CT may outperform clinical exam, ultrasonography in detecting intraocular foreign bodies

Issue: July 25, 2012

Computed tomography proved more effective than clinical examination or ultrasonography in identifying intraocular foreign bodies in traumatic open-globe injuries, a large study found.

“Accurate, timely determination of the presence or absence of an intraocular foreign body is important in cases of open globe injury,” the study authors said. “Confirmation of the presence of an [intraocular foreign body] is especially important given the potential for good visual recovery with appropriate surgical management.”

The authors retrospectively reviewed the records of 527 patients who presented with traumatic open-globe injuries between 1998 and 2008. Intraocular foreign bodies were confirmed intraoperatively in 74 patients with a mean age of 33 years.

Clinical eye examination findings, B-scans and CT images, visual acuity, IOP, traumatic features and surgical procedures were reviewed.

Study results showed that foreign bodies were removed in 70 eyes during primary globe repair; four foreign bodies were removed during subsequent procedures.

All patients underwent clinical examination. B-scans were performed in 27 cases of suspected posterior segment pathology. CT scans were performed in 59 cases of suspected foreign body or orbital fracture.

Clinical examination detected foreign bodies in 34 of 74 patients (45.6%). B-scan echography showed foreign bodies in 14 of 27 cases (51.9%). CT scans of the orbits showed foreign bodies in 56 of 59 cases (94.9%).

CT scans and B-scans were significantly more effective than clinical eye examination in identifying posterior segment foreign bodies (P < .05). CT scans were significantly more effective than B-scans in detecting posterior segment foreign bodies.

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Source:

Eur J Ophthalmol. 2012;22(2):259-268.