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Ricardo Moreno-Mendoza, Miguel Pedroza-Seres, Rosalva Bobadilla, Monica Almanza, Alejandro Javier Zermeno-Arce; Traumatic Uveitis Following Blunt Ocular Trauma and Complications. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4142.
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© ARVO (1962-2015); The Authors (2016-present)
We performed a retrospective study to describe the demographic characteristics and complications of patients with diagnosis of traumatic uveitis, in an ophthalmologic Center in Mexico City.
We analyzed the electronic medical records of patients diagnosed with traumatic uveitis from January 2008 to January 2015 who came to the emergency service at our hospital; as well as their follow-up visits for the same diagnosis or its complications. Complete ophthalmologic evaluation was performed in all cases.
We included 447 patients initially diagnosed as traumatic uveitis following blunt trauma, only 243 patients returned for a subsequent visit. Ninety three (20.80%) were female, and 354 (79.19%) male. We classified them according to their age into 4 groups: 0-20 years: 139 patients (31.09%), 21-40 years: 193 (43.17%), 41-60 years: 88 (19.68%) and >61 years: 27 (6.04%). The main traumatic mechanisms were: thrown objects 129 (28.80%), punch/kick 99 (22.14%), unknown mechanism 71 (16.10%), soccer ball trauma 51 (11.40%), gotcha bullet 21 (4.69%), tree branch 21 (4.69%), bottle cap 17 (3.80%), fireworks 13 (2.90%), rocks 11 (2.46%), and falls from standing position 8 (1.78%). Visual acuity was measured at the first and final visit and classified in 5 groups: excellent, 141 (31.54%), good 165 (36.91%), bad 90 (20.13%), very bad 20 (4.47%) and non-functional vision in 31 (6.93%). Four hundred and one patients had initial intraocular pressure (IOP) under 20 mmHg (89.70%), and 46 were above 20mmHg (10.29%). The main complications included: 141 (31.54%) retinal contusion, 121 (27.06%) angle recession, 30 (6.71%) vitreous hemorrhage and 23 (19%) intraocular hypertension. One patient developed an increase in IOP due to topical steroid overreaction, 15 patients presented an iris sphincter tear (3.35%), 11 traumatic cataract (2.46%), 9 iridodialysis (2.01%), 4 choroidal rupture (0.89%), 3 cyclodialysis (0.67%) and 3 patients had a lens subluxation (0.67%).
We observed that traumatic uveitis was more frequent in young males; the main mechanism of trauma was by direct impact of fast travelling objects. Elevated IOP was associated with angle recession bigger than 180°. Our results demonstrate that very bad or non-functional vision at the moment of diagnosis is related to a poorer future visual acuity. The patients who had the worst visual prognosis were those who suffered retinal or lens injuries.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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