Peking University Eye Center, Peking University Third Hospital, Beijing, P.R. China.
Retina. 2011 Nov;31(10):1988-96. doi: 10.1097/IAE.0b013e318213d8c7.
Investigate possible risk factors of no light perception (NLP) after open-globe injury. Explore whether these risk factors are predictors for an unfavorable visual outcome.
This case-control study matched 72 eyes with NLP according to type and zone of injury to 2 controls per case with light perception or better vision. Cases were selected from the Eye Injury Vitrectomy Study database. All injured eyes in the study underwent surgical intervention.
Ciliary body damage (odds ratio = 2.94), closed funnel retinal detachment (odds ratio = 2.43), and choroidal damage (odds ratio = 2.80) were independent risk factors for NLP after open-globe injury. There were 67 traumatized eyes with NLP that had ≥1 of these risk factors. In 43 of the cases (64.2%), the eyes recovered light perception or better after vitreoretinal surgery. The five traumatized NLP cases without these risk factors obtained a favorable visual outcome after vitreoretinal surgery. There was no statistical significance in visual outcome between them (P = 0.162).
Ciliary body damage, closed funnel retinal detachment, and choroidal damage are independent risk factors for NLP posttrauma but not prognostic indicators for NLP visual outcome. Traumatized eyes with NLP may recover light perception or better vision if appropriate interventional measures are used for treatment of the injured ciliary body, retina, and choroid.
探讨巩膜穿通伤后无光感（NLP）的可能危险因素。探讨这些危险因素是否是不良视力预后的预测因素。
本病例对照研究根据损伤类型和部位，将 72 只 NLP 眼与每例 2 只光感或更好视力的对照眼相匹配。病例选自眼外伤玻璃体切除术研究数据库。研究中所有受伤的眼睛均接受了手术干预。
睫状体损伤（比值比=2.94）、闭漏斗状视网膜脱离（比值比=2.43）和脉络膜损伤（比值比=2.80）是巩膜穿通伤后 NLP 的独立危险因素。在 67 只 NLP 受伤眼中，有≥1 种这些危险因素。在 64.2%的情况下（67 例中的 43 例），眼外伤后行玻璃体视网膜手术后恢复了光感或更好的视力。在没有这些危险因素的 5 例 NLP 眼外伤中，玻璃体视网膜手术后获得了良好的视力结局。它们之间的视力结局没有统计学意义（P=0.162）。
睫状体损伤、闭漏斗状视网膜脱离和脉络膜损伤是创伤后 NLP 的独立危险因素，但不是 NLP 视力预后的预测指标。如果对受伤的睫状体、视网膜和脉络膜采取适当的介入措施进行治疗，NLP 的受伤眼可能会恢复光感或更好的视力。
