1
|
Cheng T, Zhao H, Chen Q, Wang S, Jiang C. Efficiency of different imaging methods in detecting ocular foreign bodies. Med Phys 2024; 51:3124-3129. [PMID: 38055556 DOI: 10.1002/mp.16818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/08/2023] [Accepted: 08/20/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Ocular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements. PURPOSE To compare the efficiency of different imaging methods in detecting and localizing OFBs. METHODS We conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B-scan ultrasonography (B-scans) were selected. RESULTS This study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8-78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2-120 months). Most OFBs were metallic (51.82%) or plant-based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B-scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant-based versus non-plant-based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B-scans were less efficient for plant-based and eyeball wall-located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118). CONCLUSIONS CT, radiography, and B-scans showed lower detection rates for plant-based, small, and eyeball wall-located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected.
Collapse
Affiliation(s)
- Tongjie Cheng
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Hongmei Zhao
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Qian Chen
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Shenjiang Wang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Chunhui Jiang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| |
Collapse
|
2
|
Clinical Characteristics and Visual Outcomes in Patients with Intralenticular Foreign Bodies with Self-Sealing Corneal Penetrating Wounds. J Ophthalmol 2021; 2021:6613205. [PMID: 34239720 PMCID: PMC8241495 DOI: 10.1155/2021/6613205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 05/19/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose Siderosis bulbi may occur as a result of retained intralenticular foreign bodies (ILFBs) that were missed during examination in patients with self-sealing wounds and without a significant decrease in visual acuity. This study aimed to explore the clinical characteristics and visual outcomes of ILFBs with self-sealing corneal penetrating wounds. Methods Fifteen eyes of 15 patients with ILFBs and self-sealing corneal penetrating wounds, seen between October 2014 and September 2019, were retrospectively analyzed. Data regarding the patient demographics, clinical features, surgical procedure, and initial and final best-corrected visual acuity (BCVA) were analyzed. Results All patients were male with a mean age of 41 years. The foreign bodies passed through the cornea, sometimes through the iris, through the anterior capsule, and finally localized in the lens. All ILFBs were pointed and metallic objects and were successfully removed with phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Anterior capsule violation was found in three eyes, but no posterior capsule rupture was found. The IOL was placed in a capsule bag in all the cases. The BCVA ranged from 20/200 to 20/25 preoperatively and improved to between 20/32 and 20/20 at the last follow-up visit. The IOLs were well-centered. Apart from posterior capsule opacity in four eyes, no other postoperative complications were found. Conclusions In patients with a pointed metallic ILFB and self-sealing corneal penetrating wounds (with or without cataracts), early diagnosis and removal of the metallic ILFB combined with lens removal and IOL implantation may avoid late complications and achieve good visual outcomes.
Collapse
|
3
|
Lin YC, Kuo CL, Chen YM. Intralenticular foreign body: A case report and literature review. Taiwan J Ophthalmol 2019; 9:53-59. [PMID: 30993070 PMCID: PMC6432851 DOI: 10.4103/tjo.tjo_88_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
day, a zonal cortical cataract and posterior subcapsular cataract formed rapidly. Left-eye bare vision dramatically decreased from 20/100 to counting fingers. One month later, the patient received elective extracapsular cataract extraction. A fine metal thread was completely embedded in the lens; the lens and FB were removed together during the operation. The posterior capsule was not injured; an intraocular lens was implanted in the capsular bag. Two months postoperatively, left-eye vision had returned to 20/25. No adverse events were noted during the follow-up period. In addition to the case report, some 28 previously reported cases of intralenticular FB are reviewed here. Patient demographics, time and course of management, and visual outcome are all summarized and compared.
Collapse
Affiliation(s)
- Yen-Chun Lin
- Department of Ophthalmology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chin-Liang Kuo
- Department of Ophthalmology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yan-Ming Chen
- Department of Ophthalmology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
4
|
Yang X, Liu C, Liu L, Zhang L. A missed diagnosis of multiple intraocular foreign bodies for 21 years. Cont Lens Anterior Eye 2017; 40:432-435. [PMID: 28844655 DOI: 10.1016/j.clae.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 06/17/2017] [Accepted: 08/15/2017] [Indexed: 02/05/2023]
Abstract
A 30-year-old patient went to the emergency department because of a chemical burn to the left eye more than 10 days ago by toilet cleanser. Surprisingly, a small piece of glass was found in the inferior anterior chamber in the same eye. The visual acuity was counting fingers. There was conjunctival congestion, corneal oedema and Descemet's membrane striae. And there was also a corneal leukoma around 4 to 5 o'clock. Through repeated questioning he recalled that he was injured by an exploded light bulb around 21 years ago. He was asymptomatic until he saw "something moving" in front of the left eye one month ago. Computed tomography (CT) scanning, ultrasonography, ultrasound biomicroscopy (UBM), anterior segment optical coherence tomography (AS-OCT) verified the presence of multiple intraocular foreign bodies (IOFBs) in the anterior chamber and vitreous cavity. B-scan verified the IOFB in the vitreous cavity. Thus, he was diagnosed with corneal chemical burn, IOFBs and corneal leukoma of the left eye. The IOFB in the anterior chamber was removed through surgery. An attempt was made to remove the IOFB in the vitreous cavity with electromagnet, but it was not successful. Vitrectomy could not be performed as it was hindered by the opacity of cornea. After surgery, the visual acuity remained counting fingers and the corneal oedema still existed. This case is a reminder that a detailed history taking, a thorough physical examination and modern imaging techniques are beneficial for establishing the diagnosis and treatment of IOFBs.
Collapse
Affiliation(s)
- Xubo Yang
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China; Department of Optometry and Visual Science, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China
| | - Chunling Liu
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China.
| | - Longqian Liu
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China; Department of Optometry and Visual Science, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China.
| | - Lanlan Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan, 610041, PR China
| |
Collapse
|
5
|
Loporchio D, Mukkamala L, Gorukanti K, Zarbin M, Langer P, Bhagat N. Intraocular foreign bodies: A review. Surv Ophthalmol 2016; 61:582-96. [PMID: 26994871 DOI: 10.1016/j.survophthal.2016.03.005] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/06/2016] [Accepted: 03/10/2016] [Indexed: 01/15/2023]
Abstract
Intraocular foreign body injuries may result in a wide range of intraocular pathology and visual outcomes based on the mechanism of injury, type of foreign body, and subsequent complications. We have reviewed the literature to describe the epidemiology and mechanisms of such injuries; types of foreign bodies; imaging tools for diagnosis; current trends in management, presurgical, and surgical interventions; as well as visual prognosis and potential complications. The purpose of this review is to familiarize clinicians with the recent advances in diagnosis and management of such injuries.
Collapse
Affiliation(s)
- Dean Loporchio
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Lekha Mukkamala
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Kavya Gorukanti
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Marco Zarbin
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Paul Langer
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Neelakshi Bhagat
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA.
| |
Collapse
|
6
|
Yang Z, Yang XL, Xu LS, Dai L, Yi MC. Application of Prussian blue staining in the diagnosis of ocular siderosis. Int J Ophthalmol 2014; 7:790-4. [PMID: 25349794 DOI: 10.3980/j.issn.2222-3959.2014.05.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/05/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To explore the value of Prussian blue staining in the diagnosis of ocular siderosis. METHODS Between January 2012 and January 2013, the Prussian blue stain used in anterior lens capsule and vitreous liquid after centrifugation from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis. At the same time, give a negative control. RESULTS Anterior lens capsule membrane and liquid of vitreous cavity from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis revealed ferric ions that stained positively with Prussian blue. In the control group, there is no positive reaction. CONCLUSION Prussian blue staining in the diagnosis of ocular siderosis has a very significant worth, suspected cases can be definitive diagnosed.
Collapse
Affiliation(s)
- Zhen Yang
- Department of Ophthalmology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Li Yang
- Department of Ophthalmology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Li-Shuai Xu
- Department of Ophthalmology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Le Dai
- Department of Ophthalmology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Mei-Chao Yi
- Department of Ophthalmology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| |
Collapse
|