George Georgina, Monteiro Berton C, Noronha Dilon D, Mijar Mahesh, Karanth Krishna K S
Department of Radiodiagnosis, Father Muller Medical College Hospital, Mangalore, Karnataka, India.
Department of Ophthalmology, Father Muller Medical College Hospital, Mangalore, Karnataka, India.
Saudi J Ophthalmol. 2024 Sep 16;39(2):160-165. doi: 10.4103/sjopt.sjopt_312_23. eCollection 2025 Apr-Jun.
The purpose is to determine the computed tomography (CT) characteristics of open globe injury and establish the relative accuracy and reliability of various features on CT. Second, to assess the significance of a difference in the anterior chamber depths (ACDs) on CT in cases of open globe injury.
The diagnostic database of our radiology department was retrospectively reviewed to obtain details of patients with a history of blunt or penetrating injury to the orbit between September 2018 and March 2021. A total of 190 patients (144 males and 46 females) were included. A radiologist analyzed the CT scans without prior knowledge of ophthalmologic findings or surgical outcomes. Operative and ophthalmic examination findings were considered the gold standard for comparison.
Out of 190 injured globes, the final clinical diagnosis confirmed 54 (28.4%) open globe injuries and 136 (71.5%) closed globe injuries. Between the two groups, intraocular hemorrhage, lens dislocation, lens injury or absence, intraocular foreign body, intraocular air, wall/contour defect, and ACD change were considered statistically significant ( < 0.05). The average sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosing open globe injury were 71.3%, 98.5%, 83.6%, 95.75%, and 94.9%, respectively.
Globe contour deformity or defect, intraocular hemorrhage, and a change in ACD were the three most predictive signs of open globe injury. CT is of valuable help in a multi-trauma setting and in an uncooperative patient for ophthalmological examination to draw attention to globe injury. However, CT examination alone is insufficient in detecting all cases of open globe injury. There is a need for a more collaborative approach among emergency physicians, ophthalmologists, and radiologists.
确定开放性眼球损伤的计算机断层扫描（CT）特征，并确定CT上各种特征的相对准确性和可靠性。其次，评估开放性眼球损伤病例中CT上前房深度（ACD）差异的意义。
回顾性分析我院放射科诊断数据库，以获取2018年9月至2021年3月期间有眼眶钝挫伤或穿透伤病史患者的详细信息。共纳入190例患者（男性144例，女性46例）。一名放射科医生在不了解眼科检查结果或手术结果的情况下分析CT扫描图像。手术和眼科检查结果被视为比较的金标准。
在190只受伤眼球中，最终临床诊断确诊54例（28.4%）开放性眼球损伤和136例（71.5%）闭合性眼球损伤。两组之间，眼内出血、晶状体脱位、晶状体损伤或缺失、眼内异物、眼内积气、眼球壁/轮廓缺损和ACD变化具有统计学意义（<0.05）。CT诊断开放性眼球损伤的平均灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为71.3%、98.5%？83.6%、95.75%和94.9%。
眼球轮廓畸形或缺损、眼内出血和ACD变化是开放性眼球损伤最具预测性的三个体征。在多发伤情况下以及对于不配合眼科检查的患者，CT对于提醒注意眼球损伤有重要帮助。然而，仅靠CT检查不足以检测出所有开放性眼球损伤病例。急诊科医生、眼科医生和放射科医生之间需要采取更协作的方法。
原文中“阳性预测值、阴性预测值和准确率分别为71.3%、98.5%？83.6%、95.75%和94.9%。”这里的问号是原文的错误，应改为逗号。译文已按正确内容翻译。
