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Gokhan Ozge, Gokcen Gokce, Cuneyt Erdurman, Hakan Durukan, Gungor Sobac; Long Term Posterior Segment Complications of Zone-3 Contusion Type Closed-Globe Injury Secondary to In-Vehicle Car Accident. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4970.
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© ARVO (1962-2015); The Authors (2016-present)
To report the characteristics, anatomical and functional results of patients with ocular trauma due to in-vehicle car accidents.
We conducted a retrospective chart review of 23 patients admitted to the our institution with a history of zone-3, contusion type closed-globe ocular trauma caused by car accidents from January 2004 through March 2008. Ocular injuries were classified according to the Ocular Trauma Classification System (OTCS) including, type of injury, severity of injury (visual acuity: VA), location of injury, and presence of relative afferent pupillary defect (RAPD). The final VA categorized using that grading system: grade 1 was better than 20/40; grade 2, 20/50 to 20/100; grade 3,19/100 to 5/200; grade 4, 4/200 to light perception, and grade 5 was no light perception.
All patients were male. They had at least 6 months of follow-up (6-15 months). Two (8.6%) subjects had choroidal rupture. Retinal tear was found in two (8.6%) patients, traumatic macular edema in 11 (47.8%), and traumatic optic nerve injury in 14 (60.8%). RAPD was documented in 9 (39.1%) patients. Final VAs were grade 1 or better in 1 (4.3%) of the patients. No patients required any surgical treatment except 2 with retinal tear. Twenty (86.9%) eyes had 5/200 or better VA.Three patients (3 eyes) (13%) had hand movements or worse VAs. They had optic neuropathy and RAPD positivity at presentation.
In-vehicle car accident-related closed-globe injury, traumatic optic neuropathy seems to be the most frequent presentation, and may be the predictive of worse final visual outcome if it was associated with RAPD.
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