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Poor vision likely after choroidal hemorrhage involving macula from combat trauma

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WAILEA, Hawaii — Choroidal hemorrhage involving the macula is associated with the highest likelihood of poor final visual outcome from combat ocular trauma, a physician said here.

Eric D. Weichel, MD, reported at the American Society of Retina Specialists annual meeting the results of a retrospective consecutive case series of posterior segment injuries following open/closed globe and adnexal trauma of 387 military personnel injured in Iraq between 2003 and 2006.

"It's very hard to document eye protection usage during the blast," Dr. Weichel said. "Two-thirds of these patients have traumatic brain injury with loss of consciousness and post-traumatic amnesia."

The primary outcome measure of risk factors for poor visual outcome of posterior segment injuries was best corrected visual acuity. Eyes were assigned as BCVA either better or worse than 20/200.

Posterior segment risk factors associated with poor vision were choroidal hemorrhage involving the macula, sclopetaria involving the macula, choroidal hemorrhage not involving the macula, retinal detachment, subretinal hemorrhage within the macula, retinal tear, penetrating wound in zone 3, vitreous hemorrhage and traumatic macular hole.