Imaging findings linked with long-term vision outcomes in patients with ocular trauma
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Key takeaways:
- Imaging findings in ocular trauma cases were linked with vision outcomes.
- A combination of clinical examination and ancillary imaging should be taken into account.
Specific imaging findings in patients with ocular trauma were associated with vision outcomes, which may help establish a more accurate visual recovery prognosis, according to a study.
“Our team found that in the setting of ocular trauma, certain findings detected on initial imaging (B-scan, CT scan and ultrasound biomicroscopy) have an association with long-term visual acuity outcomes,” Leanne M. Clevenger, MD, formerly of Cleveland Clinic’s Cole Eye Institute and now at Shriners Hospitals for Children Medical Center – Lexington, Kentucky, told Healio.
The retrospective chart review examined 134 patients who presented to Cole Eye Institute with ocular trauma between January 2013 and December 2020. The initial ocular exam included relevant slit lamp and fundus ophthalmoscopy findings, and imaging included CT scans, B-scan ultrasonography and ultrasound biomicroscopy (UBM). The median visual acuity at presentation was logMAR 2.7.
“We found a correlation between the presence or absence of certain initial clinical examination features and the presence or absence of positive findings on initial B-scan,” Clevenger said.
Of the 136 cases of ocular trauma, 62% were open globe injuries. Globe deformity was the most common finding on initial CT scan (30%) and choroidal detachment the most common on initial B-scan (20%). The most common UBM findings were intraocular foreign body, ciliochoroidal effusions and angle recession (21% each).
At 6 months after injury and at the final exam, patients positive for retinal detachment on initial B-scans had worse vision overall than those who were negative (median logMAR 2.7 vs. logMAR 0.5, P < .0001, and median logMAR 3.7 vs. logMAR 0.4, P < .0001, respectively).
“Those patients with positive conjunctiva/sclera findings and anterior chamber findings on clinical examination were more likely to also have positive features on initial B-scan,” Clevenger said.
clinical examination and ancillary imaging is important to determine accurate prognostic indicators for patients with ocular trauma.
“Both should be taken into account for surgical planning and when counseling patients on visual outcomes,” Clevenger said.
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