The Role of Computed Tomography in the Immediate Workup of Open Globe Injury

Allon, Gilad; Beiran, Itzhak; Seider, Nir; Blumenthal, Eytan Z.

doi:10.5301/ejo.5000788

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…However, the sensitivity of CT in diagnosing OGI is poor (51%-77%), 21,22 and preoperative CT scan results may not affect immediate management of OGI. 23 Ophthalmologists in our study who were in practice for fewer than 10 years were significantly more likely to obtain pre-operative orbital CT scans. This difference may reflect the trend of increased use of imaging across all fields of medicine.…”

Section: Discussionmentioning

confidence: 73%

Variations in Management of Zone 1 Open Globe Injuries Across Corneal Specialists

Foley,

Colby,

Rapuano

et al. 2023

Cornea

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Purpose: The aim of this study was to describe variations in practice patterns for the management of zone 1 open globe injuries among corneal specialists worldwide. Methods: This cross-sectional study was performed using an online survey distributed to members of The Cornea Society. Responses were collected between September 9, 2021, and September 30, 2021. Results: Of 94 responses included in analysis, respondents averaged 18.2 ± 14.5 years of postfellowship experience. Among respondents, 53 (56.4%) were affiliated with an academic institution and 41 (43.6%) with private practice. Ophthalmologists practicing in the United States were significantly more likely to use an eye shield preoperatively (98.5% vs. 85.7%, P = 0.03) and less likely to perform primary lensectomy in cases of lens involvement (40.9% vs. 75.0%, P = 0.002) compared with those practicing outside the United States. Ophthalmologists in practice fewer than 10 years were more likely to administer preoperative systemic antibiotics (91.4% vs. 66.1%, P = 0.006) and tetanus prophylaxis (88.6% vs. 67.8%, P = 0.03), and to obtain preoperative computed tomography scans (85.7% vs. 54.2%, P = 0.002) compared with more senior physicians. Ophthalmologists at academic institutions were more likely to perform preoperative B-scan (30.2% vs. 9.8%, P = 0.02), use general anesthesia (90.6% vs. 70.7%, P = 0.03), and admit for postoperative antibiotics (28.3% vs. 9.8%, P = 0.04), and were less likely to perform surgery overnight (45.3% vs. 70.7%, P = 0.02) compared with private practice physicians. Conclusions: There is significant variation in the practice patterns for the management of zone 1 open globe injuries among corneal specialists, which presents an opportunity to investigate whether certain treatment options lead to better outcomes in these injuries.

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Section: Discussionmentioning

confidence: 73%

Variations in Management of Zone 1 Open Globe Injuries Across Corneal Specialists

Foley,

Colby,

Rapuano

et al. 2023

Cornea

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“…Apart from its limitations in diagnosis of some open-globe injuries, CT is a useful tool in the evaluation of the injuries of the eyeball. Prognostic value of CT scan in OGIs has been evaluated in many studies [ 5 , 19 , 20 ]. CT imaging is invaluable to be able to make a relatively confident prediction of clinical findings and decide upon the necessity for acute ophthalmic surgical intervention [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics and scoring method of computed tomography in open-globe injuries

Chen,

Jin,

Zhou

et al. 2024

BMC Ophthalmol

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Background Open-globe injuries (OGIs) remain the important cause of visual impairment and loss in all ages. Computed Tomography (CT) is a useful and common tool in the evaluation of the injuries of the eyeball. Prognostic value of CT scan in OGIs has been evaluated in many studies. However, there is no published consistent systematic scoring method for CT scan in OGIs. The purpose of this study was to evaluate the CT characteristics of OGIs and build a scoring method according to the CT scans which may aid the clinicians in management of OGIs. Methods Retrospective chart review of inpatients with clinical diagnosis of OGIs between 2017 and 2021 at Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan provincial People’s Hospital (Zhengzhou, China). Results There were 1120 eyes from 1117 patients included in our study. The mean age was 35.7 ± 21.9 years with the range from 1 to 91 years. Significant male predominance was noted (889, 79.6%). CT scans of the OGIs were evaluated. Abnormality of anterior segment, posterior segment, and globe contour and volume were graded respectively. The most serious abnormality of anterior segment, posterior segment, and globe contour and volume were grade 3, 4 and 3 respectively and score 3, 4 and 3 respectively. Score of the CT scans of an open-injured globe ranged from 0 to 10. The correlation coefficient between the score and wound length was 0.798. The correlation coefficient between the score and final visual acuity was 0.799. In 78 eyes with 0 score, 70 eyes (89.7%) gained final visual acuity of 0.3 or better. In 31 eyes with 10 score, 20 eyes (64.5%) underwent evisceration of the eye globe and 10 eyes got visual acuity of no light perception and 1 eye lost to follow-up. Conclusions CT scans is a useful tool in evaluating the severity of an open-injured globe. Scoring of the CT scans of an open-injured globe is a meaningful attempt and it may provide useful prognostic information regarding the outcome of an open-injured globe.

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“…Computed tomography (CT) and B-scan ultrasonography are important clinical tests for the diagnosis of OGI. Although CT may provide information for the diagnosis of OGI (13), it is insufficient for making the decision of immediate treatment (14). B-scan ultrasonography is able to locate retinal detachment points, retinal tears and vitreous traction, and thus may be beneficial for further medical treatment (15).…”

Section: Introductionmentioning

confidence: 99%

Network centrality in patients with acute unilateral open globe injury: A voxel-wise degree centrality study

Wang

Chen

et al. 2017

Molecular Medicine Reports

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The present study aimed to investigate functional networks underlying brain‑activity alterations in patients with acute unilateral open globe injury (OGI) and associations with their clinical features using the voxel‑wise degree centrality (DC) method. In total, 18 patients with acute OGI (16 males and 2 females), and 18 healthy subjects (16 males and 2 females), closely matched in age, sex and education, participated in the present study. Each subject underwent a resting‑state functional magnetic resonance imaging scan. The DC method was used to assess local features of spontaneous brain activity. Receiver operating characteristic curve analysis was used to distinguish OGIs from healthy controls (HCs). Correlation analysis was used to examine the association between the observed mean DC values of different brain areas and behavioral performance. Compared with HCs, patients with acute unilateral OGI had significantly increased DC values in the bilateral primary visual cortex (V1/V2) and left precuneus (PCUN), and significantly decreased DC values in the right insula, left insula, right inferior parietal lobule (IPL)/supramarginal gyrus (SMG), IPL/SMG, right supplementary motor area and right postcentral gyrus. Additionally, in the acute OGI group, it was observed that the duration of OGI was negatively correlated with the DC signal value of the bilateral V1/V2 (r=‑0.581; P=0.011) and left PCUN (r=‑0.508; P=0.031). Acute OGI led to brain functional network dysfunction in a number of brain regions, which may indicate impairment of the visual cortex and other vision‑associated brain regions in OGI.

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The Role of Computed Tomography in the Immediate Workup of Open Globe Injury

Cited by 8 publications

References 7 publications

Variations in Management of Zone 1 Open Globe Injuries Across Corneal Specialists

Variations in Management of Zone 1 Open Globe Injuries Across Corneal Specialists

Characteristics and scoring method of computed tomography in open-globe injuries

Network centrality in patients with acute unilateral open globe injury: A voxel-wise degree centrality study

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