Determining the Sensitivity in the Diagnosis of Preoperative Orbital Computed Tomography in Patients With Open Globe Injury and Evaluating the Affecting Factors
Abstract
Purpose
Open globe injuries are diagnosed by ophthalmological examination. The purpose of this study is to determine the sensitivity in the diagnosis of preoperative orbital computed tomography (CT) in our patients with open globe injury and to evaluate the affecting factors.
Materials and Methods
The data of patients who underwent open globe injury repair between September 2014 and February 2021 in the Akdeniz University Hospital Ophthalmology Clinic were retrospectively analyzed. Demographic data of 290 patients’ were recorded. Patients suffer from corneal, scleral and corneoscleral injury; classified as pediatric and adult age groups. The presence of open globe injury, foreign body(FB) and orbital fracture in the preoperative orbital CT report were recorded.
Results
Sixty (20.7%) women and 230 (79.3%) men were included in the study. Of the patients, 58 (20%) were pediatric and 232 (80%) were adults. There were corneal, 76 (26.2%) scleral, and 59 (20.3%) corneoscleral injuries in 155 (53.4%) patients. In the preoperative orbital CT report, it was stated that 163 (56.2%) patients had open globe injuries. We did not observe any statistical difference between the diagnostic efficiency of orbital CT in pediatric and adult groups (p=0.636). When we evaluate according to the location of wound; scleral and corneoscleral injuries were compared with corneal injuries, we found that orbital CT was more effective in diagnosing (p<0.001). Similarly, as the length of wound increased, the diagnostic efficiency of orbital CT increased (p<0.001).
Conclusion
In this study, we found the sensitivity of orbital CT in diagnosing open globe injury as 56.2%. Diagnostic efficiency increases in the presence of scleral and corneoscleral injuries and a full-thickness incision greater than 4 mm. We found that age, gender, and presence of orbital fracture had no effect on the sensitivity of orbital CT in diagnosing open globe injury. It should be kept in mind that nearly half of the patients may miss the diagnosis by orbital CT.
Keywords
References
- 1. Crowell EL, Koduri VA, Supsupin EP, Klinglesmith RE, Chuang AZ, Kim G, Baker LA, Feldman RM, Blieden LS. Accuracy of Computed Tomography Imaging Criteria in the Diagnosis of Adult Open Globe Injuries by Neuroradiology and Ophthalmology. Acad Emerg Med. 2017;24:1072-1079.
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- 4. Kuhn F, Morris R, Witherspoon CD, Heimann K, Jeffers JB, Treister G. A standardized classification of ocular trauma. Ophthalmology 1996;103:240–243.
- 5. Russell SR, Olsen KR, Folk JC. Predictors of scleral rupture and the role of vitrectomy in severe blunt ocular trauma. Am J Ophthalmol 1988;105:253–257.
- 6. Werner MS, Dana MR, Viana MA, Shapiro M. Predictors of occult scleral rupture. Ophthalmology 1994;101:1941–1944.
- 7. Dunkin JM, Crum AV, Swanger RS, Bokhari SA. Globe trauma. Semin Ultrasound CT MR. 2011;32:51-56.
- 8. Kim SY, Lee JH, Lee YJ, Choi BS, Choi JW, In HS, Kim SM, Baek JH. Diagnostic value of the anterior chamber depth of a globe on CT for detecting open-globe injury. Eur Radiol. 2010;20:1079-1084.
- 9. Greven CM, Engelbrecht NE, Slusher MM, Nagy SS. Intraocular foreign bodies: management, prog¬nostic factors, and visual outcomes. Ophthalmology 2000;107:608–612.
- 10. Kubal WS. Imaging of orbital trauma. Radio¬Graphics 2008;28(6):1729–1739.
- 11. Sung EK, Nadgir RN, Fujita A, Siegel C, Ghafouri RH, Traband A, Sakai O. Injuries of the globe: what can the radiologist offer? Radiographics. 2014;34:764-776.
- 12. Chazen JL, Lantos J, Gupta A, et al. Orbital soft-tissue trauma. Neuroimaging Clin N Am. 2014;24:425e37.
- 13. Gad K, Singman EL, Nadgir RN, et al. CT in the evaluation of acute injuries of the anterior eye segment. AJR Am J Roentgenol. 2017;209:1353e9.
- 14. Hoffstetter P, Schreyer AG, Schreyer CI, et al. Multidetector CT (MD-CT) in the diagnosis of uncertain open globe injuries. Rofo. 2010;182:151–154.
- 15. Joseph DP, Pieramici DJ, Beauchamp NJ Jr. Computed tomography in the diagnosis and prognosis of open-globe injuries. Ophthalmology. 2000;107:1899–1906.
- 16. Weissman JL, Beatty RL, Hirsch WL, Curtin HD. Enlarged anterior chamber: CT finding of a ruptured globe. AJNR Am J Neuroradiol 1995;16:936–938.
Abstract
References
- 1. Crowell EL, Koduri VA, Supsupin EP, Klinglesmith RE, Chuang AZ, Kim G, Baker LA, Feldman RM, Blieden LS. Accuracy of Computed Tomography Imaging Criteria in the Diagnosis of Adult Open Globe Injuries by Neuroradiology and Ophthalmology. Acad Emerg Med. 2017;24:1072-1079.
- 2. Kalaycı M, Çetinkaya E. Somali Popülasyonundaki Açık Glob Yaralanmalarının Epidemiyolojisi. Acıbadem Univ. Sağlık Bilim. Derg. 2021;12:92-196.
- 3. Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am 2002;15:139–143.
- 4. Kuhn F, Morris R, Witherspoon CD, Heimann K, Jeffers JB, Treister G. A standardized classification of ocular trauma. Ophthalmology 1996;103:240–243.
- 5. Russell SR, Olsen KR, Folk JC. Predictors of scleral rupture and the role of vitrectomy in severe blunt ocular trauma. Am J Ophthalmol 1988;105:253–257.
- 6. Werner MS, Dana MR, Viana MA, Shapiro M. Predictors of occult scleral rupture. Ophthalmology 1994;101:1941–1944.
- 7. Dunkin JM, Crum AV, Swanger RS, Bokhari SA. Globe trauma. Semin Ultrasound CT MR. 2011;32:51-56.
- 8. Kim SY, Lee JH, Lee YJ, Choi BS, Choi JW, In HS, Kim SM, Baek JH. Diagnostic value of the anterior chamber depth of a globe on CT for detecting open-globe injury. Eur Radiol. 2010;20:1079-1084.
- 9. Greven CM, Engelbrecht NE, Slusher MM, Nagy SS. Intraocular foreign bodies: management, prog¬nostic factors, and visual outcomes. Ophthalmology 2000;107:608–612.
- 10. Kubal WS. Imaging of orbital trauma. Radio¬Graphics 2008;28(6):1729–1739.
- 11. Sung EK, Nadgir RN, Fujita A, Siegel C, Ghafouri RH, Traband A, Sakai O. Injuries of the globe: what can the radiologist offer? Radiographics. 2014;34:764-776.
- 12. Chazen JL, Lantos J, Gupta A, et al. Orbital soft-tissue trauma. Neuroimaging Clin N Am. 2014;24:425e37.
- 13. Gad K, Singman EL, Nadgir RN, et al. CT in the evaluation of acute injuries of the anterior eye segment. AJR Am J Roentgenol. 2017;209:1353e9.
- 14. Hoffstetter P, Schreyer AG, Schreyer CI, et al. Multidetector CT (MD-CT) in the diagnosis of uncertain open globe injuries. Rofo. 2010;182:151–154.
- 15. Joseph DP, Pieramici DJ, Beauchamp NJ Jr. Computed tomography in the diagnosis and prognosis of open-globe injuries. Ophthalmology. 2000;107:1899–1906.
- 16. Weissman JL, Beatty RL, Hirsch WL, Curtin HD. Enlarged anterior chamber: CT finding of a ruptured globe. AJNR Am J Neuroradiol 1995;16:936–938.
Details
| Primary Language | English |
|---|---|
| Subjects | Ophthalmology |
| Journal Section | Research Article |
| Authors | |
| Publication Date | July 1, 2022 |
| Submission Date | January 20, 2022 |
| Published in Issue | Year 2022 |