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动物致眼外伤的临床特征与视觉预后:伊朗一项前瞻性多中心研究

Clinical characteristics and visual outcomes of animal-induced ocular injuries: a prospective multicenter study in Iran.

作者信息

Mohammadi Mohammad, Attar Alireza, Mahmoudinezhad Golnoush, Shahesmaeilinejad Armita, Zhu Dagny, Fowler Brian, Farsi Yeganeh, Shirvani Mohammad, Gohari Mohsen

机构信息

School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Front Med (Lausanne). 2024 Sep 30;11:1462252. doi: 10.3389/fmed.2024.1462252. eCollection 2024.

Abstract

BACKGROUND

Animal-induced ocular injuries represent an under-documented health problem that may pose significant visual complications. This study aimed to investigate the clinical characteristics and outcomes of ocular injuries caused by animals.

METHODS

This multicenter prospective study enrolled patients with a history of animal-induced ocular injuries presenting to the ophthalmology departments of two tertiary hospitals over a one-year period. All participants underwent comprehensive assessments by ophthalmologists, and the following data were collected: demographic information, animal species involved, injury details, pre- and post-treatment visual data, management strategies, and follow-up outcomes.

RESULTS

Seventy-two patients (62.5% male) were included in the study. Insects were the most common species, causing 37.5% of ocular injuries. The type of animal involved was significantly associated with injury patterns ( < 0.0001), visual impairments at presentation ( < 0.05), and need for surgery ( < 0.001). Insects predominantly caused periorbital soft tissue injuries; birds primarily affected the anterior segment; dogs and cats mainly led to adnexal injuries; and equines often involved both anterior and posterior segments. Equine-related injuries resulted in the most severe visual impairments, requiring surgical interventions in all cases. At the same time, the majority of cases involved with other animal species experienced no visual impairment. The number of patients without visual impairment increased from 46 cases (63.9%) at the time of presentation to 58 (80.6%) at discharge after treatment. At follow-up, eight patients (11.1%) experienced complications, including traumatic cataract ( = 6, 8.3%), endophthalmitis ( = 3, 4.2%), corneal scarring ( = 1, 1.4%), and retinal detachment ( = 1, 1.4%). Rooster pecking was the leading cause of complications, including endophthalmitis and traumatic cataract.

CONCLUSION

This study revealed that depending on the type of animal causing the injury, animal-induced ocular injuries present with diverse characteristics, requiring appropriate treatment approaches and potentially resulting in different outcomes. These findings may promote public awareness and improve preventive strategies and clinical guidelines development.

摘要

背景

动物致眼外伤是一个记录不足的健康问题,可能会引发严重的视觉并发症。本研究旨在调查动物致眼外伤的临床特征及预后。

方法

这项多中心前瞻性研究纳入了在一年期间到两家三级医院眼科就诊的有动物致眼外伤史的患者。所有参与者均接受眼科医生的全面评估,并收集以下数据:人口统计学信息、涉及的动物种类、损伤细节、治疗前后的视力数据、治疗策略及随访结果。

结果

72例患者(62.5%为男性)纳入研究。昆虫是最常见的致伤动物,导致37.5%的眼外伤。涉及的动物种类与损伤类型(<0.0001)、就诊时的视力损害(<0.05)及手术需求(<0.001)显著相关。昆虫主要导致眶周软组织损伤;鸟类主要影响眼前段;狗和猫主要导致附属器损伤;马常累及前后段。与马相关的损伤导致最严重的视力损害,所有病例均需手术干预。同时,大多数涉及其他动物种类的病例无视力损害。无视力损害的患者数量从就诊时的46例(63.9%)增加到治疗后出院时的58例(80.6%)。随访时,8例患者(11.1%)出现并发症,包括外伤性白内障(n = 6,8.3%)、眼内炎(n = 3,4.2%)、角膜瘢痕(n = 1,1.4%)和视网膜脱离(n = 1,1.4%)。公鸡啄伤是并发症的主要原因,包括眼内炎和外伤性白内障。

结论

本研究表明,根据致伤动物的种类,动物致眼外伤具有不同特征,需要采取适当的治疗方法,并可能导致不同的预后。这些发现可能会提高公众意识,并改善预防策略及临床指南的制定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2667/11471565/0686f92c42db/fmed-11-1462252-g001.jpg

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