Lima-Gómez Virgilio, Barrera-Fournier Lizette Verónica
Servicio de Oftalmología, Hospital Juárez de México.
Cir Cir. 2007 Mar-Apr;75(2):65-9.
A high rate of traumatic retinal injuries does not require a directed ocular fundus evaluation but those that deserve urgent care need it. The rate of traumatic retinal injuries that require urgent care was identified in order to learn whether there is a need of evaluating the ocular fundus in an emergency room.
Patients with ocular trauma and ocular fundus evaluation who were referred to an Ophthalmology Service of a general hospital were included; patients with superficial foreign bodies were excluded. The rate of injuries that require urgent care (retinal detachment, intraocular foreign body) was identified and 95% confidence intervals (CI) were calculated.
One hundred fifty-three eyes of 148 patients (age 3-74 years, mean 26.4 years) were examined. Of 75 retinal injuries, 7 required urgent care (4.6%, 95% CI 1.3-7.9); the rate was 0.8% in closed globe trauma (95% CI 0-2.37) and 20.7 in open globe trauma (95% CI 5.9-35.5).
According to the rate of retinal injuries that would require urgent care in similar groups, in closed-globe trauma ocular fundus evaluation in the Emergency Room could be substituted by the evaluation of the fundus reflex; findings of any of these injuries in open-globe trauma does not modify the initial approach.
高比例的外伤性视网膜损伤并不需要直接进行眼底评估，但那些需要紧急治疗的损伤则需要进行眼底评估。确定需要紧急治疗的外伤性视网膜损伤的比例，以了解在急诊室是否有必要评估眼底。
纳入转诊至一家综合医院眼科的眼外伤且接受眼底评估的患者；排除有浅表异物的患者。确定需要紧急治疗的损伤（视网膜脱离、眼内异物）比例，并计算95%置信区间（CI）。
检查了148例患者（年龄3 - 74岁，平均26.4岁）的153只眼。在75例视网膜损伤中，7例需要紧急治疗（4.6%，95%CI 1.3 - 7.9）；在闭合性眼球外伤中该比例为0.8%（95%CI 0 - 2.37），在开放性眼球外伤中为20.7%（95%CI 5.9 - 35.5）。
根据类似群体中需要紧急治疗的视网膜损伤比例，在闭合性眼球外伤中，急诊室的眼底评估可用眼底反射评估替代；开放性眼球外伤中出现这些损伤中的任何一种，都不改变初始治疗方法。
