Boucenna W, Taright N, Delbarre M, El Sanharawi M, Khawaja O, Jany B, Froussart-Maille F, Milazzo S
Service d'ophtalmologie, CHU d'Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France.
Institut ophtalmique de Somain, 28, rue Anatole-France, 59490 Somain, France.
J Fr Ophtalmol. 2020 Jun;43(6):517-524. doi: 10.1016/j.jfo.2019.11.006. Epub 2020 Feb 26.
To analyse the clinical ocular characteristics and determine prognostic factors for functional recovery in eyes presenting with no light perception (NLP) after open globe ocular trauma.
In this retrospective study were included all the patients with no light perception after open globe trauma who presented to Amiens University Hospital between October 2014 and June 2018.
Fifteen eyes of 15 patients were included in this study. The main mechanism of the trauma was globe rupture (80 %, n=12). The most common location was zone III (66 %, n=10). The wound size was greater than 10mm in 9 patients (60 %). The ocular lesions included expulsion of the crystalline lens or posterior chamber intraocular lens, hyphema, retinal detachment, vitreous hemorrhage and ciliochoroidal lesions. Damage to the ciliary body was a negative prognostic factor for functional recovery (P=0.04). Nine patients remained with no light perception, whereas 6 patients experienced an improvement in visual acuity (2.3 logMAR in 3 patients, 0.7 logMAR in 1 patient, 0.4 logMAR in 1 patient and 0.2 logMAR in 1 patient). These 6 patients had undergone posterior vitrectomy due to vitreoretinal involvement (P<0.001).
In the case of open globe trauma with no light perception on presentation, a functional recovery is possible if there is no irreversible anatomical damage.
分析开放性眼球外伤后无光感(NLP)眼的临床眼部特征,并确定功能恢复的预后因素。
本回顾性研究纳入了2014年10月至2018年6月期间在亚眠大学医院就诊的所有开放性眼球外伤后无光感患者。
本研究纳入了15例患者的15只眼。外伤的主要机制是眼球破裂(80%,n = 12)。最常见的部位是Ⅲ区(66%,n = 10)。9例患者(60%)的伤口大小大于10mm。眼部病变包括晶状体或后房型人工晶状体脱出、前房积血、视网膜脱离、玻璃体积血和睫状体脉络膜病变。睫状体损伤是功能恢复的不良预后因素(P = 0.04)。9例患者仍无光感,而6例患者视力有所改善(3例患者视力提高2.3logMAR,1例患者提高0.7logMAR,1例患者提高0.4logMAR,1例患者提高0.2logMAR)。这6例患者因玻璃体视网膜受累接受了玻璃体切割术(P < 0.001)。
对于就诊时无光感的开放性眼球外伤患者,如果没有不可逆的解剖损伤,功能恢复是可能的。