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Ophthalmic evaluation and management of traumatic accidents associated with retinal breaks and detachment: a
Raffaele Nuzzi1, Elisa Buschini, Alessandro Guido Actis
1Ophthalmic Section, Department of Clinical Pathophysiology, University of Torino, Torino, Italy.
Purpose:
This retrospective study reviews a group of patients with retinal breaks or retinal detachment following ocular trauma.
Methods:
A total of 94 patients were included in the study. They underwent closed globe injuries causing multiple retinal breaks or retinal detachment at time of presentation in the emergency department. Analysis concerned epidemiologic, clinical, and therapeutic aspects, both in short-term (1 and 3 months) and long-term (6-12 months) follow-up.
Results:
A total of 85% of patients were male, involved in work-related injuries, and complaining visual function decrease. Retinal breaks were mostly singular, U-shaped, and located in the upper temporal quadrant. At presentation, visual acuity ≥5/10 and Ocular Trauma Score of 4 were the most represented. Fifty-eight patients (61.70%) underwent repair within 48 hours of the trauma, 27 (28.73%) within 7 days, and 9 (9.57%) more than 7 days after trauma. Procedures performed were photocoagulation with argon laser (52%), episcleral buckle (34.45%), or vitrectomy associated with episcleral buckle and intraoperative argon laser (13.55%). A total of 92% of patients treated within 48 hours had better or unchanged visual acuity in 6-12 months of follow-up. All patients treated more than 7 days after trauma had worse visual acuity (p<0.01 with Student t test).
Conclusions:
Detailed clinical history, well-done preoperative examination, early diagnosis, and prompt parasurgical or surgical repair are significant prognostic factors for better visual outcome and lower incidence of relapse.
