非外伤性开放性眼球损伤：临床表现特征和视力预后。
Non-traumatic open globe injuries: presenting characteristics and visual outcomes.
机构信息
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
Memorial Hermann-Texas Medical Center, Houston, TX, USA.
出版信息
Eye (Lond). 2022 Dec;36(12):2323-2327. doi: 10.1038/s41433-021-01869-4. Epub 2021 Dec 2.
PURPOSE
To describe clinical characteristics and visual outcomes of non-traumatic open globe injuries.
SETTING
A level 1 trauma centre in a large urban medical centre.
DESIGN
Retrospective study.
METHODS
Charts of non-traumatic open globe patients admitted to MHH-TMC from 1/2010 to 3/2015 were reviewed for demographics, cause, clinical characteristics, visual acuity (VA) and enucleation.
RESULTS
Thirty eyes were included: 15 (50%) were males with a mean age of 47 (±28) years. All presented with zone 1 injury. Twenty-five (83%) had a perforated corneal ulcer. Presenting VA was count fingers (n = 3, 10%) to NLP (n = 6, 20%). Twenty-four (80%) involved infection, 5 (17%) congenital, 3 (10%) chemical burn and 2 (7%) neurotrophic. Conjunctival injection (n = 22, 77%), corneal opacification (n = 20, 71%) and relative afferent pupillary defect (n = 9, 44%) were common. After treatment, 23 (88%) were worse than 6/60 (20/200), 9 (35%) were NLP and 8 (27%) required enucleation.
CONCLUSIONS
Often non-traumatic open globe injuries are zone 1 and due to perforated infectious ulcers. Compared to previously reported traumatic injuries, these have higher rates of enucleation (27% vs 8%) and poorer final VA (88% vs 68% worse than 6/60 20/200).
目的
描述非外伤性开放性眼球损伤的临床特征和视力结果。
地点
大型城市医疗中心的 1 级创伤中心。
设计
回顾性研究。
方法
回顾 2010 年 1 月至 2015 年 3 月期间入住 MHH-TMC 的非外伤性开放性眼球损伤患者的病历，记录人口统计学、病因、临床特征、视力和眼球摘除情况。
结果
纳入 30 只眼：15 只（50%）为男性，平均年龄 47（±28）岁。所有患者均为 1 区损伤。25 只（83%）有穿孔性角膜溃疡。就诊时视力为指数（n=3，10%）至无光感（n=6，20%）。24 只（80%）与感染有关，5 只（17%）为先天性，3 只（10%）为化学烧伤，2 只（7%）为神经源性。常见的有结膜充血（n=22，77%）、角膜混浊（n=20，71%）和相对性传入性瞳孔障碍（n=9，44%）。治疗后，23 只（88%）视力低于 6/60（20/200），9 只（35%）无光感，8 只（27%）需要眼球摘除。
结论
非外伤性开放性眼球损伤通常为 1 区，且多由穿孔性感染性溃疡引起。与之前报道的外伤性损伤相比，这些损伤眼球摘除率更高（27% vs 8%），最终视力更差（88% vs 68%低于 6/60 20/200）。
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