CT of globe rupture: analysis and frequency of findings.
OBJECTIVE
The objective of our study was to evaluate the CT characteristics of globe rupture.


METHODS
The medical records of patients seen in the emergency department with blunt, penetrating, or explosive orbit injury were retrospectively reviewed. A total of 75 patients (76 injured globes) were included (56 males and 19 females; average age, 45.1 years; age range, 5-95 years). CT examinations were reviewed by two experienced radiologists without knowledge of ophthalmologic findings, original orbital CT images, or surgical outcomes.


RESULTS
Of the 76 globe injuries, 33 (43%) were ruptured and 43 (57%) were nonruptured. There were significant differences between the ruptured and nonruptured globes with respect to intraocular hemorrhage, lens dislocation and destruction, an intraocular foreign body, intraocular gas, anterior chamber depth (ACD), and globe deformity and wall irregularity (p < 0.05). There was good interrater agreement between the two radiologists (kappa value range, 0.63-0.96). The average sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CT for the detection of globe rupture based on readings by two radiologists were 76%, 85%, 80%, 82%, and 81%, respectively.


CONCLUSIONS
Although CT is extremely useful in the evaluation of ocular trauma, it should not be solely relied on for the diagnosis of globe rupture because of the potentially catastrophic consequences of an undiagnosed injury. A difference in ACD can be diagnostic of globe rupture.
1 Division of Radiology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan, Republic of China.
Wei-Hsin
WH
Yuan
Hui-Chen
HC
Hsu
Hui-Cheng
HC
Cheng
Wan-Yuo
WY
Guo
Michael Mu-Huo
MM
Teng
Shih-Jen
SJ
Chen
Tai-Chi
TC
Lin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture; D014057:Tomography, X-Ray Computed; D055815:Young Adult