Intraocular Foreign Body: Diagnostic Protocols and Treatment Strategies in Ocular Trauma Patients.

Hyun Chul Jung,Sang Yoon Lee,Chang Ki Yoon,Eun Kyoung Lee,Un Chul Park,Jang Won Heo

doi:10.3390/jcm10091861

Hyun Chul Jung, Sang Yoon Lee + Show 4 more

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https://doi.org/10.3390/jcm10091861

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Abstract

Intraocular foreign bodies (IOFBs) are critical ophthalmic emergencies that require urgent diagnosis and treatment to prevent blindness or globe loss. This study aimed to examine the various clinical presentations of IOFBs, determine the prognostic factors for final visual outcomes, establish diagnostic protocols, and update treatment strategies for patients with IOFBs. We retrospectively reviewed patients with IOFBs between 2005 and 2019. The mean age of the patients was 46.7 years, and the most common mechanism of injury was hammering (32.7%). The most common location of IOFBs was the retina and choroid (57.7%), and the IOFBs were mainly metal (76.9%). Multivariate regression analysis showed that poor final visual outcomes (<20/200) were associated with posterior segment IOFBs (odds ratio (OR) = 11.556, p = 0.033) and retinal detachment (OR = 4.781, p = 0.034). Diagnosing a retained IOFB is essential for establishing the management of patients with ocular trauma. To identify IOFBs, ocular imaging modalities, including computed tomography or ultrasonography, should be considered. Different strategies should be employed during the surgical removal of IOFBs depending on the material, location, and size of the IOFB.

Highlights

Intraocular foreign bodies (IOFBs) are defined as intraocularly retained, unintentional projectiles that require urgent diagnosis and treatment to prevent blindness or globe loss.intraocular foreign body (IOFB) account for 16–41% of open globe injuries, and frequently cause severe visual loss in patients with ocular trauma [1,2,3,4]
Ocular damage and visual loss may be caused by laceration or hemorrhage directly caused by IOFBs at the time of injury, but it may occur due to the consequent development of retinal detachment or endophthalmitis
We retrospectively reviewed the medical records of patients who were diagnosed with IOFB and underwent surgical removal of an IOFB between 2005 and 2019

Summary

Introduction

Intraocular foreign bodies (IOFBs) are defined as intraocularly retained, unintentional projectiles that require urgent diagnosis and treatment to prevent blindness or globe loss. IOFBs account for 16–41% of open globe injuries, and frequently cause severe visual loss in patients with ocular trauma [1,2,3,4]. Ocular damage and visual loss may be caused by laceration or hemorrhage directly caused by IOFBs at the time of injury, but it may occur due to the consequent development of retinal detachment or endophthalmitis. These factors include the initial visual acuity [7,8,9,10,11,12,13], size and location of the IOFB [9,11,12,13,14,15,16], size and location of the IOFB entry wound [7,12,14,17], presence of relative afferent pupillary defect (RAPD) [8,18], intraocular hemorrhage [8,12,18], retinal detachment [9,11,12,14,16,17,18], and endophthalmitis [10,12,15]

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