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A. E. Oester, Jr., J. C. Fleming, P. Sahu; Radiographic Predictors of Visual Outcome in Orbital Compartment Syndrome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4873.
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© ARVO (1962-2015); The Authors (2016-present)
To determine radiographic predictors for visual outcome in patients with orbital compartment syndrome.
A retrospective chart review of all patients presenting to the oculoplastics service at Hamilton Eye Institute with retrobulbar hematoma or orbital cellutlitis from January 2000 until October 2009 was performed. Patients were only included if CT scans of the orbits were available for review and had documented follow up visits to 4 weeks after initial presentation. The CT scans were used to measure several parameters including medial wall length, lateral wall length, intraorbital optic nerve length, distance from globe to apex, and a novel measurement of the angle created by the posterior sclera, optic nerve, and medial rectus. The non-involved orbit was also measured as an internal control. The results were then compared to the visual acuity at presentation and the final best corrected visual acuity.
Final results of all data collected are not yet available; however, initial data indicates a strong correlation between measurements of the posterior angle of less than 15 degrees (normal being ~34 degrees in non-involved eyes) and poor visual outcome.
Orbital compartment syndrome is a potentially vision threatening condition. Minimal objective data is currently available in the literature to guide physicians in clinical judgement making regarding these patients. This study provides objective measurements that can aid ophthalmologist and radiologist in determining the relative threat to vision in patients presenting with orbital cellulitis and retrobulbar hematomas. Hopefully, the data can help select patients that may benefit from more aggressive intervention and will ulitmately result in superior visual outcomes.
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