Abstract
Purpose :
Accommodative and anatomic changes in the anterior segment of the eye following traumatic hyphema are frequently seen in clinical practice. However, the Scheimpflug method has never been used to assess these changes. We hypothesize that changes related to trauma in the anatomy and function of the anterior chamber can be assesed with the Pentacam and are permanently affected after hyphema resolution.
Methods :
We included 11 consecutive patients with unilateral resolved traumatic hyphema and visual acuity equal or better than 20/40 that presented to the emergency clinic of the Ophthalmology Department at our University Hospital. We analyzed the traumatized eye (TE) from our 11 patients and considered the non-traumatized eye (NTE) as control. Six anterior segment recordings were obtained from each eye with the Pentacam, three in unaccommodated (0 diopter (D) accommodative stimulus) and three in an accommodated state (5 D accommodative stimulus). Demographic data, visual acuity, intraocular pressure and slit-lamp findings were also reported. Mann-Whitney U, Wilcoxon, Pearson’s, and chi-squared tests were used for statistical analysis.
Results :
The mean age of the participants was 13±4.1 years with male preponderance (n=10, 90.9%). Projectiles thrown by homemade launchers were the primary agents of trauma (n=4, 36.36%). We observed in the TE a significant increase in the pupillary diameter (PD) without accommodation compared to the NTE (mean, SD and p value for the next values) 3.73±0.81 vs. 2.82±0.52mm, p=0.008. TE compared to NTE showed a higher but non-significant anterior chamber depth (ACD) 3.17±0.23 vs. 3.05±0.23mm, p=0.24 and anterior chamber volume (ACV) 192.78±33.23 vs. 177.45±27.96mm3, p=0.24. Similarly, higher but non-significant ACD 3.15±0.26 vs. 3.03±0.22mm, p=0.20 and ACV 188.78±32.26 vs. 176.48±26.14mm3, p=0.27 were observed during accommodation. Tendency towards narrower anterior chamber angle (ACA) was found in eyes with trauma during accommodation 37.70±4.62 vs. 42.62±6.77°, p=0.061.
Conclusions :
Anatomical modifications after trauma were observed with the Pentacam. Only PD was significantly increased following the trauma. However, ACD and ACV were higher but non-significant in TE with and without accommodation. Further studies with greater samples are needed, in order to fully understand the consequences of these anatomical changes and their effect in function.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.