Clinical and instrumental criteria in predicting the clinical course of chronic posttraumatic uveitis after penetrating ocular trauma

Abstract

Aim. To identify the prognostic criteria for the recovery or transformation to chronic form in patients with prolonged clinical course of uveitis associated with penetrating ocular trauma basing on the results of clinical examination and instrumental methods. Methods. 120 patients with chronic clinical course of post-traumatic uveitis were examined 2-3 months after the penetrating ocular trauma using clinical examination and ultrasonography of eye and orbita. 1st group consisted of 60 convalescents, 2nd included 60 patients with chronic disease. The control group consisted of 40 healthy volunteers. Ultrasonography included measurement of innermost eye coat thickness and the retrobulbar part of the optic nerve thickness measured 10 mm behind the eyeball bilaterally. Results were statistically analyzed. Results. Prognostic criteria for recovery or chronic inflammation development in chronic post-traumatic uveitis were found. They are: G-index and interocular asymmetry coefficient of innermost eye coat and optic nerve thickness. At calculation of G-index, which characterizes inflammatory consequences of trauma, presence of cornea imbibition, rubeosis iridis, cataract, vitreous body fibrosis, pulled-in cornea and sclera scars, retinal and choroidal detachment, the eyeball subatrophy, decreased eye fluid pressure, optic nerve thickening. The value of all the parameters equaled 1. An interocular thickness asymmetry coefficient characterized innermost eye coat thickness or optic nerve thickness ratio in injured eye compared to other eye. 2-3 weeks after the trauma characteristic G-index value of G ≥4, an interocular asymmetry coefficient value of ≥1,3 for innermost eye coat thickness and ≥1,1 for optic nerve thickness are the indicators of a high risk of chronic development. Lesser values predict recovery. Conclusion. Use of the set of found prognostic criteria in patients with prolonged clinical course of uveitis provides high prognosis accuracy of 93,3% at predicting recovery or chronic uveitis development.