Alsaleh Fares, Dhillon Jobanpreet, Nassrallah Emmanuel Issa B, Gaffar Judy, Kondoff Matthew, Nassrallah Georges B, Ross Michael, Deschenes Jean
Department of Ophthalmology & Visual Sciences, McGill University, Montreal, Quebec, Canada.
Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Orbit. 2023 Oct;42(5):487-495. doi: 10.1080/01676830.2022.2125536. Epub 2022 Sep 21.
Ocular pathology (OP) following orbital fracture can vary vastly in complexity and severity. Extra-ocular motility (EOM) limitations are frequently present in orbital trauma cases, with patterns of duction limitations being symmetrical or asymmetrical. The aim of this study was to identify if there was any association between increased OP following orbital fracture cases based on the pattern of EOM deficits.
This is a retrospective cohort study of patients with fractured orbits presenting with or without EOM limitations to a level 1 trauma center between August 2015 to January 2018. All pertinent elements of the ophthalmic examination were recorded. Outcome measures: Chi-square analyses assessed for association between symmetrical or asymmetrical EOM limitation and OP. Odds ratios were calculated with 95% confidence interval.
278 orbits with wall fractures were included in this study. A significant correlation between EOM limitation and increased OP following orbital trauma was found (p = 0.000081). Cases with symmetrical and asymmetrical EOM limitation were 7.9 (95%CI: 2.3-27.2) and 5.22 (95%CI: 1.9-13.9) times more likely to have OP than cases with no EOM limitation, respectively. With extraocular muscle entrapment excluded, cases with symmetrical limitations had a significantly higher incidence of OP than cases with asymmetrical limitations (p = 0.0161).
OP is frequently observed in cases of orbital fracture. While any EOM limitations should prompt the clinicians to anticipate OP, intra-ocular injury may be more likely in cases of symmetrical EOM limitation. Future prospective studies are needed to further elucidate the relationship between EOM symmetricity and OP following orbital trauma.
眼眶骨折后的眼部病理学（OP）在复杂性和严重程度上可能有很大差异。眼外肌运动（EOM）受限在眼眶创伤病例中经常出现，其牵拉受限模式可为对称或不对称。本研究的目的是确定基于EOM缺陷模式的眼眶骨折病例中OP增加之间是否存在关联。
这是一项回顾性队列研究，研究对象为2015年8月至2018年1月期间在一级创伤中心就诊的有或无EOM受限的眼眶骨折患者。记录眼科检查的所有相关要素。结果指标：采用卡方分析评估对称或不对称EOM受限与OP之间的关联。计算比值比及95%置信区间。
本研究纳入了278例眼眶壁骨折病例。发现眼眶创伤后EOM受限与OP增加之间存在显著相关性（p = 0.000081）。与无EOM受限的病例相比，对称和不对称EOM受限的病例发生OP的可能性分别高7.9倍（95%CI：2.3 - 27.2）和5.22倍（95%CI：1.9 - 13.9）。排除眼外肌嵌顿后，对称受限病例的OP发生率显著高于不对称受限病例（p = 0.0161）。
眼眶骨折病例中经常观察到OP。虽然任何EOM受限都应促使临床医生预期会发生OP，但对称EOM受限的病例发生眼内损伤的可能性可能更大。未来需要进行前瞻性研究，以进一步阐明眼眶创伤后EOM对称性与OP之间的关系。
