to a single institution between January 2013 and December 2020 were evaluated. Initial examination and imaging findings were compared for associations with each other and with VA outcomes.</p><p><strong>Results: </strong>136 ocular traumas on 134 patients were included. The median presenting logMAR VA was 2.7 (interquartile range (IQR) 1.2-3.7) with 62% open globe injuries. The most commonly reported finding on initial CT scan was globe deformity (30%), on B-scan was choroidal detachment (20%), and on ultrasound biomicroscopy was intraocular foreign body, ciliochoroidal effusions, or angle recession (21% each). Worse vision was observed for patients positive for retinal detachment on initial B-scan compared to those negative for this finding at 6-month (median logMAR 2.7 vs. 0.5; <i>P</i> < 0.0001) and at final post-injury evaluation (median logMAR 3.7 vs. 0.4; <i>P</i> < 0.0001). Similarly, worse VA was observed for patients with choroidal detachment on initial B-scan compared to those without this finding at 6-month (median logMAR 1.4 vs. 0.5; <i>P</i> = 0.002) and at final post-injury evaluation (median logMAR 2.0 vs. 0.4; <i>P</i> < 0.0001). If positive conjunctiva/sclera examination findings were identified, 66% had positive findings on B-scan, whereas if the conjunctiva/sclera examination findings were absent, 41% had positive findings on B-scan (<i>P</i> = 0.005). If anterior chamber (AC) examination findings were positive, 59% had positive findings on B-scan, whereas if the AC examination findings were absent, 37% had positive findings on B-scan (<i>P</i> = 0.03). <i>Discussion</i>. The predictive value of examination findings in this study may offer insight as to long-term visual prognosis. Positive B-scan or CT findings should increase suspicion for open globe injuries.</p>","PeriodicalId":16674,"journal":{"name":"Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186687/pdf/","citationCount":"0","resultStr":"{\"title\":\"Demographics, Presenting Features, and Outcomes of Adult Patients with Ocular Trauma.\",\"authors\":\"Leanne M Clevenger, Jessica L Cao, Megan S Steinkerchner, Amy S Nowacki, Alex Yuan\",\"doi\":\"10.1155/2024/8871776\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Ocular trauma is a common cause of permanent vision loss in adults. The combination of an accurate clinical examination and imaging offers the best prognostic indicators for patients and helps to navigate treatment modalities. This is a retrospective chart review of examination and imaging findings for ocular trauma and how they correlate with treatment course and visual acuity (VA) outcomes.</p><p><strong>Methods: </strong>Adult patients with ocular trauma presenting to a single institution between January 2013 and December 2020 were evaluated. Initial examination and imaging findings were compared for associations with each other and with VA outcomes.</p><p><strong>Results: </strong>136 ocular traumas on 134 patients were included. The median presenting logMAR VA was 2.7 (interquartile range (IQR) 1.2-3.7) with 62% open globe injuries. The most commonly reported finding on initial CT scan was globe deformity (30%), on B-scan was choroidal detachment (20%), and on ultrasound biomicroscopy was intraocular foreign body, ciliochoroidal effusions, or angle recession (21% each). Worse vision was observed for patients positive for retinal detachment on initial B-scan compared to those negative for this finding at 6-month (median logMAR 2.7 vs. 0.5; <i>P</i> < 0.0001) and at final post-injury evaluation (median logMAR 3.7 vs. 0.4; <i>P</i> < 0.0001). Similarly, worse VA was observed for patients with choroidal detachment on initial B-scan compared to those without this finding at 6-month (median logMAR 1.4 vs. 0.5; <i>P</i> = 0.002) and at final post-injury evaluation (median logMAR 2.0 vs. 0.4; <i>P</i> < 0.0001). If positive conjunctiva/sclera examination findings were identified, 66% had positive findings on B-scan, whereas if the conjunctiva/sclera examination findings were absent, 41% had positive findings on B-scan (<i>P</i> = 0.005). If anterior chamber (AC) examination findings were positive, 59% had positive findings on B-scan, whereas if the AC examination findings were absent, 37% had positive findings on B-scan (<i>P</i> = 0.03). <i>Discussion</i>. The predictive value of examination findings in this study may offer insight as to long-term visual prognosis. 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引用次数: 0
摘要
介绍:眼外伤是导致成人永久性视力丧失的常见原因。准确的临床检查和影像学检查相结合,可为患者提供最佳预后指标,并有助于确定治疗方法。这是对眼外伤检查和成像结果的回顾性病历回顾,以及这些结果与治疗过程和视力(VA)结果的相关性:方法:对 2013 年 1 月至 2020 年 12 月期间在一家医疗机构就诊的眼外伤成人患者进行评估。方法:对 2013 年 1 月至 2020 年 12 月期间在一家医疗机构就诊的眼外伤成人患者进行评估,比较初步检查和成像结果与 VA 结果之间的关联:结果:共纳入 134 名患者的 136 例眼外伤。出现的中位对数MAR VA为2.7(四分位距(IQR)为1.2-3.7),62%为开球伤。最初的 CT 扫描最常见的发现是眼球畸形(30%),B 型扫描是脉络膜脱离(20%),超声生物显微镜检查是眼内异物、纤毛膜积液或角膜后退(各占 21%)。在 6 个月和伤后最终评估中(中位数对数分辨力 2.7 对 0.5;P < 0.0001),观察到初次 B 扫描视网膜脱离阳性的患者视力比阴性患者差(中位数对数分辨力 3.7 对 0.4;P < 0.0001)。同样,与未发现脉络膜脱离的患者相比,初次 B 扫描发现脉络膜脱离的患者在 6 个月时的视力较差(中位数 logMAR 1.4 vs. 0.5;P = 0.002),在伤后最终评估时的视力也较差(中位数 logMAR 2.0 vs. 0.4;P < 0.0001)。如果发现结膜/巩膜检查结果呈阳性,66%的患者在 B 型扫描中发现阳性结果,而如果没有结膜/巩膜检查结果,41%的患者在 B 型扫描中发现阳性结果(P = 0.005)。如果前房(AC)检查结果呈阳性,则 59% 的人在 B 型扫描中获得阳性结果,而如果前房检查结果缺失,则 37% 的人在 B 型扫描中获得阳性结果(P = 0.03)。讨论。本研究中检查结果的预测价值可为长期视觉预后提供启示。B-扫描或CT阳性结果应增加对开球损伤的怀疑。
Demographics, Presenting Features, and Outcomes of Adult Patients with Ocular Trauma.
Introduction: Ocular trauma is a common cause of permanent vision loss in adults. The combination of an accurate clinical examination and imaging offers the best prognostic indicators for patients and helps to navigate treatment modalities. This is a retrospective chart review of examination and imaging findings for ocular trauma and how they correlate with treatment course and visual acuity (VA) outcomes.
Methods: Adult patients with ocular trauma presenting to a single institution between January 2013 and December 2020 were evaluated. Initial examination and imaging findings were compared for associations with each other and with VA outcomes.
Results: 136 ocular traumas on 134 patients were included. The median presenting logMAR VA was 2.7 (interquartile range (IQR) 1.2-3.7) with 62% open globe injuries. The most commonly reported finding on initial CT scan was globe deformity (30%), on B-scan was choroidal detachment (20%), and on ultrasound biomicroscopy was intraocular foreign body, ciliochoroidal effusions, or angle recession (21% each). Worse vision was observed for patients positive for retinal detachment on initial B-scan compared to those negative for this finding at 6-month (median logMAR 2.7 vs. 0.5; P < 0.0001) and at final post-injury evaluation (median logMAR 3.7 vs. 0.4; P < 0.0001). Similarly, worse VA was observed for patients with choroidal detachment on initial B-scan compared to those without this finding at 6-month (median logMAR 1.4 vs. 0.5; P = 0.002) and at final post-injury evaluation (median logMAR 2.0 vs. 0.4; P < 0.0001). If positive conjunctiva/sclera examination findings were identified, 66% had positive findings on B-scan, whereas if the conjunctiva/sclera examination findings were absent, 41% had positive findings on B-scan (P = 0.005). If anterior chamber (AC) examination findings were positive, 59% had positive findings on B-scan, whereas if the AC examination findings were absent, 37% had positive findings on B-scan (P = 0.03). Discussion. The predictive value of examination findings in this study may offer insight as to long-term visual prognosis. Positive B-scan or CT findings should increase suspicion for open globe injuries.
期刊介绍:
Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.