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2021 ◽  
Vol 14 (10) ◽  
pp. 1589-1594
Author(s):  
Simon Dulz ◽  
◽  
Toam Katz ◽  
Robert Kromer ◽  
Eileen Bigdon ◽  
...  

AIM: To elucidate the question of whether the ocular trauma score (OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment (RD) in patients with open globe injury (OGI). METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12mo follow-up and a median age at of 48.6y (range: 3-104y) were identified. Final best corrected visual acuity (BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score I (P<0.0001) or II (P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >III. OGI associated RD was observed in 36/102 patients (35.3%), whereas post traumatic RD (defined as RD following 14d after OGI) occurred in 37 patients (36.3%). OGI associated RD did not correlate with the OTS and the zone of injury (P=0.193), yet post traumatic RD correlated significantly with zone III injuries (P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone III injury with lower final BCVA and a higher number of surgeries, but only zone III could be significantly associated with a higher rate of RD.


2021 ◽  
Author(s):  
Oluwafemi Adekunmi Ibrahim ◽  
Danait Michael ◽  
Hermela Misghna ◽  
Amir Ibrahim ◽  
Rut Russom

Abstract Background Ocular trauma is a significant disabling health problem and a leading cause of visual impairment and loss worldwide. These injuries have many diverse costs including human suffering, long term disabilities, loss of productivity and economic hardship. Therefore, assessing the profile of ocular trauma, the etiology and its outcome is critical to the prevention of ocular injuries Methods This cross-sectional study was conducted on ocular trauma patients presenting to Berhan Ayni National Eye Referral Hospital from August – November, 2018. Data on demography, presenting visual acuity, type of injury and visual outcome were collected using a standardized questionnaire. The types of injuries were classified according to Birmingham Eye Trauma Terminology System. Pearson Chi-Square test (χ2)/or Fisher’s exact test in the Crosstab procedure was used to evaluate the relationship between specific variables. Logistic regression models were constructed to assess risk factors associated with blindness. Result 280 patients were seen with ocular trauma in the hospital during the study period. Males were 198 (70.7%) and peak age was 18–40 years. Ocular injury commonly occurred at home (31.8%), street and high way (31.4%) and workplace (28.9%). 24.7% of the injury was work-related. Common causes of injury were blunt objects (37.5%), sharp objects (31.1%) and fall (12.5%). 27.8% had open globe injury (OGI). Blindness was associated with rural residence (p < 0.0001), presentation greater than 24 hours (p = 0.04), non-use of eye protection goggles (p = 0.007), open globe injury (p = 0.018), posterior segment involvement (p < 0.0001) and hospitalization (p < 0.0001). Conclusion Immediate and comprehensive medical care is mandatory for ocular trauma patients. Educating the public especially at home and workplace is essential to prevent eye injuries.


2021 ◽  
Vol 62 (9) ◽  
pp. 1292-1299
Author(s):  
Sang Yoon Kim ◽  
Tae Hoon Kim ◽  
Sang Joon Lee ◽  
Han Jo Kwon

Purpose: To report the first case of Curtobacterium endophthalmitis within 6 hours after open globe injury, with extensive phlebitis and secondary subretinal neovascularization. Case summary: A 53-year-old man with hypersensitivity to beta-lactam antibiotics was admitted due to visual disturbance in the left eye experienced while working in a rural area. Fundus examination was impossible due to a full-layer corneal laceration and traumatic cataract in the left eye. B-scan ultrasonography and orbital computed tomography showed no shadowing of retained intraocular foreign bodies. After a corneal scraping smear, primary closure, lensectomy, and vitrectomy were performed. Organic material was observed in a focal area of pale macula, accompanied by extensive retinal phlebitis in the mid-periphery. After diagnosing acute bacterial endophthalmitis, intravitreal vancomycin and dexamethasone were injected. Curtobacterium pusillum was cultured on an automated microbial identification system. Intravenous vancomycin and oral clarithromycin were administered for 2 weeks. After 3 months, endophthalmitis had not recurred, and the visual acuity reached 20/100. However, subretinal neovascularization was newly detected under the damaged macula. No complications of neovascularization were observed until 6 months after primary closure. Conclusions: Curtobacterium pusillum can induce acute endophthalmitis through direct penetration in cases of ocular trauma, and may be accompanied by extensive phlebitis and secondary subretinal neovascularization. In cases of open globe injury sustained in rural areas, acute endophthalmitis caused by a rare Gram-positive bacillus, such as Curtobacterium species, should be considered.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wen-Long Wei ◽  
Zhong Lin ◽  
Ming-Na Xu ◽  
Ke-Mi Feng ◽  
Zhen-Quan Zhao

Purpose. Approximately 30% of patients with an open-globe injury (OGI) develop a secondary epiretinal membrane (ERM). This study was performed to assess whether internal limiting membrane (ILM) peeling in the treatment of posterior segment OGI prevents ERM formation. Methods. The medical records of 33 patients who underwent vitrectomy for posterior segment OGI from 2016 to 2019 were retrospectively analyzed. Of these patients, 17 underwent ILM peeling during the vitrectomy and 16 did not. The patients’ demographic and surgical data were collected. The associations of ILM peeling with the preoperative findings of posterior segment OGI and development of a postoperative ERM were analyzed. Student’s t-test was used to evaluate differences in continuous variables, and the chi-squared test or Fisher’s exact test was used for categorical variables. Time-to-event curves were calculated from postestimation Cox proportional hazards models. Results. An ERM developed in three eyes (17.6%) in the ILM peeling group and in eight eyes (50.0%) in the nonpeeling group ( p < 0.05 ). There was no statistically significant difference between the groups in visual acuity at baseline (1.68 vs. 1.58 logMAR, p = 0.68 ) or at final follow-up (0.72 vs. 0.78 logMAR, p = 0.66 ). Median visual acuity significantly improved in both groups ( p < 0.001 ). In the multivariable models, ILM peeling (odds ratio, 0.19; 95% confidence interval, 0.04–0.91; p = 0.04 ) and worse preoperative vision (odds ratio, 0.29; 95% confidence interval, 0.10–0.80; p = 0.02 ) were associated with lower likelihood of ERM formation. Conclusion. Preventative treatment with ILM peeling contributed to decreased development of an ERM in patients with OGI involving areas near the fovea.


2021 ◽  
Vol 11 (2) ◽  
pp. 297-300
Author(s):  
Nazia Imam ◽  
Mobashir Sarfraz Ali ◽  
Bibhuti Prassan Sinha ◽  
Gyan Bhaskar ◽  
Rakhi Kusumesh

To study the mechanism and clinical features of ocular injury and its outcome associated with bungee cord related eye trauma. A retrospective review of medical records was performed at our tertiary care centre to identify patients presented with bungee cord related eye injury between March 2016 to February 2017. Data collected from medical records were age, sex, mechanism of injury, clinical features, therapeutic intervention, presenting visual acuity, final visual acuity and length of follow up. Total of thirteen patients with bungee cord related trauma were identified. Ten (77%) patients presented with closed globe injury and 3(23%) presented with open globe injury. All patients were male with mean age group of 30.15±7.38 years. Presenting visual acuity ranges from 6/12 to NPL. Only seven (54%) of patients were having final visual acuity of better than or equal to 6/18 in injured eye. Three patients (23.1%) with open globe injury had final visual acuity of counting fingers or worse. Main mechanism of injury being combination of blunt and high speed projectile injury due to slippage of metal or plastic hook while the cord is stretched. Trauma with bungee cord is usually affecting working age group male with injury resulting in loss of workable vision to loss of eye hence there is need of appropriate intervention like use of printed warning on package and modification of hook design to decrease the incidence of bungee cord related trauma.


2021 ◽  
pp. 028418512110340
Author(s):  
Chu-Qi Li ◽  
Fan Yao ◽  
Chen-Yu Yu ◽  
Hui-Ye Shu ◽  
Li-Juan Zhang ◽  
...  

Background Open globe injury (OGI) is a serious condition that can lead to visual impairment and lifelong sequelae, brain activity of some brain regions would change in patients with OGI. Purpose To evaluate changes in brain activity associated with unilateral OGI by resting-state functional magnetic resonance imaging (rs-fMRI) and analysis of percentage amplitude of fluctuation (PerAF). Material and Methods A total of 22 patients with OGI (12 men, 10 women) and 22 healthy controls (HCs) matched for sex, age, and body weight were enrolled. All patients underwent rs-fMRI scans. Brain activity in the relevant brain regions was assessed with the PerAF method. The ability of PerAF to distinguish patients with OGI from HCs was assessed by receiver operating characteristic (ROC) curve analysis. We also examined the relationship between Hospital Anxiety and Depression Scale (HADS) scores and PerAF signals by Pearson’s correlation analysis. Results PerAF values in amygdala_R and Frontal_Inf_Orb_L/Frontal_Inf_Oper_L were increased whereas that in Cerebellum Anterior Lobe/Cerebelum_8_L was decreased in patients with OGI compared to HCs. The areas under the ROC curve showed that these brain regions could distinguish between patients with OGI and HCs. The PerAF value of amygdala_R was positively correlated with HADS scores. Conclusion Changes in PerAF in the amygdala_R, Frontal_inferior_Orb_L/Frontal_Inf_Oper_L, and Cerebellum Anterior Lobe/Cerebelum_8_L in patients with OGI may be related to an increased risk of developing psychiatric disorders such as anxiety and depression. PerAF can be used to investigate the neural basis of complications associated with OGI and monitor disease progression.


Author(s):  
Christine L. Tan ◽  
Myra B. McGuinness ◽  
Rohan Essex ◽  
Rosie C. H. Dawkins ◽  
Penelope J. Allen

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