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Humniski N, Ahn JS, Manji R, Kim DJ. Globe Rupture Diagnosed with Point-of-Care Ultrasound. J Emerg Med 2023; 65:e453-e456. [PMID: 37806809 DOI: 10.1016/j.jemermed.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 03/29/2023] [Accepted: 06/13/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Nicholas Humniski
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, Richmond Hospital, Richmond, British Columbia, Canada
| | - Justin S Ahn
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Rahim Manji
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Daniel J Kim
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
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Pirhan D, Subasi S, Musaoğlu BK, Alparslan B, Karabaş L. The relationship between computed tomography findings and ocular trauma and pediatric ocular trauma scores in pediatric globe injuries: Does imaging have prognostic and diagnostic value? ULUS TRAVMA ACIL CER 2023; 29:1280-1287. [PMID: 37889035 PMCID: PMC10771248 DOI: 10.14744/tjtes.2023.72470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND The aim of this study is to assess the relationship between computed tomography (CT) findings in open globe injuries (OGIs) in pediatric patients and the pediatric ocular trauma score (POTS) and OTS in pediatric ocular trauma. METHODS In 34 pediatric patients with OGI, CT findings were categorized into nine main categories: Scleral irregularity, lens dislocation, abnormal vitreous density, choroid-retinal layer thickening, preseptal thickness increase, intraocular foreign body and air, vitreous hemorrhage, retinal detachment, and perforation. The relationship between different types and numbers of CT findings and the POTS and OTS was evaluated. RESULTS The mean age of trauma was 6.6±3.1. Of the patients, 9 (26.5%) were female and 25 (73.5%) were male. The most com-mon CT findings are scleral irregularity and increased preseptal thickness (47.1%). In univariate analysis, a P<0.05 was found between 16 patients with 1 or less CT findings (median POTS value 80 [71.25-90.0]) and 11 patients with 2 or 3 CT findings (median POTS value 60 [15-70]). A P<0.05 was found between 16 patients with 1 or less CT findings (median POTS value 80 [71.25-90.0]) and 7 patients with 4 or more CT findings (median POTS value 45 [25-80]). A P > 0.05 was found between 11 patients with 2 or 3 CT findings (median POTS value 60 [15-70]) and 7 patients with 4 or more CT findings (median POTS value 45 [25-80]). No significant difference was found between the number of CT findings and OTS stages. While POTS was significant (P<0.05) in patients with ab-normal vitreous density (median 45 [30-69.6]), OTS value was not significant (P>0.05). There was no significant difference between POTS and OTS in other CT findings. CONCLUSION The number of CT findings may assist in predicting POTS and, consequently, estimating visual prognosis in pediatric patients with OGI. In emergency situations where, sufficient clinical data are unavailable, the objective findings from CT may help in assessing the severity of ocular trauma and potentially predicting long-term visual outcomes.
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Affiliation(s)
- Dilara Pirhan
- Department of Ophthalmology, Kocaeli University, School of Medicine, Kocaeli, Türkiye
| | - Sevgi Subasi
- Department of Ophthalmology, Kocaeli University, School of Medicine, Kocaeli, Türkiye
| | - Büşra Kurt Musaoğlu
- Department of Ophthalmology, Kocaeli University, School of Medicine, Kocaeli, Türkiye
| | - Burcu Alparslan
- Department of Radiology, Kocaeli University, School of Medicine, Kocaeli, Türkiye
| | - Levent Karabaş
- Department of Ophthalmology, Kocaeli University, School of Medicine, Kocaeli, Türkiye
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Sharief S, Jayadev C, Gadde SGK. Commotio retinae halo. BMJ Case Rep 2022; 15:e249270. [PMID: 35301188 PMCID: PMC8932277 DOI: 10.1136/bcr-2022-249270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shama Sharief
- Department of Vitreo-Retina, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Chaitra Jayadev
- Department of Vitreo-Retina, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
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Abstract
PURPOSE To investigate the choroidal thickness (CT) and choroidal area (CA) in patients with unilateral commotio retinae of the macula using spectral domain optical coherence tomography with enhanced-depth imaging. METHODS This is a retrospective review of 16 eyes of 8 consecutive patients with unilateral macular commotio retinae within 7 days of blunt ocular trauma that underwent optical coherence tomography with enhanced-depth imaging seen at our institution. The contralateral, nontraumatized eye served as the control group. All patients underwent spectral domain optical coherence tomography imaging with enhanced-depth imaging protocol. Using the electronic caliper within the Zeiss optical coherence tomography review software, CT was measured from the outer portion of the retinal pigment epithelium band to the inner surface of the sclera. The central horizontal and vertical rasters were averaged to calculate the final CT measurement of each eye. The final CA reading of each eye was obtained by averaging the central 1,500 μm2 of subfoveal CA using the same rasters. The researchers compared the CT, CA, and best-corrected visual acuity in traumatized eyes with macular commotio with their fellow nontraumatized control eyes. RESULTS Traumatized eyes with macular commotio retinae had greater subfoveal CT and CA (P = 0.0027, P = 0.0279) compared with the normal fellow eye. An increase in CT and CA in the subfoveal area in the presence of commotio retinae was associated with worse visual acuity (P = 0.0180). CONCLUSION Subfoveal CT and CA were greater in eyes with commotio retinae when compared with normal fellow eyes. Increased CT and CA in macular commotio retinae were associated with decreased visual acuity.
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Affiliation(s)
- Marie Burke
- Kresge Eye Institute, Department of Ophthalmology, Wayne State University School of Medicine, Detroit, Michigan
| | - Philip Lieu
- W. K. Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan; and
| | - Gary Abrams
- Kresge Eye Institute, Department of Ophthalmology, Wayne State University School of Medicine, Detroit, Michigan
| | - Joseph Boss
- Kresge Eye Institute, Department of Ophthalmology, Wayne State University School of Medicine, Detroit, Michigan
- Cleveland Clinic Foundation, Cole Eye Institute, Department of Ophthalmology, Cleveland, Ohio
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5
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Li X. Ultrasound Biomicroscopy Diagnosis Analysis and Fine Care of Anterior Segment Injury of Traumatic Anterior Chamber Based on Intelligent Virtual Reality Technology. J Healthc Eng 2021; 2021:9930686. [PMID: 34055276 PMCID: PMC8133863 DOI: 10.1155/2021/9930686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/15/2021] [Accepted: 05/04/2021] [Indexed: 11/18/2022]
Abstract
The front part of the eye is exposed to the surface of the body, making it susceptible to injury. Blunt eye injuries often destroy the tissue structure in the anterior part of the eye. Often there is detachment of the iris root, separation of the ciliary body, the angle of retraction of the chamber, and complete dislocation or subluxation of the lens. Ordinary ocular ultrasound can penetrate into opaque tissue, but because of its low resolution, it can only show its outline, which is still very small for doctors in assisting diagnosis. Ultrasonic biomicroscopy is a very real-time analysis, will not be affected by the refraction space, and has great application value for ocular trauma. Based on this, this article proposes the ultrasound biomicroscope diagnosis analysis and fine nursing research of traumatic anterior chamber injury based on intelligent virtual reality technology. This article describes literature methods, experimental analysis methods, and other methods, in-depth study of the causes of traumatic anterior injuries, ultrasound biomicroscopy, and other theoretical knowledge, ultrasound biomicroscopy and microcontrol experiments for traumatic anterior injury design, and finally the causes of eye damage. This study compares the pairing results of ultrasound biomicroscopy biological measurements, analyzes the relationship between anterior bleeding level and anterior ocular injury, and analyzes the outcome and extent of service ophthalmology. The angle retreat accounted for 52.17% in grade I, 72.22% in grade II, and 60% in grade III. Anterior bleeding can cause single or complex iris root detachment, iris root detachment, ciliary body detachment, and angular leakage. The more the bleeding, the more serious the eye damage.
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Affiliation(s)
- Xiaoli Li
- Department of Ophthalmology, Linqu People's Hospital, Weifang 262600, Shandong, China
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6
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Li SS, Engelke CB. Case Report: Atraumatic Orbital Emphysema after Bronchoscopy with Endobronchial Biopsy. Optom Vis Sci 2021; 98:440-445. [PMID: 33973915 DOI: 10.1097/opx.0000000000001689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Orbital emphysema is a well-documented condition where air enters the orbital soft tissue typically because of direct or indirect trauma; however, atraumatic cases can be encountered. The following is a novel case report of acute unilateral atraumatic orbital emphysema 24 hours after bronchoscopy with endobronchial biopsy. PURPOSE To the best of the authors' knowledge, this is the first known case report of atraumatic orbital emphysema as a postprocedure complication of bronchoscopy with endobronchial biopsy in the literature. CASE REPORT A 74-year-old man presented with painless swelling of the left upper and lower eyelids upon awakening. The patient had a history of bronchoscopy and endobronchial biopsy with conscious sedation for a right upper lobe lung mass 24 hours before the visit. Slit-lamp examination revealed air entrapment in the left upper and lower lids with enlarged subconjunctival air pockets of the left eye. Head and maxillofacial computed tomography without contrast revealed extensive emphysema tracking and dissecting along the subcutaneous and deep soft tissue spaces of the neck and face that was more pronounced along the left side. The patient was admitted for overnight observation and prescribed a prophylactic oral course of 250 mg of azithromycin daily for 2 days by the attending hospitalist. The subsequent follow-up visit 3 days later revealed complete resolution of signs and symptoms. CONCLUSIONS This case report demonstrates the importance of considering orbital emphysema in patients with a history of recent bronchoscopy with endobronchial biopsy. Clinicians should be aware of this potential complication and refer for appropriate testing and comanagement.
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Akram H, Seifelnasr M, Roberts H, Myerscough J. Blinding ocular trauma caused by remote controlled aerial drone. BMJ Case Rep 2021; 14:e242132. [PMID: 33832943 PMCID: PMC8039268 DOI: 10.1136/bcr-2021-242132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Haseeb Akram
- Ophthalmology, Southend University Hospital NHS Foundation Trust, Southend-On-Sea, UK
| | - Mohamed Seifelnasr
- Ophthalmology, Southend University Hospital NHS Foundation Trust, Southend-On-Sea, UK
| | - Harry Roberts
- Ophthalmology, Southend University Hospital NHS Foundation Trust, Southend-On-Sea, UK
| | - James Myerscough
- Ophthalmology, Southend University Hospital NHS Foundation Trust, Southend-On-Sea, UK
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Finn AP, Chen X, Viehland C, Izatt JA, Toth CA, Vajzovic L. COMBINED INTERNAL LIMITING MEMBRANE FLAP AND AUTOLOGOUS PLASMA CONCENTRATE TO CLOSE A LARGE TRAUMATIC MACULAR HOLE IN A PEDIATRIC PATIENT. Retin Cases Brief Rep 2021; 15:107-109. [PMID: 29979253 PMCID: PMC6401324 DOI: 10.1097/icb.0000000000000762] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe a case of a large, traumatic macular hole in a pediatric patient closed using an internal limiting membrane flap in combination with autologous plasma concentrate (APC). METHODS Description of a surgical technique as performed in one patient. RESULTS Successful macular hole closure and improvement in postoperative visual acuity were achieved in the patient in whom the technique was performed. CONCLUSION The combined use of APC with the internal limiting membrane flap is advantageous because the APC acts to hold the internal limiting membrane in proper position and promotes the proliferation of glial cells through the presence of growth factors. This technique may be particularly advantageous in chronic or recalcitrant holes particularly in the setting of trauma.
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Affiliation(s)
- Avni P. Finn
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Xi Chen
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | | | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Cynthia A. Toth
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
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9
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Gelston CD, Deitz GA. Eye Emergencies. Am Fam Physician 2020; 102:539-545. [PMID: 33118787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Central retinal artery occlusions, chemical injuries, mechanical globe injuries, and retinal detachments are eye emergencies that can result in permanent vision loss if not treated urgently. Family physicians should be able to recognize the signs and symptoms of each condition and be able to perform a basic eye examination. Patients with a central retinal artery occlusion require urgent referral for stroke evaluation and should receive therapy to lower intraocular pressure and vasodilating agents to minimize retinal ischemia. Chemical injuries require immediate irrigation of the eye to neutralize the pH of the ocular surface. A globe laceration or rupture is common in patients with a recent history of trauma from a blunt or penetrating object. Physicians should administer prophylactic oral antibiotics after a globe injury to prevent endophthalmitis. The eye should be covered with a metal shield until evaluation by an ophthalmologist. Patients with symptomatic floaters and flashing lights should be referred to an ophthalmologist for a dilated funduscopic examination to evaluate for a retinal tear or detachment.
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Affiliation(s)
| | - Galia A Deitz
- University of Colorado School of Medicine, Aurora, CO, USA
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10
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Larsen MB, Lehrmann BB. [Retinal injury after playing with a laser pointer]. Ugeskr Laeger 2020; 182:V05200317. [PMID: 33000746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this case report, two boys were admitted to an eye department at a hospital in Denmark. They had been playing with a laser pointer, which had been bought abroad during a holiday. The laser was pointed directly into the eyes of both boys eyes, resulting in small retinal marks afterwards. The boys had visual discomfort and a feeling of missing some central vision. On an optical coherence tomography it was possible to capture a small retinal damage affecting the outer segment of the retina but without damage to Bruchs membrane. Both boys recovered from discomfort and were discharged from the department after a four month follow-up.
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11
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Mozo Cuadrado M, Tabuenca Del Barrio L, Compains Silva E, Abárzuza Cortaire R, Plaza Ramos P, Magán Seviñé F. Choroidal rupture after ocular blunt trauma caused by airbag. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:e65. [PMID: 31176494 DOI: 10.1016/j.oftal.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Affiliation(s)
- M Mozo Cuadrado
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - L Tabuenca Del Barrio
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - E Compains Silva
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | | | - P Plaza Ramos
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
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Lartizien R, Schouman T, Raux M, Debelmas A, Lanciaux-Lemoine S, Chauvin A, Toutee A, Touitou V, Bourges JL, Goudot P, Bertolus C, Foy JP. Yellow vests protests: facial injuries from rubber bullets. Lancet 2019; 394:469-470. [PMID: 31402026 DOI: 10.1016/s0140-6736(19)31764-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Rodolphe Lartizien
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France; Université Grenoble Alpes, Grenoble, France
| | - Thomas Schouman
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Mathieu Raux
- Department of Anaesthesiology and Critical Care, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Alexandre Debelmas
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Sophie Lanciaux-Lemoine
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Aurore Chauvin
- Department of Ophthalmology, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Adélaide Toutee
- Department of Ophthalmology, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Valérie Touitou
- Department of Ophthalmology, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Jean-Louis Bourges
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Patrick Goudot
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Chloé Bertolus
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France
| | - Jean-Philippe Foy
- Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France.
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Abstract
Abusive head trauma (AHT) is a form of inflicted head injury. AHT is more frequent in 2-year-old or younger children. It is an important cause of neurological impairment and the major cause of death from head trauma in this age group. Brain magnetic resonance imaging allows the depiction of retinal hemorrhages, injured bridging veins, and identifying and localizing extra- and intra-axial bleeds, contusions, lacerations, and strokes. The diagnosis of AHT is a multidisciplinary team effort which includes a careful evaluation of social, clinical, laboratory, and radiological findings. Notwithstanding, the introduction in the current clinical practice of high-resolution techniques is adding forensic evidence to the recognition of AHT.
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Affiliation(s)
- Sara Reis Teixeira
- Division of Radiology, Clinical Hospital, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto
| | | | - Carolina A Servin
- Centro Medico La Costa - Centro de Diagnóstico, Av General José Gervasio Artigas, Asunción, Paraguay
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Giulio Zuccoli
- Professor of Radiology, University of Pittsburgh School of Medicine, Director of Pediatric Neuroradiology, Children Hospital of Pittsburgh, Pittsburgh, PA
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14
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Clemente-Tomás R, Bayo-Calduch P, Neira-Ibáñez P, Gargallo-Benedicto A, Duch-Samper AM. Bilateral maculopathy after exposure to a laser pointer: Optical coherence tomography angiography findings. Arch Soc Esp Oftalmol (Engl Ed) 2018; 93:551-554. [PMID: 29456174 DOI: 10.1016/j.oftal.2017.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/19/2017] [Accepted: 12/31/2017] [Indexed: 06/08/2023]
Abstract
CASE REPORT A 36-year-old man went to the emergency department the day after exposure to a laser pointer. Funduscopy revealed dispersed macular pigment alterations, and optical coherence tomography showed a disruption of the retinal layers. The visual acuity was counting fingers in both eyes. Nine months later, optical coherence tomography angiography showed a rarefaction in the choriocapillaris vascular flow in the area of the laser injuries. DISCUSSION The retinal layer mainly damaged by the laser injury was the retinal pigment epithelium. However, it is suggested that the laser injury could involve tissues beyond the retinal pigment epithelium, since a rarefaction of the choriocapillaris was found after exposure to the laser.
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Affiliation(s)
- R Clemente-Tomás
- Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
| | - P Bayo-Calduch
- Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - P Neira-Ibáñez
- Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - A Gargallo-Benedicto
- Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - A M Duch-Samper
- Departamento de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España; Facultad de Medicina, Universidad de Valencia, Valencia, España
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15
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Mtanes K, Mimouni M, Zayit-Soudry S. Laser Pointer-Induced Maculopathy: More Than Meets the Eye. J Pediatr Ophthalmol Strabismus 2018; 55:312-318. [PMID: 29913024 DOI: 10.3928/01913913-20180405-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/20/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the clinical findings in patients with laser-induced retinal injury. METHODS Consecutive patients presenting to a tertiary center between January 2014 and December 2015 following inadvertent ocular exposure to a laser pointer were included. Evaluation included a full ophthalmic examination and spectral-domain optical coherence tomography (SD-OCT). RESULTS Seven young patients (8 eyes) were identified. Their mean age was 18.7 years (median: 16 years; range: 12 to 36 years). In most cases, patients were exposed for several seconds to a 5-mW green laser. At presentation, all patients complained of a central/paracentral scotoma. Snellen best corrected visual acuity (BCVA) at presentation ranged from counting fingers to 6/6. In 5 eyes, a round, well-defined deep yellowish-orange discoloration at the level of the retinal pigment epithelium in the foveola, ranging from 150 to 350 μm in diameter, was noted on ophthalmoscopic examination. Additional findings were macular subhyaloid hemorrhage in 2 eyes and a full-thickness macular hole with cystoid macular edema in 1 eye. In all cases, baseline SD-OCT revealed disruption involving the photoreceptor inner segment/outer segment junction/ellipsoid zone band, and extended toward the inner aspect of the retinal pigment epithelium band, ranging from focal interruption to extensive full-thickness macular hole. All patients received oral corticosteroid treatment with prednisone (0.5 to 1 mg/kg). Follow-up ranged between 2 and 12 months. Over time, improvement in visual acuity to 6/8 and 6/6 was noted in all eyes but one, which remained poor at counting fingers from 2 meters. The visual improvement was associated with complete or near-complete restoration of the integrity of macular structure noted on SDOCT. CONCLUSIONS Commercial handheld laser pointers may inflict notable macular injury and damage vision permanently. Although good visual recovery was often noted, access to commercially available laser devices is potentially hazardous, especially to minors, and public awareness should be raised. [J Pediatr Ophthalmol Strabismus. 2018;55(5):312-318.].
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16
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Berná-Serna JDD, Chico-Sánchez P, Berná-Mestre JDD, Carbonell-López Del Castillo G. A new method for ocular ultrasound examination. Med Ultrason 2018; 20:402-403. [PMID: 30167599 DOI: 10.11152/mu-1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Pablo Chico-Sánchez
- Radiology Departament, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
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17
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Peschel A, Moser K, Korbel R. [Three-dimensional ultrasonographic examination of the avian eye: technique and physiological findings]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2018; 46:236-245. [PMID: 30149405 DOI: 10.15654/tpk-170674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The paper describes the possibilities and the clinical utility of three-dimensional (3D) ultrasonography in the avian eye. MATERIAL AND METHODS The healthy eyes of 44 patients (six various raptor, three psittacine bird and four other bird species) were examined using the Voluson i ultrasound unit (GE Healthcare, Austria) in combination with a high-resolution 18 MHz linear probe. Physiological findings should be demonstrated to obtain a clinical basis for the evaluation of pathological ocular findings. Additionally, the blood flow of the pecten oculi was assessed using 3D colour Doppler ultrasonography. RESULTS By means of 3D ultrasonography, the physiological structures in the avian eye could be demonstrated in their spatial context for the first time. In addition, the 3D appearance of the blood flow of the pecten oculi was shown. CONCLUSION AND CLINICAL RELEVANCE 3D ultrasonography is a valuable diagnostic addition to classical optical-based ophthalmological examination of the avian eye and becomes essential when the posterior segment of the eye is obscured, as, for example, in opacities of the anterior dioptric apparatus or in patients with haemorrhage in the anterior eye chamber. The method may significantly enhance ophthalmological diagnostics in birds, particularly in situations with frequently occurring posttrauma intraocular haemorrhage as well as retinal detachment or lesions of the pecten oculi.
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Ben Artsi E, Wygnanski-Jaffe T, Shalev B, Spierer A, Yassur I, Zloto O, Prat D, Priel A, Ben Simon G. Challenging Management of Double Vision After Functional Endoscopic Sinus Surgery-A Series of 6 Cases. Am J Ophthalmol 2018; 190:134-141. [PMID: 29604283 DOI: 10.1016/j.ajo.2018.03.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/03/2018] [Accepted: 03/20/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To present 6 cases of orbital trauma, diplopia and strabismus after functional endoscopic sinus surgery (FESS). DESIGN Retrospective observational case series. METHODS The medical charts of suitable patients were reviewed for information on medical examination, imaging studies, the type of corrective surgery, and surgical outcomes. STUDY POPULATION All patients with diplopia and strabismus after undergoing FESS who were treated or consulted at our institution between 2008 and 2017 were included. MAIN OUTCOME MEASURES The presence and extent of strabismus and double vision at the end of follow-up. RESULTS Six patients complained of diplopia after FESS; all of them had proven orbital trauma. In Cases 1-5, patients suffered medial rectus (MR) muscle transection and subsequent exotropia. Their prognosis was guarded despite prompt surgical intervention, and ranged from large exotropia when direct recovery of the MR was attempted, to primary gaze orthotropia but with minimal adduction capacity, during which vertical recti transposition was attempted. Patient 6 sustained transient diplopia, although all of his extraocular muscles appeared intact on imaging. His eye position and movement were completely resolved with conservative measures only. CONCLUSIONS Our experience was that immediate recovery procedures to reattach the muscle in cases with proven transection of the MR muscle are futile, and that definitive corrective strabismus surgery (ie, vertical muscle transposition) has a better chance to achieve favorable results.
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Affiliation(s)
- Elad Ben Artsi
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.
| | | | - Benjamin Shalev
- Ophthalmology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Abraham Spierer
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Iftach Yassur
- Ophthalmology Division, Rabin Medical Center, Petach Tikva, Israel
| | - Ofira Zloto
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Daphna Prat
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Ayelet Priel
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Guy Ben Simon
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
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Abstract
Three unrelated patients attended the accident and emergency department with pain and blurred vision after ocular injury with a Nerf gun. Two were adults and one was a child, all of which presented within a 3 months' period. All three cases were found to have ≥1 mm of traumatic hyphema (pooling of blood in anterior chamber of the eye), indicating significant ocular trauma. The two adult patients had formed hyphema and uveitis. The 11-year-old child had formed hyphema, corneal oedema, anterior uveitis, localised angle recession and commotio retinae, which further highlight the severity of the ocular trauma. Significant Nerf gun ocular injuries are not reported in the literature, as far as we know. This case series serves to raise awareness of the seriousness of Nerf gun ocular injuries. It encourages further exploration of reasons for such injuries, as well as a review of protective measures against ocular trauma.
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Affiliation(s)
- Mukhtar Bizrah
- Accident & Emergency Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Seema Verma
- Accident & Emergency Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Affiliation(s)
- Parul C Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jagat Ram
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Acute ocular trauma accounts for a substantial number of emergency department visits in the USA, and represents a significant source of disability to patients; however, the orbits remain a potential blind spot for radiologists. The goal of this article is to review the relevant anatomy of the orbit and imaging findings associated with commonly encountered acute ocular traumatic pathology, while highlighting the salient information which should be reported to the ordering clinician. Topics discussed include trauma to the anterior and posterior chamber, lens dislocations, intraocular foreign bodies, and open and contained globe injuries.
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Affiliation(s)
- Jarett Thelen
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Asha A Bhatt
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Alok A Bhatt
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA.
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Tatum JM, Barmparas G, Choi M, Ley EJ, Melo N. Polysubstance-Induced Self-Enucleation after Motor Vehicle Collision. Am Surg 2017; 83:e155-e156. [PMID: 28541840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Zha L, Chen KQ, Zheng XZ, Wu J. The safety and feasibility of diagnostic acoustic radiation force impulse elastography used for eyes. A preliminary in vivo study. Med Ultrason 2017; 19:185-189. [PMID: 28440353 DOI: 10.11152/mu-996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIMS To assess the safety and feasibility of acoustic radiation force impulse (ARFI) elastography in the eyes of rats. Material and methods: One hundred and twenty-six SD rats were divided into 7 groups. Group 1 was the control group and Group 2 to Group 7 were investigated by ARFI elastography using increased powers of 5%, 10%, 20%, 50%, and 100% and repetitions of 5 or 10. The changes of ocular architecture structures and functions were examined by phthalmoscopic, histopathologic, and light reflex examination, and the expression level of IL-6, IL-8, and TNF-α was determined in days 1, 3, and 7 after ARFI elastography, respectively. RESULTS A satisfactory ARFI elastography was obtained in all SD rats. The shear wave velocity (SWV) values of soft tissues behind the eyeball were significantly greater than those of the eyes (1.89±0.95 vs. 0.84±0.36 m/s, p<0.05). The SWV values of eyes and the soft tissues behind the eyeball did not differ among any groups at any time-point (p>0.05). The SD rats of each group showed good light perception, pupillary light reflex, and avoidance reaction induced by the sudden bright light from the dark environment at any time. In each group, ocular architecture structures were well preserved, and with a normal expression level of IL-6, IL-8, and TNF-α (p>0.05). CONCLUSIONS Diagnostic ARFI elastography is a safe and feasible ultrasonic imaging mode and may potentially be applied for human eyes in its present form.
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Affiliation(s)
- Li Zha
- Department of Ophtalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, P.R. China
| | - Ke Qi Chen
- Department of Ultrasound, Yancheng Institute of Clinical (The First People's Hospital of Yancheng), Xuzhou Medical University, Yancheng, Jiangsu Province, P.R. China
| | - Xiao Zhi Zheng
- Department of Ultrasound, Yancheng Institute of Clinical (The First People's Hospital of Yancheng), Xuzhou Medical University, Yancheng, Jiangsu Province, P.R. China.
| | - Jing Wu
- Department of Ultrasound, Yancheng Institute of Clinical (The First People's Hospital of Yancheng), Xuzhou Medical University, Yancheng, Jiangsu Province, P.R. China
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Rocha Cabrera P, Cordovés Dorta L, González Hernández M. Bilateral solar retinopathy. Autofluorescence and optical coherence tomography. Arch Soc Esp Oftalmol 2016; 91:391-396. [PMID: 26944206 DOI: 10.1016/j.oftal.2016.01.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 01/23/2016] [Accepted: 01/26/2016] [Indexed: 06/05/2023]
Abstract
CASE REPORT A 33-year-old man referred decreased bilateral visual acuity for five years, with no history of interest. Military profession and probably previous sun exposure. Focal pigmented lesions in the macular area of the fundus were observed, with impairment of the photoreceptor layer in the fovea, observed by optical coherence tomography (OCT), in various sectors of the fovea. DISCUSSION Solar retinopathy is associated with professions at risk of sun exposure. The diagnosis is based on autofluorescence and macular OCT, that later will provide key data to establish the cause.
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Affiliation(s)
- P Rocha Cabrera
- Sección de Retina Médica, Servicio de Oftalmología, Hospital San Juan de Dios, Santa Cruz de Tenerife, España.
| | - L Cordovés Dorta
- Sección de Retina Médica, Servicio de Oftalmología, Hospital San Juan de Dios, Santa Cruz de Tenerife, España
| | - M González Hernández
- Sección de Retina Médica, Servicio de Oftalmología, Hospital San Juan de Dios, Santa Cruz de Tenerife, España
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Olszycki M, Kozakiewicz M, Elgalal M, Majos A, Stefanczyk L. In vitro and in vivo imaging of ultra-high-molecular-weight polyethylene orbital implants. Int J Oral Maxillofac Implants 2015; 30:e24-9. [PMID: 25830408 DOI: 10.11607/jomi.3790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study is to compare magnetic resonance imaging (MRI) with computed tomography (CT) for visualization of an orbital alloplastic prosthesis made of ultra-high-molecular-weight polyethylene (UHMW-PE) both in vitro and in vivo. A study of 15 test implants from UHMW-PE visualized in vitro in CT and MRI and an in vivo visualization in a patient who suffered from orbital injury and underwent reconstructive surgery is presented. The postsurgery MRI showed the UHMW-PE material clearly, with no significant artifacts. The surrounding tissues could be satisfactorily evaluated. The CT scans did not present the graft material. Both techniques were sufficient tools for in vitro evaluation of the shape and measurement of the prosthesis.
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Tabakin ER, Dean AJ, Panebianco N. An alternative explanation for abnormal globe contour. J Emerg Med 2015; 48:e77-e79. [PMID: 25497843 DOI: 10.1016/j.jemermed.2014.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 10/08/2014] [Accepted: 10/12/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Erica R Tabakin
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anthony J Dean
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nova Panebianco
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Sun MT, Wu W, Watanabe A, Kakizaki H, Chen B, Ueda K, Katori N, Takahashi Y, Selva D. Orbital blowout fracture location in Japanese and Chinese patients. Jpn J Ophthalmol 2014; 59:65-9. [PMID: 25377495 DOI: 10.1007/s10384-014-0357-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 09/05/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To characterize the location of orbital blowout fractures in Asian individuals. METHODS This was a retrospective review of 470 consecutive Asian patients with orbital blowout fractures who presented to four tertiary care hospitals in Japan and China. Computed tomography (CT) characterized the location and severity of fractures involving the medial wall, the orbital floor, and/or the maxilloethmoidal strut. RESULTS A total of 475 orbital blowout fractures were identified. More than one fracture location was involved in 19% of all cases. The medial orbital wall was the most commonly involved location, presenting in 29 cases (61%), of which 204 (43%) were isolated medial blowout fractures. The orbital floor was the second most common location involved, present in 226 cases (48%) with 150 isolated orbital floor fractures (32%), while the maxilloethmoidal strut was involved in 45 cases (9%) with 30 of those being isolated strut fractures (6%). The majority of fractures (62%) were classified as moderately severe, whilst 14% were mild, and 24% were severe. Associated nasal fractures were present in 16% of the cases. CONCLUSIONS Orbital blowout fractures in Japanese and Chinese individuals occur most commonly in the medial wall. This is in contrast to previous reports on white individuals, who tend to sustain fractures involving the orbital floor rather than the medial wall.
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Affiliation(s)
- Michelle T Sun
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, South Australian Institute of Ophthalmology and Royal Adelaide Hospital, Adelaide, Australia,
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Dastevska-Djosevska E. Ultrasonography in ocular trauma. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2013; 34:105-113. [PMID: 24280785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Ultrasonography is a non-invasive, simple and effective diagnostic method which enables visualization and evaluation of intraocular injury degree in cloudy eye media. The basic aim of this investigation was to find out the frequency of various types of ocular injuries using ultrasonography and to make an analysis of their frequency in relation to gender and age. MATERIALS AND METHODS This retrospective study included 182 patients hospitalized at the Clinic of Ophthalmology in Skopje due to mechanical eye trauma. The patients underwent ultrasonography on the Alcon Ultrascan Imagining System apparatus and Sonomed EZ Scan AB 5500+. B scan technique was used primarily, while the A scan had a positive and correlative role. RESULTS Ocular trauma was more present in males (85.2%) compared to females (14.8%). 49.5% of the patients had open, and 50.5% had closed globe injuries. The most represented age group in ocular injuries was the age ranged from 51 to 60 years. There was no significant difference between the type of mechanical injury and the age (Chi-Squares=5.52 p=0.47895025). Ultrasonography showed that the most frequent pathologic result, both in open and closed globe injuries, was vitreous hemorrhage. CONCLUSION Ultrasonography has an irreplaceable role in the clinical evaluation and management of ocular trauma. It showed that the most frequent finding in ocular trauma was vitreous haemorrhage, and the male gender was more frequently exposed to ocular trauma.
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Urban B, Bakunowicz-Łazarczyk A. [Evaluation of anterior segment lesions in children and adolescents with ocular trauma using Visante OCT]. Klin Oczna 2013; 115:208-212. [PMID: 24741925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To evaluate the anterior eye segment in children and adolescents after unilateral ocular trauma, using optical coherence tomography Visante OCT. MATERIAL AND METHODS 19 patients (17 boys and 2 girls), hospitalized in Department of Pediatric Ophthalmology due to ocular trauma, were examined. Mean age was 12.6 years (6-17 years). 12 patients had blunt ocular trauma, and 7 patients had a penetrating injury. RESULTS Hyphaema impeded the view in 5 eyes, so Visante OCT was helpful for the right treatment. The anterior chamber shallowing was diagnosed in 9 cases, and anterior chamber deepening in 5 cases. Lens pathology (subluxation, cataract) was recognized in 4 patients. OCT was useful in diagnosis of corneal wound (1 case) and in foreign body removal (1 case). CONCLUSIONS Visante OCT provides easy visualization and high-resolution documentation. Its ability to image the anterior segment structures despite corneal opacification seems particularly important. This technique can be very useful in children and adolescents with ocular trauma.
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Debiec M, Frazier T, Colyer M, Nelson M. Inappropriate use of ultrasound in ocular trauma. Mil Med 2012; 177:v-vi. [PMID: 23397681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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31
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Affiliation(s)
- Rajesh C Rao
- Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
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32
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Chupova NA, Bodrova IV, Ternovoĭ SK, Grusha IO, Danilov SS. [Functional multislice spiral computed tomography of the rectus muscle of the eye in scar changes]. Vestn Rentgenol Radiol 2011:5-8. [PMID: 22288140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The study deals with the capacities of functional multislice spiral computed tomography (FMSCT) in choosing a treatment policy and planning the tactic and scope of surgery for posttraumatic scar changes in the rectus muscle of the eye. Orbital MSCT and FMSCT were conducted in 15 patients (30 orbits). The findings showed that it was necessary to perform orbital FMSCT in posttaumatic scar changes to evaluate the contractility of the rectus muscles and their involvement in the area where a fracture occurs. Improved diagnosis achieved by FNSCT could optimally choose the tactics and scope of surgical intervention.
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Abstract
We present the case of an orbital fracture and a wooden foreign body found during surgery. The patient had undergone a pre-operative computed tomography scan but the foreign body had not been seen on these images. We discuss the difficulties in demonstrating wooden objects on CT and describe indicators in patient history, examination findings and radiological signs that might suggest the presence of a wooden object. We emphasise the necessity to explore any orbital injury if there are clinical signs suggesting an intraorbital foreign body.
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Affiliation(s)
- A M Paul
- Addenbrooke's Hospital, Cambridge, UK.
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34
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Eze KC, Enock ME, Eluehike SU. Ultrasonic evaluation of orbito-ocular trauma in Benin-City, Nigeria. Niger Postgrad Med J 2009; 16:198-202. [PMID: 19767906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS AND OBJECTIVES To find out the causes, time of presentation for ultrasound scan, pattern of eye injuries and orbital ultrasound findings in patients with orbito-ocular trauma. MATERIALS AND METHODS Retrospective study of request cards, case notes and ultrasound reports of 67 patients who had trauma to the eye and were assessed with ultrasonography over a 3-year period (between 20th January 2000 and 19th January 2003) was done. The collected data included age, sex, presenting complaint, past medical history, duration of the injury before presentation to ultrasonographic study and ultrasound findings. RESULT Sixty-seven patients were seen consisting of 54 males (83.58%) and 11 females (16.42%) with male to female ratio of 5:1. Age range was 4 to 91 years with mean age of 30.8 years. 44 patients (65. 67%) had blunt trauma while 23 patients (34.32%) had penetrating trauma. The causes of the ocular trauma include road traffic accidents 32 (47.76%), assaults 16 (23.88%), gunshot injuries 10 (14. 93%), sports injuries 5 (7.46%), and falls from heights 4 (5.92%) patients. 42 patients (53.73%), especially those with severe injuries presented late for ultrasonography. Those who made early presentation were cases of assault because of police involvement. Forty-five patients (67.16%) had structurally identifiable pathology in one or both eyes. Retinal detachment 18 (26.87%), vitreous haemorrhage 17 (25.37%), traumatic cataract 13 (19.40), ruptured globe 6 (8.96%) and posterior dislocation of the lens 6 (8.96) were the commonest abnormal sonographic findings. In 22 patients (32.84%) both eyes were normal. CONCLUSION Ultrasound scan is a useful imaging modality for examination of the globe in patients with ocular trauma. Road traffic accident is the commonest cause of traumatic ocular injury affecting the globe. Retinal detachment and vitreous haemorrhage are the most frequent injuries to the globe diagnosed by ultrasound scan. Measures to reduce road traffic accidents will have far reaching positive effect in preventing blindness resulting from orbito-ocular trauma in Nigeria.
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Affiliation(s)
- K C Eze
- Department of Radiology, Ophthalmology University of Benin Teaching Hospital, Benin City, Nigeria
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Abstract
In this article, we express concerns regarding the availability of airguns, the injuries that they cause and their abuse as weapons of assault. We wish to stimulate debate on this topic and report a 5-year retrospective analysis of all airgun injuries to the head and neck, presenting to Alder Hey Children's Hospital, Liverpool, from June 1998 to June 2003. We identified 16 patients who suffered such injuries with ages ranging from 5 to 15 years. The majority of cases were violent assaults, which is not in accordance with previous published reports. All of these occurred in public places outside the home. Most incidents occurred through the spring and summer period. Six patients required overnight stay in hospital. Nine patients required operative procedures to remove the airgun pellets. Two patients had serious eye injuries resulting in loss of vision. Two patients had penetrating neck injuries requiring exploration of the wound. The remaining group had either skin-penetrating injuries with lodgement of fragments in subcutaneous tissues or non-skin penetrating injuries. This study highlights serious injuries arising from the abuse of airguns as weapons of assault. Airguns are readily available to people without license. Recent legislation has increased the minimum age at which airguns can be carried in a public place, but we believe that stricter legislation is required to produce a reduction in the number of airgun-related injuries.
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Affiliation(s)
- P Holland
- Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Liverpool, UK
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Affiliation(s)
- P Ceruti
- Eye Clinic, Department of Neurological and Visual Sciences, University of Verona, Borgo Trento Hospital, P.le Stefani 1, 37126, Verona, Italy.
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Kothari TH, Khara S, Verma R. Medical image. Ruptured globe. N Z Med J 2008; 121:76-77. [PMID: 18815609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Truptesh H Kothari
- Internal Medicine, Bronx VA Medical Center, Mount Sinai (Bronx) Program, Bronx, NY 10468, USA.
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Affiliation(s)
- Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Parbhu KC, Galler KE, Li C, Mawn LA. Underestimation of Soft Tissue Entrapment by Computed Tomography in Orbital Floor Fractures in the Pediatric Population. Ophthalmology 2008; 115:1620-5. [PMID: 18440640 DOI: 10.1016/j.ophtha.2008.02.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2006] [Revised: 02/05/2008] [Accepted: 02/26/2008] [Indexed: 11/17/2022] Open
Affiliation(s)
- Keshini C Parbhu
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA
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Malandrini A, Balestrazzi A, Martone G, Tosi GM, Caporossi A. Diagnosis and management of traumatic cyclodialysis cleft. J Cataract Refract Surg 2008; 34:1213-6. [PMID: 18571092 DOI: 10.1016/j.jcrs.2008.02.038] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Accepted: 02/01/2008] [Indexed: 11/18/2022]
Affiliation(s)
- Alex Malandrini
- Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy
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Paza AO, Farah GJ, Passeri LA. Traumatic carotid cavernous fistula associated with a mandibular fracture. Int J Oral Maxillofac Surg 2007; 37:86-9. [PMID: 17822873 DOI: 10.1016/j.ijom.2007.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Revised: 05/04/2007] [Accepted: 06/14/2007] [Indexed: 10/22/2022]
Abstract
Carotid cavernous sinus fistula is an abnormal vascular interconnection between a branch of the carotid artery and the cavernous sinus. This is an uncommon complication of craniofacial injuries, as it occurs in only 0.17-0.27% of cases, according to the literature. The differential diagnosis should include superior orbital fissure syndrome, orbital apex syndrome, orbital haematoma and cavernous sinus thrombosis. The case is reported of an 18-year-old white woman who was involved in a motor vehicle accident. Clinical examination revealed only mandibular fractures, with the absence of skull-base, mid-face or any other fractures. Two days after the trauma, her condition deteriorated, and extraocular movements were totally absent. Magnetic resonance angiographic scanning was performed, and a carotid cavernous sinus fistula was found. This was treated by embolization resulting in restoration of eye movement and vision.
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Affiliation(s)
- A O Paza
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Campinas, São Paulo, Brazil
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Abstract
CASE REPORT After cataract extraction and placement of a posterior chamber intraocular lens, a 70-year-old man had 5 vitreous hemorrhages over 3 years. Iris transillumination defects and apposition of the nasal haptic and ciliary body were found. COMMENTS Iris chafing is a rare complication of cataract extraction. Vitreous hemorrhage presumably resulted from iris erosion caused by the IOL haptic.
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Affiliation(s)
- Hassanain S Toma
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Md. 21287, USA
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Abstract
PURPOSE To describe postoperative laser-assisted in situ keratomileusis (LASIK) flap dislocation occurred after trauma METHODS Ultrabiomicroscopy (UBM) is used to obtain a high-resolution imaging of the cornea. RESULTS The UBM results are presented and compared with histologic and confoscan findings CONCLUSIONS The technique is useful and easy to perform, offering more opportunities to study the anatomical changes in LASK flap dislocation occurred after trauma.
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Affiliation(s)
- G Mannino
- II School of Medicine, University of Rome La Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
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Zeller J, Murray SB, Fisher J. Spontaneous globe subluxation in a patient with hyperemesis gravidarum: a case report and review of the literature. J Emerg Med 2007; 32:285-7. [PMID: 17394993 DOI: 10.1016/j.jemermed.2006.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Accepted: 06/29/2006] [Indexed: 11/17/2022]
Abstract
Globe subluxation, or anterior dislocation of the eyeball, is rarely encountered by emergency physicians. We report a case of subluxation of the globe secondary to severe vomiting followed by a discussion of globe subluxation, potential causes, procedure for reduction, and treatment for recurrent episodes. Early treatment by emergency physicians may prevent long-term complications and limit patient discomfort and anxiety.
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Affiliation(s)
- Julie Zeller
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
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Hossain GA, Islam SM, Mahmood S, Khan N, Chakraborty RK, Talukder AK. High resolution ultrasound of ophthalmic patients in a tertiary hospital. Mymensingh Med J 2007; 16:50-6. [PMID: 17344780 DOI: 10.3329/mmj.v16i1.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The study was done to find out pathologic processes in ophthalmic patients in different age group to understand the use, role and limitations of ultrasonography in the diagnosis of ocular pathology in this locality. A prospective study was done on total 143 patients from September 2004 to January 2006 who attended Centre for Nuclear Medicine & Ultrasound, Mymensingh for ultrasound evaluation of eye. Total 100 (69.93%, n=100) cases were male and 43 (30.06%, n=43) cases were female. The age ranges were 2 months to 80 years. A variety of ocular pathology was diagnosed with the help of high resolution ultrasound (HRUS) with unique ultrasound appearance. Bulk of the referral patients had history of ocular trauma (38.46 %, n= 38) and most commonly detected pathology in these group are vitreous hemorrhage (34.44%, n=34) and cataract formation (28.28%, n=28). Almost all of the patients did not have conclusive diagnosis clinically and by conventional means available before ultrasonography were performed. High resolution sonography may be used as a valuable tool for evaluation of ophthalmic pathology as a well suited, noninvasive method, and only practical imaging modality for assessing those cases particularly when light conducting media are opaque.
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Affiliation(s)
- G A Hossain
- Centre For Nuclear Medicine and Ultrasound (CNMU), Mymensingh.
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46
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Ivanov AN, Degtiareva EM, Maliuta GD. [YAG-laser treatment for traumatic hemophthalmia]. Vestn Oftalmol 2007; 123:22-5. [PMID: 17650605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The paper deals with noninvasive YAG-laser surgery that is used in the treatment of hemophthalmia, particularly hemophthalmia of posttraumatic genesis. A Visulas YAG laser unit ("Karl Zeiss") was used for YAG laser radiation. Its energy parameters were 0.8 to 9.2 mJ; 2-10 impulses; 1-30 laser treatment sessions. YAG-laser radiation affected the altered part of vitreous body: from fresh blood to the emergence of hemophthalmia as adhesions and conglomerates. YAG-laser applied to pathological vitreous body changes in hemophthalmia is effective and causes their elimination with subsequent lysis. YAG-laser vitreolysis is the operation of choice in traumatic hemophthalmia and may be used not only as an independent surgical technique, but also an additional one in the surgical and medical treatment of hemophthalmia. YAG-laser application to the vitreous body reduces the time of treatment for traumatic hemophthalmia.
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Espana EM, Tello C, Liebmann JM, Ritch R. Cyclodialysis cleft secondary to removal of an anterior chamber phakic intraocular lens. J Cataract Refract Surg 2007; 33:542-4. [PMID: 17321410 DOI: 10.1016/j.jcrs.2006.09.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2006] [Accepted: 09/27/2006] [Indexed: 11/20/2022]
Abstract
We present a patient who had decreased visual acuity and hypotony in the left eye 2 months after removal of an anterior chamber phakic intraocular lens (pIOL). Gonioscopy demonstrated a cyclodialysis cleft at the 6 o'clock position in the region of the IOL footplate, which was confirmed by ultrasound biomicroscopy. A cyclodialysis cleft formation is one possible complication of pIOL removal. Careful gonioscopy evaluation before removal of pIOLs should be mandatory to assess the amount of fibrosis and the presence of synechia between the IOL and the surrounding tissues.
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Affiliation(s)
- Edgar M Espana
- Department of Ophthalmology, the New York Eye and Ear Infirmary, New York, USA
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48
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Wilczyński M, Suprunowicz I. [The applications of three-dimensional ultrasound scans in ophthalmology]. Klin Oczna 2007; 109:89-93. [PMID: 17687923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Development of ophthalmology in recent years is connected with perfecting diagnostic methods and equipment. Ultrasound examination, because of its good availability, repetitiveness and non-invasiveness has become a commonly used method in ophthalmic diagnosis. Three-dimensional ultrasound (3DUS), also called three-dimensional ultrasound tomography, is an advanced method based on digital analysis of series of two-dimensional images. This technique is especially useful in ocular oncology, vitreoretinal pathologies and ocular trauma. Authors present selected cases visualised using 3DUS technique and discuss its advantages in comparison with traditional two-dimensional scans.
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49
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Gundorova RA, Alekseeva IB, Kosakian SM, Kharlap SI. [Early postcontusion eyeball circulation as evidenced by color Doppler mapping]. Vestn Oftalmol 2006; 122:26-9. [PMID: 17217198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Early postcontusion hemodynamic disorders were studied, by analyzing the results of color Doppler mapping. The study included patients aged 10 to 45 years with moderate and severe postcontusion retinal changes and a visual acuity of 0.8 to 0.01. Color Doppler mapping was used to visualize blood flow in the ophthalmic artery, central retinal artery, and posterior short ciliary arteries. Preliminary studies revealed circulatory changes in the ophthalmic arterial system in the early postcontusion period. In severe macular and optic nerve lesions, a significant reduction in blood flow was detectable in all the vessels under study, but there was its more pronounced reduction in the central retinal artery and posterior short ciliary arteries, which directly corrected with the found retinal changes since these arteries are the only source of retinal circulation.
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Doro D, Deligianni V. Ultrasound biomicroscopy in traumatic aniridia 2 years after phacoemulsification. J Cataract Refract Surg 2006; 32:1753-5. [PMID: 17010879 DOI: 10.1016/j.jcrs.2006.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2006] [Accepted: 05/07/2006] [Indexed: 10/24/2022]
Abstract
A 45-year-old man with retinitis pigmentosa experienced total aniridia in the left eye due to direct blunt trauma 2 years after uneventful bilateral phacoemulsification via a 3.5 mm clear corneal incision. Ultrasound biomicroscopy (UBM) of the left eye revealed no missing or stretched zonular fibers extending from the ciliary body to the anterior capsule, a few iris root remnants, a normal ciliary body, an in-the-bag acrylic intraocular lens, and Descemet's membrane dehiscence at the corneal tunnel through which the iris extruded. The eye recovered 20/25 visual acuity after 1 week. Transient hyphema and a rise in intraocular pressure were recorded. This is the first report of traumatic aniridia 2 years after phacoemulsification with UBM evidence of undamaged zonular apparatus. A UBM examination may be clinically helpful, especially when blood prevents accurate slitlamp examination of the anterior segment.
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Affiliation(s)
- Daniele Doro
- Department of Neurosciences-Ophthalmology, University of Padua, Padua, Italy.
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