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Computed Tomography in Preoperative Assessment of Ocular Trauma Due to Pellet Gun


Affiliations
1 Dept. Ophthalmology, Government Medical College, Srinagar, India
 

Purpose: To determine significance of findings on orbital computed tomography in classifying ocular injuries into Open Globe or Closed Globe

Methods: The study design was prospective observational case series carried between July 2016 and July 2017. About 604patients with suspected foreign body, in our case pellet, were studied. All patients did undergo helical CT direct scanning in axial plane and multi planar reconstruction of coronal and sagittal planes. The images were studied by masked observers, one radiologist and two ophthalmologists.

Results: Statistically significant CT findings for open-globe injury included intraocular foreign body, globe contour change, intraocular air, vitreous haemorrhage, retinal detachment, and Choroidal detachment. The overall sensitivity, specificity and accuracy of CT for determining open-globe injury were89.89%, 92.04% and 90.57% respectively. Positive predictive value ranged from 93.85% to 97.51% and negative predictive value from 76.01% to 84.80%. Positive likelihood ratio and negative likelihood ratio was found to be 11.29(7.05-18.09) and 0.11(0.08-0.15). Furthermore optic nerve sheath haemangioma (n=13), avulsion (n=3), inflammation (n=23), and retro-ocular haemorrhage (n=22) and relative proptosis (n=9) did not correlated significantly to either group. Also intraconal foreign body correlated more to open-globe injury than extraconal foreign body.

Conclusions: CT can be considered initial investigation of choice in such injuries as it is rapid, non-invasive, provides information regarding posterior segment and retro-ocular tissue, accurate localisation of FB and guides management particularly in settings of multisystem injury. We recommend CT as initial investigation of choice in suspected FB injury and occult open-globe injury.


Keywords

Ocular Trauma, Ocular Imaging, Computed Tomography, Shotgun, Pellet, Ct Accuracy in Ocular Trauma.
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  • Computed Tomography in Preoperative Assessment of Ocular Trauma Due to Pellet Gun

Abstract Views: 482  |  PDF Views: 187

Authors

Faisal Qayoom Shah
Dept. Ophthalmology, Government Medical College, Srinagar, India
Syed Tariq Qureshi
Dept. Ophthalmology, Government Medical College, Srinagar, India
Shahnawaz Shafi
Dept. Ophthalmology, Government Medical College, Srinagar, India

Abstract


Purpose: To determine significance of findings on orbital computed tomography in classifying ocular injuries into Open Globe or Closed Globe

Methods: The study design was prospective observational case series carried between July 2016 and July 2017. About 604patients with suspected foreign body, in our case pellet, were studied. All patients did undergo helical CT direct scanning in axial plane and multi planar reconstruction of coronal and sagittal planes. The images were studied by masked observers, one radiologist and two ophthalmologists.

Results: Statistically significant CT findings for open-globe injury included intraocular foreign body, globe contour change, intraocular air, vitreous haemorrhage, retinal detachment, and Choroidal detachment. The overall sensitivity, specificity and accuracy of CT for determining open-globe injury were89.89%, 92.04% and 90.57% respectively. Positive predictive value ranged from 93.85% to 97.51% and negative predictive value from 76.01% to 84.80%. Positive likelihood ratio and negative likelihood ratio was found to be 11.29(7.05-18.09) and 0.11(0.08-0.15). Furthermore optic nerve sheath haemangioma (n=13), avulsion (n=3), inflammation (n=23), and retro-ocular haemorrhage (n=22) and relative proptosis (n=9) did not correlated significantly to either group. Also intraconal foreign body correlated more to open-globe injury than extraconal foreign body.

Conclusions: CT can be considered initial investigation of choice in such injuries as it is rapid, non-invasive, provides information regarding posterior segment and retro-ocular tissue, accurate localisation of FB and guides management particularly in settings of multisystem injury. We recommend CT as initial investigation of choice in suspected FB injury and occult open-globe injury.


Keywords


Ocular Trauma, Ocular Imaging, Computed Tomography, Shotgun, Pellet, Ct Accuracy in Ocular Trauma.

References