Axial or coronal CT scan; which is more accurate in detection of open globe injury?
Amir Arabi1 , 2. Toktam Shahraki2 , 3. Rezvan Nezam-slami2 , 4. Hamed Esfandiari3 , 5. Mehdi Tavakoli4 , Homayoun Nikkhah2 *
- 1. Ophthalmic research center, Shahid Beheshti university of medical sciences, Tehran, Iran
- SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES, Tehran, Iran, Islamic Republic Of
- 2. Olmsted Medical Center, Department of Ophthalmology, Rochester, Minnesota, USA
- 3. University of Alabama at Birmingham, Department of ophthalmology and visual sciences, Birmingham, Al, USA
Abstract: To evaluate and compare the accuracy of axial versus coronal computerized tomography (CT) scan in detection of open globe injury
Methods: In this retrospective study, records of 60 patients with open and 70 patients with closed globe injury were reviewed. Two experienced ophthalmologists read the orbital CT scans and accuracy of the axial and coronal planes in detecting open globe injuries were compared. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated and compared for axial and coronal planes.
Results: The most common CT finding in open globe injuries was scleral irregularity (71.6%), followed by dislocation of the crystalline lens (55%) and vitreous hemorrhage (51.6%). The sensitivity and specificity of axial CT scan was 71.7% and 95.7%, respectively. There was no significant difference between axial and coronal CT scans for detecting open globe injuries (P value=0.611). In both axial and coronal planes, the sensitivity of detecting open globe injury was higher for blunt trauma, compared to sharp trauma (P value=0.008 and 0.001 for axial and coronal planes, respectively). There was a perfect agreement between readers for all CT scan readings with a Kappa value of 0.9.
Conclusion: Axial CT reading may be as adequate as a multiplanar reading in detection of open globe injury. CT scan seems to be more sensitive in detection of open globe injury following blunt trauma and in posterior scleral ruptures.
