Kylstra J A, Lamkin J C, Runyan D K
Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill 27599-7040.
Am J Ophthalmol. 1993 Apr 15;115(4):530-5. doi: 10.1016/s0002-9394(14)74458-7.
We conducted a two-part study to define better the clinical predictors of scleral rupture after blunt trauma. In part 1 we ascertained the prevalence of scleral rupture among a population of patients examined in an ophthalmic emergency room with severe blunt ocular trauma over a six-month period. Scleral rupture was diagnosed in ten of 283 patients (3.5%). In part 2 we compared the clinical findings in 29 patients with scleral rupture to those of 273 patients with no scleral rupture after blunt trauma. We noted that eyes with visual acuity of light perception or less, an intraocular pressure of 5 mm Hg or less, an abnormally deep or shallow anterior chamber, or a media opacity preventing a view of fundus details by indirect ophthalmoscopy, should be considered ruptured when severe intra- or periocular hemorrhage is present. This diagnostic algorithm had a sensitivity of 100.0% (98.7% to 100.0%), specificity of 98.5% (97.1% to 99.9%), and a positive predictive value of 71.4% (66.3% to 76.5%).
我们进行了一项分为两部分的研究，以更好地确定钝性眼外伤后巩膜破裂的临床预测因素。在第一部分中，我们确定了在眼科急诊室接受检查的严重钝性眼外伤患者群体中巩膜破裂的患病率。在283例患者中，有10例被诊断为巩膜破裂（3.5%）。在第二部分中，我们比较了29例巩膜破裂患者与273例钝性眼外伤后无巩膜破裂患者的临床检查结果。我们注意到，当存在严重的眼内或眼周出血时，视力为光感或更低、眼压为5 mmHg或更低、前房异常深或浅、或介质混浊妨碍通过间接检眼镜观察眼底细节的眼睛，应被视为巩膜破裂。这种诊断算法的敏感性为100.0%（98.7%至100.0%），特异性为98.5%（97.1%至99.9%），阳性预测值为71.4%（66.3%至76.5%）。
