Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

Dong Ho Chang; Pyung Lee; Seung Chan Lee; Kyung Hyun Jin

doi:10.3341/jkos.2010.51.1.106

Journal List > J Korean Ophthalmol Soc > v.51(1) > 1008612

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Chang, Lee, Lee, and Jin: Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

Original Article

J Korean Ophthalmol Soc 2010;51(1):106-111.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.1.106

Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

Dong Ho Chang, MD¹, Pyung Lee, MD¹, Seung Chan Lee, MD², Kyung Hyun Jin, MD¹

¹Department of Ophthalmology, KyungHee University, College of Medicine, Seoul, Korea

²Department of Ophthalmology, Kangwon University, College of Medicine, Chuncheon, Korea

Address reprint requests to Kyung Hyun Jin, MD Department of Ophthalmology, KyungHee University College of Medicine #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: khjinmd@khmc.or.kr

Received 2 May 2008 Accepted 15 September 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical significance of angle-opening distance 500 (AOD500) using ultrasound biomicroscopy (UBM) in the early stage of traumatic hyphema.

Methods

The participants of this study were 46 hospitalized traumatic hyphema patients. We measured the quantity of initial blood clotting using a slit-lamp and the range of angle recession, AOD500 using UBM and then reviewed the relationship between the two.

Results

The difference of AOD500 in the traumatic and the non-traumatic eye measured by UBM at admission increased significantly in the wider recessed angle group (p=0.008), but did not increase at a statistically significantly level in the larger initial blood clot grade group (≥ Grade 2).

Conclusions

These results suggest that the measurement of the angle-opening distance of both eyes using UBM will aid in evaluating the range of angle recession in patients in the early stage of traumatic hyphema.

Go to :

Keywords: Angle-opening distance 500 (AOD 500), Traumatic hyphema, Ultrasound biomicroscopy (UBM)

References

1. Tesluk GC, Spaeth GL. The occurrence of primary open-angle glaucoma in the fellow eye of patients with unilateral angle-cleavage glaucoma. Ophthalmology. 1985; 92:904–11.

2. Pettit TH, Keates EU. Traumatic cleavage of the chamber angle. Br J Ophthalmol. 1963; 69:438–44.

3. Kaufman JH, Tolpin DW. Glaucoma after traumatic angle recession. Am J Ophthalmol. 1974; 78:648–54.

4. Sihota R, Kumar S, Gupta V, et al. Early predictors of traumatic glaucoma after closed globe injury: trabecular pigmentation, widened angle recess, and higher baseline intraocular pressure. Br J Ophthalmol. 2008; 126:921–6.

5. Kobayashi H, Ono H, Kiryu J, et al. Ultrasound biomicroscopic measurement of development of anterior chamber angle. Br J Ophthalmol. 1999; 83:559–62.

6. Agapitos PJ, Noel LP, Clarke WN. Traumatic hyphema in children. Ophthalmology. 1987; 94:1238–41.

7. Jung KS, Hong SW, Chang HK. The incidence of complication and decreased visual acuity in traumatic hyphema patients aberrations to the amount of blood clot. J Korean Ophthalmol Soc. 1997; 38:1852–9.

8. Edwards WC, Layden WE. Traumatic hyphema. Am J aberrations. 1973; 75:110.

9. Crouch ER Jr, Crouch ER. Management of traumatic hyphema: therapeutic options. J Pediatr Ophthalmol Strabismus. 1999; 36:238–50.

10. Cho JS, Jun BK, Lee YJ, et al. Factors associated with the poor final visual outcome after traumatic hyphema. J Korean aberrations Soc. 1998; 12:122–9.

11. Pavlin CJ, Harasiewicz K, Sherar MD, Foster FS. Clinical use of ultrasound biomicroscopy. Ophthalmology. 1991; 98:287–95.

12. Foster FS, Palvin CJ, Harasiewicz KA, et al. Advances in ultrasound biomicroscopy. Ultrasound Med Biol. 2000; 26:1–27.

13. Ozdal MP, Mansour M, Deschenes J. Ultrasound biomicroscopic evaluation of the traumatized eyes. Eye. 2003; 17:467–72.

14. Berinstein DM, Gentile RC, Sidoti PA, et al. Ultrasound aberrations in anterior ocular trauma. Ophthalmic Surg Lasers. 1997; 28:201–7.

15. Genovesi-Ebert F, Rizzo S, Chiellini S, et al. Ultrasound aberrations in the assessment of penetrating or blunt anterior-aberrations trauma. Ophthalmologica. 1998; 212:6–7.

16. Lee KW, Park CH, Hahn DK. Anterior chamber angle recession and elevation of intraocular pressure. J Korean Ophthalmol Soc. 1987; 28:595–8.

Go to :

Figure 1.

Ultrasound biomicroscopic image of the anterior chamber and the definition of angle-opening distance at 500 μm from the scleral spur (AOD500).

undefined

Figure 2.

The photographs of the anterior segment and ultrasound biomicroscopy (UBM) in 2 traumatic hyphema patients (A, B). The angle recession (short arrow) was seen in UBM photograph at 12 and 3 o'clock (in the middle upper and lower photograph). The blood clot (long arrow) is well-visualized in the UBM photograph at 6 o'clock (in the right upper and lower photograph).

undefined

Figure 3.

The grade of angle recession and angle opening distance 500 (AOD500) (μm). The difference of AOD500 in traumatic & nontraumatic eye measured by UBM at admission were increased statistically significantly in larger area recessed angle group (p=0.008).

undefined

Table 1.

Patient demographics

Table 2.

Angle-opening distance 500 (μm) in traumatic and nontraumatic eye, and the difference of angle-opening distance 500 (μm) in traumatic and nontraumatic eye (Mean± SD^*)

	AOD 500^† (μm)
Traumatic eye	572.740±244.899
Nontraumatic eye	373.750±115.431
Traumatic eye ^AOD500-	198.997±198.334
Nontraumatic eye ^AOD500	
p-value^‡	0.000

^* SD=standard deviation

^† AOD500=angle-opening distance 500

^‡ p-value=statistical significance evaluated by paired t-test.

Table 3.

The difference of angle-opening distance 500 (μm) in traumatic and nontraumatic eye according to degree of angle recession

The degree of angle recession (˚)	traumatic eye ^AOD500* – nontraumatic eye ^AOD500*	p-value^†
≤1 point of angle recession (+)^‡	158.777±149.269	0.008
≥2 point of angle recession (+)^‡	423.077±291.226	0.008

^* AOD500=angle-opening distance 500

^† p-value=statistical significance evaluated by Mann-Whitney U test

^‡ Angle recession was estimated in the 4 points (12, 3, 6, 9 o'clock) in the UBM.

Table 4.

Angle-opening distance 500 (μm) in traumatic and nontraumatic eye, and the difference of angle-opening distance 500 (μm) in traumatic and nontraumatic eye according to the grade group of initial blood clot

The grade of initial blood clot group	traumatic eye ^AOD500* – nontraumatic eye ^AOD500*	p-value^†
Group 1^‡	192.301±204.933	0.173
Group 2^§	269.231±94.211	0.173

^* AOD500=angle-opening distance 500

^† p-value=statistical significance was evaluated by Mann-Whitney U test

^‡ Group 1=initial blood clot grade 0, Ⅰ

^§ Group 2=initial blood clot grade Ⅱ, Ⅲ, Ⅳ.

TOOLS

Similar articles