Screening Criteria for Detecting Severe Ocular Injuries in the Setting of Orbital Fractures
| Autor: | Margaret L. Pfeiffer, Alice Z Chuang, Helen A. Merritt, Thai H Do, Karina Richani, Margaret E. Phillips |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Visual acuity genetic structures Vision Disorders Diagnostic Techniques Ophthalmological Sensitivity and Specificity Article Young Adult 03 medical and health sciences Eye Injuries 0302 clinical medicine Blurred vision Predictive Value of Tests medicine Humans Mass Screening Young adult Orbital Fracture Orbital Fractures Aged Retrospective Studies Receiver operating characteristic business.industry Incidence Incidence (epidemiology) Retrospective cohort study General Medicine Middle Aged eye diseases Ophthalmology Logistic Models Anesthesia Predictive value of tests 030221 ophthalmology & optometry Female Surgery sense organs medicine.symptom business |
| Zdroj: | Ophthalmic Plast Reconstr Surg |
| ISSN: | 0740-9303 |
| DOI: | 10.1097/iop.0000000000001422 |
| Popis: | PURPOSE Define incidence of severe ocular trauma in orbital fracture patients and determine if ocular signs and symptoms are useful predictors of severe ocular injuries. METHODS Retrospective chart review was performed on all patients with orbital fractures between April 1, 2013, and December 31, 2014. Patients were included if they had radiographic evidence of acute fracture of at least one orbital wall and were evaluated by the Ophthalmology service. Demographics, concurrent injury data, and symptoms and signs of ocular trauma were collected. Concurrent ocular injuries were grouped by severity. Predictive signs or symptoms for severe ocular trauma were identified by stepwise logistic regression analysis. The threshold point for predictive signs and symptoms was detected by a receiver operating characteristic (ROC). RESULTS Five-hundred-twelve patients were included. The most common mechanisms of injury were assault (39%), fall (25%), and motor vehicle accident (21%). The incidence of any concurrent ocular trauma was 75% (383/512), with 14% (70/512) being severe. Four signs and symptoms were predictors of severity: blurred vision (P < 0.0001), pain with eye movements (P < 0.0001), visual acuity worse than 20/40 in the ipsilateral eye (P < 0.001), and restricted motility (P < 0.001). The presence of 2 or more of these signs or symptoms was predictive of severe ocular trauma with high sensitivity (91%) and specificity (86%). CONCLUSIONS In cooperative patients with acute orbital wall fractures, the presence of 2 or more signs or symptoms is predictive of severe ocular trauma and necessitates the need for urgent ophthalmic consultation.Severe ocular injury associated with orbital wall fracture is more likely in patients with 2 or more ophthalmic signs or symptoms. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|