April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Anatomical Manifestations of Primary Blast Ocular Trauma Observed in an Ex Vivo Porcine Model
Author Affiliations & Notes
  • William Eric Sponsel
    Biomedical Engineering, UTSA, San Antonio, TX
    Visual Science, Rosenberg School of Optometry; UIW, San Antonio, TX
  • Matthew Aaron Reilly
    Biomedical Engineering, UTSA, San Antonio, TX
  • Brian J Lund
    U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX
  • Walter Gray
    Geological Sciences, UTSA, San Antonio, TX
  • Richard Watson
    Biomedical Engineering, UTSA, San Antonio, TX
    Biodynamic Research Corporation, San Antonio, TX
  • Sylvia Linner Groth
    Ophthalmology, Presence St. Francis Hospital, Evanston, IL
  • Randolph D Glickman
    Biomedical Engineering, UTSA, San Antonio, TX
    Ophthalmology, UTHSCSA, San Antonio, TX
  • Kimberly Thoe
    Glaucoma Service, WESMDPA, San Antonio, TX
  • Footnotes
    Commercial Relationships William Sponsel, None; Matthew Reilly, None; Brian Lund, None; Walter Gray, None; Richard Watson, None; Sylvia Groth, None; Randolph Glickman, None; Kimberly Thoe, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4445. doi:
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      William Eric Sponsel, Matthew Aaron Reilly, Brian J Lund, Walter Gray, Richard Watson, Sylvia Linner Groth, Randolph D Glickman, Kimberly Thoe, ; Anatomical Manifestations of Primary Blast Ocular Trauma Observed in an Ex Vivo Porcine Model. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4445.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To qualitatively describe the anatomic features of primary ocular blast injury observed using an in vitro porcine eye model. Porcine eyes were exposed to various levels of blast energy to determine the optimal conditions for future testing.

 
Methods
 

Fifty-three (53) enucleated porcine eyes were studied; 13 control eyes and 40 test eyes exposed to a range of blast overpressure levels. Eyes were pre-assessed with B-scan and UBM ultrasonography, photographed, mounted in gelatin within acrylic orbits, and monitored with high-speed videography during blast-tube impulse exposure. Post-impact photography, ultrasonography, and histopathology were performed and ocular damage was assessed. Injury scoring in each zone followed a new clinically relevant Composite Injury Scale addressing the practical needs of those engaged in the treatment of ocular injury or development of protective eyewear. Injury scores were ascribed on the basis of a stepwise algorithm to integrate the structural damage in each of the Zones 1-3 as defined by Pieramici et al (AJO 1997), where Zone 1 is the external ocular surface, Zone 2 the anterior chamber, and Zone 3 the internal posterior segment.

 
Results
 

Strong evidence for primary blast injury was obtained. Common findings included angle recession, internal scleral delamination, cyclodialysis, peripheral chorioretinal detachments, and radial peripapillary retinal detachments. No full-thickness openings of the eyewall were observed in any of the eyes tested. Scleral damage demonstrated the strongest associative tendency for increasing likelihood of injury with increased overpressure. Table 1 shows the association between primary blast peak overpressure levels and the tendency for damage to structures in anatomic Zones 1-3. Note that a level 2 injury as referred to in the table is one that would require surgery to repair and would result in chronic pathology.

 
Conclusions
 

These data provide convincing evidence that primary blast can produce clinically significant ocular damage in the absence of particle impact. We also present a new Cumulative Injury Score indicating the clinical relevance of observed injuries.

  
Keywords: 742 trauma • 697 retinal detachment • 421 anterior segment  
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