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Retinal detachment after posterior segment intraocular foreign body injuries

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Abstract

Purpose: To identify the risk factors for retinal detachment after posterior segment intraocular foreign body (IOFB) injuries and to study the association between the development of retinal detachment and visual outcome. Methods: Ninety-six consecutive patients with posterior segment IOFB injuries were retrospectively reviewed. Vitrectomy techniques were used in primary and secondary treatment. Two eyes were eviscerated after primary repair because of Clostridium perfringens endophthalmitis. Factors analyzed included (1) entrance wound location, (2) presence of uveal prolapse, (3) presence of vitreous prolapse, (4) presence of traumatized iris, (5) presence of endophthalmitis, (6) location of IOFB, (7) size of IOFB, (8) use of scleral buckling and/or an encircling band, (9) use of gas tamponade, (10) use of lensectomy. Data were analyzed using univariate and multivariate logistic regression analysis. Results:Retinal detachment was present in 6 eyes at presentation and occurred in another 19 eyes after vitrectomy. After a mean follow-up of 8.6 months, 63 (65.6%) eyes achieved visual acuities of 20/200 or better, and total retinal detachment complicated by inoperable proliferative vitreoretinopathy was present in 9 (9.4%) eyes. Multivariate analysis identified retinal detachment as a factor significantly associated with a poor visual outcome (odds ratio = 4.54, 95% confidence interval [CI] = 1.05–19.6). Foreign body size of more than 4 mm (odds ratio = 5.8, 95% CI = 1.66–2.03) and presence of endophthalmitis (odds ratio = 11.7, 95% CI = 2.57–52.9) were identified as the only predictive factors for the development of retinal detachment after vitrectomy. Use of prophylactic scleral buckling and/or an encircling band reduced the risk of developing postoperative retinal detachment. Conclusions: Retinal detachment after posterior segment IOFB injuries is associated with a poor visual outcome. Large IOFB and presence of endophthalmitis are the strongest predictive factors for the development of retinal detachment.

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References

  1. Pieramici DJ, MacCumber MW, Humayun MU, Marsh MJ, de Juan E Jr: Open−globe injury. Update on types of injuries and visual results. Ophthalmology 1996; 103: 1798–1803.

    PubMed  CAS  Google Scholar 

  2. Esmaeli B, Elner SG, Schork MA, Elner VM: Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study. Ophthalmology 1995; 102: 393–400.

    PubMed  CAS  Google Scholar 

  3. de Juan E Jr, Sternberg P Jr, Michels RG: Penetrating ocular injuries. Types of injuries and visual results. Ophthalmology 1983; 90: 1318–1322.

    PubMed  Google Scholar 

  4. Coleman DJ, Lucas BC, Rondeau MJ, Chang S: Management of intraocular foreign bodies. Ophthalmology 1987; 94: 1647–1653.

    PubMed  CAS  Google Scholar 

  5. Ahmadieh H, Sajjadi H, Azarmina M, Soheilian M, Baharivand N: Surgical management of intraretinal foreign bodies. Retina 1994; 14: 397–403.

    PubMed  CAS  Google Scholar 

  6. Gopal L, Bauker AS, Deb N, Badrinath SS, Sharma T, Parikh SN, et al: Management of glass intraocular foreign bodies. Retina 1998; 18: 213–220.

    PubMed  CAS  Google Scholar 

  7. Armstrong MFJ: A review of intraocular foreign body injuries and complications in N. Ireland from 1978–1986. Int Ophthalmol 1988; 12: 113–117.

    Article  PubMed  CAS  Google Scholar 

  8. Heimann K, Paulmann H, Tavakolian U: The intraocular foreign body. Principles and problems in the management of complicated cases by pars plana vitrectomy. Int Ophthalmol 1983; 6: 235–242.

    Article  PubMed  CAS  Google Scholar 

  9. Karel I, Diblik P: Management of posterior segment foreign bodies and long−term results. Eur J Ophthalmol 1995; 5: 113–118.

    PubMed  CAS  Google Scholar 

  10. Williams DF, Mieler WF, Abrams GW, Lewis H: Results and prognostic factors in penetrating ocular injuries with retained intraocular foreign bodies. Ophthalmology 1988; 95: 911–916.

    PubMed  CAS  Google Scholar 

  11. Ryan SJ, Allen AW: Pars plana vitrectomy in ocular trauma. Am J Ophthalmol 1979; 88: 483–491.

    PubMed  CAS  Google Scholar 

  12. Brinton GS, Aaberg TM, Reeser FH, Topping TM, Abrams GW: Surgical results in ocular trauma involving the posterior segment. Am J Ophthalmol 1982; 93: 271–278.

    PubMed  CAS  Google Scholar 

  13. Cardillo JA, Stout T, LaBree L, Azen S, Omphroy L, Cui JZ, et al: Post−traumatic proliferative vitreoretinopathy. The epidemiologic profile, onset, risk factors, and visual outcome. Ophthalmology 1997; 104: 1166–1173.

    PubMed  CAS  Google Scholar 

  14. Charteris DG, Hiscott P, Grierson I, Lightman SL: Proliferative vitreoretinopathy. Lymphocytes in epiretinal membranes. Ophthalmology 1992; 99: 1364–1367.

    PubMed  CAS  Google Scholar 

  15. Esser P, Heimann K, Wiedemann P: Macrophages in proliferative vitreoretinopathy and proliferative diabetic retinopathy: differentiation of subpopulations. Br J Ophthalmol 1993; 77: 731–733.

    PubMed  CAS  Google Scholar 

  16. Abu El−Asrar AM, Van Damme J, Put W, Veckeneer M, Dralands L, Billiau A, et al.: Monocyte chemotactic protein−1 in proliferative vitreoretinal disorders. Am J Ophthalmol 1997; 123: 599–606.

    PubMed  CAS  Google Scholar 

  17. Elner SG, Elner VM, Jaffe GJ, Stuart A, Kunkel SL, Strieter RM: Cytokines in proliferative diabetic retinopathy and proliferative vitreoretinopathy. Curr Eye Res 1995; 14: 1045–1053.

    PubMed  CAS  Google Scholar 

  18. Gapeans C, De Rojas V, Lojo S, Salono MS: C−C Chemokines in the vitreous of patients with proliferative vitreoretinopathy and proliferative diabetic retinopathy. Retina 1998; 18: 546–550.

    Google Scholar 

  19. Van Damme J: Interleukin−8 and related chemotactic cytokines. In: Thomson A, (ed) The cytokine handbook. London: Academic Press, 1994: 185–208, 1994.

    Google Scholar 

  20. Wiedemann P, Lemmen K, Schmiedl R, Heimann K: Intraocular daunorubicin for the treatment and prophylaxis of traumatic proliferative vitreoretinopathy. Am J Ophthalmol 1987; 104: 10–14.

    PubMed  CAS  Google Scholar 

  21. Blumenkranz M, Hernandez E, Ophir A, Norton EWD: 5−fluorouracil: new application in complicated retinal detachment for an established antimetabolite. Ophthalmology 1984; 91: 122–130.

    PubMed  CAS  Google Scholar 

  22. Yang CS, Khawly JA, Hainsworth DP, Chen SN, Ashton P, Guo H, et al: An intravitreal sustained−release triamcinolone and 5−fluorouracil codrug in the treatment of experimental proliferative vitreoretinopathy. Arch Ophthalmol 1998; 116: 69–77.

    PubMed  CAS  Google Scholar 

  23. Sakamoto T, Kimura H, Scuric Z, Spee C, Gordon EM, Hinton DR, et al: Inhibition of experimental proliferative vitreoretinopathy by retroviral vector−mediated transfer of suicide gene. Can proliferative vitreoretinopathy be a target of gene therapy? Ophthalmology 1995; 102: 1417–1424.

    PubMed  CAS  Google Scholar 

  24. Schubert CA, Kimura H, Spee C, Hinton DR, Gordon EM, Anderson WF, et al: Retrovirus−mediated transfer of suicide gene into retinal pigment epithelial cells in vitro. Curr Eye Res 1997; 16: 656–662.

    Article  PubMed  CAS  Google Scholar 

  25. Hutton WL, Fuller DG: Factors influencing final visual results in severely injured eyes. Am J Ophthalmol 1984; 97: 715–722.

    PubMed  CAS  Google Scholar 

  26. Miyake Y, Ando F: Surgical results of vitrectomy in ocular trauma. Retina 1983; 3: 265–268.

    PubMed  CAS  Google Scholar 

  27. Ahmadieh H, Soheilian M, Sajjadi H, Azarmina M, Abrishami M: Vitrectomy in ocular trauma. Factors influencing final visual outcome. Retina 1993; 13:107–113.

    PubMed  CAS  Google Scholar 

  28. Ryan SJ: Traction retinal detachment. XLIX Edward Jackson memorial lecture. Am J Ophthalmol 1993; 115: 1–20.

    PubMed  CAS  Google Scholar 

  29. Kreiger AE: Wound complications in pars plana vitrectomy. Retina 1993; 13: 336–344.

    Article  Google Scholar 

  30. Michels RG: Vitrectomy methods in penetrating ocular trauma. Ophthalmology 1980; 87: 629–645.

    PubMed  CAS  Google Scholar 

  31. Nelsen PT, Marcus DA, Bovino JA: Retinal detachment following endophthalmitis. Ophthalmology 1985; 92: 1112–1117.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Ahmed M. Abu El-Asrar, Saleh A. Al-Amro & Nasrat M. Khan

  2. Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Dustan Kangave

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  1. Ahmed M. Abu El-Asrar
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  2. Saleh A. Al-Amro
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  3. Nasrat M. Khan
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  4. Dustan Kangave
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Abu El-Asrar, A.M., Al-Amro, S.A., Khan, N.M. et al. Retinal detachment after posterior segment intraocular foreign body injuries. Int Ophthalmol 22, 369–375 (1998). https://doi.org/10.1023/A:1006469705126

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