Tang Min, Hui Yan-Nian, Li You-Yi, He Yue, Cao Yang, Xiang Xiao-Hong, Lyu Hong-Bin
Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
Department of Ophthalmology, Xijing Hospital of the Fourth Military Medical University, Xi'an 710023, Shaanxi Province, China.
Int J Ophthalmol. 2018 Aug 18;11(8):1371-1376. doi: 10.18240/ijo.2018.08.19. eCollection 2018.
To evaluate the value of ultra-wide field (UWF) imaging in the management of traumatic retinopathy under the condition of corneal scar or fixed small pupil after complicated ocular trauma.
Twenty-eight patients (28 eyes) with complicated ocular trauma were enrolled in the study from June 2016 to May 2017, including 19 males and 9 females with age ranged from 11 to 64 (43.42±12.62)y. All patients were treated with secondary vitrectomy after emergency operation for wound repair of open ocular trauma. Direct ophthalmoscopy and 45-degree fundus photography were taken at each time point of follow up for comparison of findings with UWF images. Routine eye examination including visual acuity, intraocular pressure, slit lamp examination were performed and analyzed as well.
Among the 28 traumatized eyes, the positive rate for identification of traumatic retinopathed was 32.1% (9 cases), 14.9% (5 cases), and 85.7% (24 cases) with direct ophthalmoscopy, 45-degree fundus photography, and UWF imaging, respectively. The detective rate of UWF imaging under the condition of corneal scar or fixed small pupil was statistically greater than that of 45-degree fundus photography and direct ophthalmoscopy (Bonferroni correction, <0.001). UWF image was obtained in 19 eyes with opaque corneal scar, otherwise their fundus could not be seen by conventional methods. The additional findings of traumatic retinopathies by UWF imaging included periretinal membranes or pre-retinal proliferating strip, retinal holes, hemorrhage in the vitreous or sub-retinal space.
UWF imaging is superior to traditional fundus photography in the evaluation of traumatic retinopathies under the condition of corneal scar or fixed small pupil after complicated ocular trauma.
评估超广角(UWF)成像在复杂眼外伤后角膜瘢痕或固定小瞳孔情况下外伤性视网膜病变管理中的价值。
2016年6月至2017年5月纳入28例(28只眼)复杂眼外伤患者,其中男性19例,女性9例,年龄11至64岁(43.42±12.62岁)。所有患者在开放性眼外伤伤口修复急诊手术后均接受二期玻璃体切除术。在随访的每个时间点进行直接检眼镜检查和45度眼底照相,以便将检查结果与UWF图像进行比较。同时进行包括视力、眼压、裂隙灯检查在内的常规眼部检查并进行分析。
在28只受伤眼中,直接检眼镜检查、45度眼底照相和UWF成像识别外伤性视网膜病变的阳性率分别为32.1%(9例)、14.9%(五例)和85.7%(24例)。在角膜瘢痕或固定小瞳孔情况下,UWF成像的检出率在统计学上高于45度眼底照相和直接检眼镜检查(Bonferroni校正,<0.001)。19只角膜瘢痕混浊的眼睛获得了UWF图像,否则用传统方法无法看到其眼底。UWF成像发现的外伤性视网膜病变的其他表现包括视网膜前膜或视网膜前增殖条、视网膜裂孔、玻璃体或视网膜下间隙出血。
在复杂眼外伤后角膜瘢痕或固定小瞳孔情况下,UWF成像在评估外伤性视网膜病变方面优于传统眼底照相。