Neuro-Ophthalmic Injuries With Systemic Neurologic Injury or Traumatic Brain Injury in Operation Iraqi Freedom and Operation Enduring Freedom
| Autor: | Marcus H. Colyer, Cameron J Elward, Grant A. Justin, Eric D. Weichel, Alexandria F Jaksha, Denise S Ryan, Daniel I Brooks |
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| Rok vydání: | 2020 |
| Předmět: |
Male
SNi Visual acuity genetic structures Eye Diseases Traumatic brain injury Visual Acuity Horner syndrome 03 medical and health sciences 0302 clinical medicine Ptosis parasitic diseases Brain Injuries Traumatic medicine Humans Iraq War 2003-2011 Retrospective Studies Diplopia business.industry Incidence Retrospective cohort study medicine.disease eye diseases United States Ophthalmology Anesthesia Cranial Nerve Injury 030221 ophthalmology & optometry Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society. 40(3) |
| ISSN: | 1536-5166 |
| Popis: | BACKGROUND To analyze the final visual acuity (VA) of neuro-ophthalmologic injuries (NOI) in combat ocular trauma and to study the association of NOI with systemic neurologic injury (SNI) and traumatic brain injury (TBI). METHODS The Walter Reed Ocular Trauma Database was reviewed. Inclusion criteria were any US service member and Department of Defense civilians who suffered NOI, SNI, or TBI in Operation Iraqi Freedom or Operation Enduring Freedom. The primary outcome measure was the rate of poor final VA in patients with an NOI with secondary outcome measures the rate of SNI and TBI. in patients with NOI. RESULTS One hundred seventy-eight (20.00%) of 890 eyes had an NOI. Optic nerve injury was observed in 79 (44.38%) eyes, other cranial nerve injury in 68 (38.20%), Horner syndrome in 4 (2.25%), diplopia in 45 (25.28%), and ptosis in 13 (7.30%). In patients with NOI, 76 (42.69%) eyes had a final VA less than 20/200. In injured eyes (n = 359) of patients (n = 251) with TBI, 154 eyes (34.26%) had a final VA less than 20/200. In multivariate analysis, optic nerve injury (P < 0.001), unlike TBI (P = 0.47), was associated with final VA less than 20/200. SNI (n = 229) had a statistically significant association (odds ratio 29.8, 95% confidence interval 19.2-47.8, P < 0.001) with NOI. Optic nerve injury and cranial nerve injury were associated with TBI and SNI (all, P < 0.001). CONCLUSION Optic nerve injury and cranial nerve injury are associated with TBI and SNI. Optic nerve injury, but not TBI or cranial nerve injury, is associated with a poor final VA. |
| Databáze: | OpenAIRE |
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