Ren Ping, Jiao Yan, Zhang Chunling, Chen Guoyue
Department of Radiology, Jinan Central Hospital, Jinan City, Shandong Province, 250013, China.
J Ophthalmol. 2022 Sep 1;2022:4995185. doi: 10.1155/2022/4995185. eCollection 2022.
The prognosis of visual outcome is important for patients and healthcare providers and guides proper decision-making in traumatic eye injury. In this study, we have evaluated the predictive value of computed tomography (CT) scan findings for poor visual outcomes in patients with traumatic eye injuries.
In a retrospective survey, documents of 200 patients with traumatic eye injury who underwent a diagnostic orbital CT scan were reviewed. Disorganized or collapsed globe, intraocular foreign body or gas, increased or decreased anterior chamber size, hemorrhage in the anterior or posterior chamber, crystalline or intraocular lens dislocation, posterior sclera thickening, globe borders haziness, orbital fracture, orbital hemorrhage, and foreign body, optic canal, and optic nerve injuries are the diagnostic clues for eye injury in CT scan. The predictive value of CT scan findings for poor visual outcome was calculated by sensitivity, specificity, accuracy, predictive values, hazard ratios, and binary logistic regression model.
The sensitivity, specificity, accuracy, and positive predictive values showed to be high. However, there was a low negative predictive value of CT findings for the prediction of poor vision. Among the investigated factors, disorganized/collapsed globe (HR 47.72, CI 6.13-371.62), increased/decreased anterior chamber size (HR 5.04, CI 2.57-9.88), hemorrhage in anterior/posterior chamber (HR 3.58, CI 1.900-6.774/3.62, CI 1.90-6.89), globe borders haziness (HR 3.06, CI 1.33-7.01), orbital foreign body (HR 3.66, CI 1.11-12.05), and optic canal/nerve injury (HR 21.62, CI 4.73-98.78) reached the statistical significance for increasing the hazard ratio for poor visual outcome in patients with a traumatic eye injury. Logistic regression analysis showed only evidence for disorganized/collapsed globe and optic canal/nerve injury in orbital CT scan as independent predictive factors for poor visual outcome.
CT scan findings can be used as prognostic factors for visual outcomes in patients with a traumatic eye injury.
视觉预后对患者和医疗服务提供者而言至关重要，且能为外伤性眼损伤的合理决策提供指导。在本研究中，我们评估了计算机断层扫描（CT）扫描结果对外伤性眼损伤患者不良视觉预后的预测价值。
在一项回顾性调查中，我们查阅了200例行眼眶诊断性CT扫描的外伤性眼损伤患者的资料。眼球结构紊乱或塌陷、眼内异物或气体、前房大小增加或减小、前房或后房出血、晶状体或人工晶状体脱位、后巩膜增厚、眼球边界模糊、眼眶骨折、眼眶出血以及异物、视神经管和视神经损伤是CT扫描中眼损伤的诊断线索。通过敏感性、特异性、准确性、预测值、风险比和二元逻辑回归模型计算CT扫描结果对不良视觉预后的预测价值。
敏感性、特异性、准确性和阳性预测值均较高。然而，CT检查结果对视力不佳预测的阴性预测值较低。在研究的因素中，眼球结构紊乱/塌陷（风险比47.72，可信区间6.13 - 371.62）、前房大小增加/减小（风险比5.04，可信区间2.57 - 9.88）、前房/后房出血（风险比3.58，可信区间1.900 - 6.774/3.62，可信区间1.90 - 6.89）、眼球边界模糊（风险比3.06，可信区间1.33 - 7.01）、眼眶异物（风险比3.66，可信区间1.11 - 12.05）以及视神经管/神经损伤（风险比21.62，可信区间4.73 - 98.78）在增加外伤性眼损伤患者不良视觉预后风险比方面具有统计学意义。逻辑回归分析表明，眼眶CT扫描中仅眼球结构紊乱/塌陷和视神经管/神经损伤是不良视觉预后的独立预测因素。
CT扫描结果可作为外伤性眼损伤患者视觉预后的预后因素。
