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开放性眼球损伤合并视网膜脱离的治疗结果:眼外伤中心的经验

Outcomes of Open-Globe Injuries With Associated Retinal Detachment: Experience at an Ocular Trauma Center.

作者信息

Sheth Neil, Chang Arthur Y, Bryan John M, Massengill Michael T, Lim Jennifer I

机构信息

Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA.

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

J Vitreoretin Dis. 2024 Dec 13:24741264241301763. doi: 10.1177/24741264241301763.

Abstract

To characterize the clinical features and outcomes of open-globe injuries with associated retinal detachment (RD). A retrospective review was performed. Thirty-six patients with open-globe injuries and subsequent rhegmatogenous RD were analyzed between January 2016 and September 2021. The median time to diagnosis and to the initial vitrectomy repair was 2.5 days and 20 days, respectively. Six months postoperatively, the median Snellen best-corrected visual acuity (BCVA) improved from light perception to hand motions. The logMAR BCVAs were significantly higher (worse) for patients who had more than 20 days between their injury and the initial vitrectomy repair ( = .01) and if their retinal detachment after open-globe injury score was higher than 5 ( = .03). The number of days between the open-globe injury and the initial vitrectomy repair was directly correlated with the final logMAR BCVA ( = .03). On multivariate analysis, a duration of more than 20 days between the open-globe injury and the initial vitrectomy repair was statistically significant for predicting the 6-month logMAR BCVA ( = .02). The final visual outcome for cases of RD associated with open-globe injury may be improved by minimizing the time between the injury and the initial vitrectomy repair.

摘要

为了描述开放性眼球损伤合并视网膜脱离(RD)的临床特征和预后。进行了一项回顾性研究。分析了2016年1月至2021年9月期间36例开放性眼球损伤并随后发生孔源性视网膜脱离的患者。诊断和首次玻璃体切除术修复的中位时间分别为2.5天和20天。术后6个月,Snellen最佳矫正视力(BCVA)中位数从光感提高到手动。受伤与首次玻璃体切除术修复间隔超过20天的患者以及开放性眼球损伤后视网膜脱离评分高于5分的患者,其logMAR BCVA显著更高(更差)(P = 0.01和P = 0.03)。开放性眼球损伤与首次玻璃体切除术修复之间的天数与最终logMAR BCVA直接相关(P = 0.03)。多因素分析显示,开放性眼球损伤与首次玻璃体切除术修复间隔超过20天对预测6个月时的logMAR BCVA具有统计学意义(P = 0.02)。通过缩短损伤与首次玻璃体切除术修复之间的时间,开放性眼球损伤合并视网膜脱离病例的最终视觉预后可能会得到改善。

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