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哥伦比亚一家眼科参考诊所外伤性前房积血患者的临床特征、处理和视力结果。

Clinical features, management and visual outcomes on patients with traumatic hyphema in a reference ophthalmological clinic in Colombia.

机构信息

Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia.

Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Santander, Colombia.

出版信息

Rom J Ophthalmol. 2020 Jan-Mar;64(1):28-34.

Abstract

To analyze clinical features, treatment, and results of patients with non-penetrating traumatic hyphema in an ophthalmological center in Colombia. A retrospective cohort study in which medical records of patients with traumatic hyphema were analyzed between 2013 and 2018. 38 eyes of 37 patients (34 men, 3 women) were included. Average age was 30.6 ± 16.6 years. Sports-related (42.1%) and occupational accidents (34.2%) were the main causes. 67.5% of the eyes had grade I hyphema. 95% received topical corticosteroids, 92.1% topical mydriatics and 52.63% ocular hypotensive eyedrops. Two eyes with hyphema grade I did not receive steroids and resolved uneventfully. None of the eyes rebleeded, even without antifibrinolytics. One patient with grade IV hyphema required surgery. Mean hyphema's clearance time was 8.4 ± 3.2 days. The last mean corrected distance visual acuity was LogMAR 0.25. There were no complications directly related to the hyphema. Working related activities were the second cause of traumatic hyphema in our cohort, which might be attributable to poor awareness of the importance or ocular protection, or limited access to recommended protective devices. Outpatient management enabled adequate outcomes. Corticosteroids and mydriatics were the treatment cornerstone, though seemed not to be imperative when hyphema was grade I. We were not able to support the contributive role from antifibrinolytics, because none of our patients rebleeded in spite of the absence of them. IOP = intraocular pressure, AC = anterior chamber, CDVA = corrected distance visual acuity.

摘要

分析哥伦比亚一家眼科中心非穿透性创伤性前房积血患者的临床特征、治疗方法和结果。这是一项回顾性队列研究,对 2013 年至 2018 年间外伤性前房积血患者的病历进行了分析。共纳入 37 例患者的 38 只眼(34 名男性,3 名女性)。平均年龄为 30.6±16.6 岁。运动相关(42.1%)和职业事故(34.2%)是主要原因。67.5%的眼为 I 级前房积血。95%的患者接受局部皮质类固醇治疗,92.1%接受局部散瞳剂治疗,52.63%接受眼部降压滴眼剂治疗。2 只 I 级前房积血的眼未接受皮质类固醇治疗,且未发生意外。即使没有使用纤维蛋白溶解抑制剂,也没有眼再出血。1 例 IV 级前房积血患者需要手术。前房积血清除时间的平均时间为 8.4±3.2 天。最后平均矫正视力为 LogMAR 0.25。没有与前房积血直接相关的并发症。与我们的队列研究相比,工作相关活动是外伤性前房积血的第二大原因,这可能归因于对眼部保护重要性或眼部保护的认识不足,或无法获得推荐的防护设备。门诊管理可实现良好的结果。皮质类固醇和散瞳剂是治疗的基石,但当积血量为 I 级时,似乎并不是必需的。我们无法支持纤维蛋白溶解抑制剂的作用,因为尽管没有使用纤维蛋白溶解抑制剂,我们的患者都没有再出血。IOP=眼内压,AC=前房,CDVA=矫正视力距离

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本文引用的文献

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Is topical corticosteroid necessary in traumatic hyphema?外伤性前房积血是否需要局部使用皮质类固醇激素?
J Fr Ophtalmol. 2014 Oct;37(8):613-7. doi: 10.1016/j.jfo.2014.04.007. Epub 2014 Sep 6.
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Management of traumatic hyphema.外伤性前房积血的处理
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