摘要
Background: Ocular injuries may lead to severe damage of the posterior segment with manifest visual impairment. Choroidal ruptures are frequently masked by ac ute subretinal haemorrhage. We analysed possible predictive factors and function al results of eyeballs with rupture of the choroid after ocular contusion. Patie nts and Methods: We performed a retrospective study of 376 consecutive inpatient s (Erlangen Ocular Contusion Registry-EOCR, over a 10-year period), who were t reated because of a blunt eye injury at our eye hospital (86%males). Detailed n otes regarding the anterior and posterior segments were extracted from the stand ardised charts. Mean age was 28.8±16.1 years (4 to 84 years). Eyes with previou s trauma or globe ruptures were excluded. Results: Twenty-six of 376 patients d eveloped choroidal rupture due to ocular contusion (6.9%). A choroidal rupture was more frequent in females (9.4%) than in males (6.5%). Patients with choroi dal rupture were treated as inpatients 5 days longer than patients without (10.7 vs 5.5 days; P< 0.001). Twenty-two percent of the injuries occurred during wor k time. Main causes of choroidal ruptures were water jet (19%), fireworks (12% ), elastic cords (12%), metal pieces (12%), gotcha (8%) and champagne corks ( 8%). The risk for developing a choroidal rupture due to water jet or fireworks injuries was increased 9 or 4 times. Ninetytwo percent of choroidal ruptures wer e located at the posterior pole and concentric, 40%were submacular, 12%outside the large temporal vessels (4%were located both centrally and peripherally). I nitial visual acuity (VA) and VA at discharge were decreased significantly in ey es with rupture of the choroid (20/200 and 20/60) in contrast to eye swithout (2 0/40 and 20/25; P< 0.001). Choroidal ruptures were often associated with iridodi alysis, lens dislocation and contusion cataract (3 x), vitreous haemorrhage (4 x ), complete retinal defects (6 x), ciliary body clefts (7 x) or hyphema rebleedi ng (4 x). No association between the height of hyphema and choroidal ruptures wa s found. The predictive level of choroidal ruptures was 40%in eyes with a combi nation of lens dislocation, traumatic cataract and vitreous bleeding. The final VA was 20/200 or less in 11 eyes associated with a prevalence of 55%of ruptures submacularly. In contrast to this, eyes with VA >20/200 developed 26 %submacul ar choroidal ruptures. Conclusions: Additional severe traumatic changes of the a nterior and posterior II segment were found 2-7 times more frequently in eyes w ith choroidal ruptures compared to eyes without those ruptures. The visual impro vement was limited due to submacular ruptures. Frequent ophthalmological control s are recommended to III minimise the risk of choroidal neovascularisation in a submacular location.
Background: Ocular injuries may lead to severe damage of the posterior segment with manifest visual impairment. Choroidal ruptures are frequently masked by ac ute subretinal haemorrhage. We analysed possible predictive factors and function al results of eyeballs with rupture of the choroid after ocular contusion. Patie nts and Methods: We performed a retrospective study of 376 consecutive inpatient s (Erlangen Ocular Contusion Registry-EOCR, over a 10-year period), who were t reated because of a blunt eye injury at our eye hospital (86%males). Detailed n otes regarding the anterior and posterior segments were extracted from the stand ardised charts. Mean age was 28.8±16.1 years (4 to 84 years). Eyes with previou s trauma or globe ruptures were excluded. Results: Twenty-six of 376 patients d eveloped choroidal rupture due to ocular contusion (6.9%). A choroidal rupture was more frequent in females (9.4%) than in males (6.5%). Patients with choroi dal rupture were treated as inpatients 5 days longer than patients without (10.7 vs 5.5 days; P< 0.001). Twenty-two percent of the injuries occurred during wor k time. Main causes of choroidal ruptures were water jet (19%), fireworks (12% ), elastic cords (12%), metal pieces (12%), gotcha (8%) and champagne corks ( 8%). The risk for developing a choroidal rupture due to water jet or fireworks injuries was increased 9 or 4 times. Ninetytwo percent of choroidal ruptures wer e located at the posterior pole and concentric, 40%were submacular, 12%outside the large temporal vessels (4%were located both centrally and peripherally). I nitial visual acuity (VA) and VA at discharge were decreased significantly in ey es with rupture of the choroid (20/200 and 20/60) in contrast to eye swithout (2 0/40 and 20/25; P< 0.001). Choroidal ruptures were often associated with iridodi alysis, lens dislocation and contusion cataract (3 x), vitreous haemorrhage (4 x ), complete retinal defects (6 x), ciliary body clefts (7 x) or hyphema rebleedi ng (4 x). No association between the height of hyphema and choroidal ruptures wa s found. The predictive level of choroidal ruptures was 40%in eyes with a combi nation of lens dislocation, traumatic cataract and vitreous bleeding. The final VA was 20/200 or less in 11 eyes associated with a prevalence of 55%of ruptures submacularly. In contrast to this, eyes with VA >20/200 developed 26 %submacul ar choroidal ruptures. Conclusions: Additional severe traumatic changes of the a nterior and posterior II segment were found 2-7 times more frequently in eyes w ith choroidal ruptures compared to eyes without those ruptures. The visual impro vement was limited due to submacular ruptures. Frequent ophthalmological control s are recommended to III minimise the risk of choroidal neovascularisation in a submacular location.
出处
《世界核心医学期刊文摘（眼科学分册）》
2005年第2期42-43,共2页
Digest of the World Core Medical Journals:Ophthalmology
