Ocular injuries secondary to motor vehicle accidents.

PURPOSE: Ocular trauma is one of the main causes of visual reduction or loss, particularly in the younger population. METHODS: In this prospective study the authors included 67 consecutive patients with ocular trauma secondary to motor vehicle accidents who were hospitalized in the Athens University Eye Clinic from September 1993 to December 1996. The mean follow-up time was 31 months, the mean age was 31.7 years, and the ratio between men and women was 2.7:1. RESULTS: Thirty-two of the accidents (47.76%) took place in populated areas. Among the 67 injured persons, 58 (86.56%) were car passengers, 8 (11.95%) were on motorcycles, and 1 (1.49%) was a pedestrian. Only 3 (5.2%) of the 58 persons injured inside automobiles used safety belts and none of the motorcyclists used crash helmets during the accidents. Fifty-three (79.1%) ocular traumas were penetrating in nature, with glass fragments being the main cause in 36 of them (67.9%). Among the 53 injured persons experiencing penetrating ocular trauma, 49 had a follow-up time of more than 6 months. Twenty of them (40.8%) underwent one surgical procedure, 22 (44.9%) were submitted to two surgical procedures, and the remaining 7 persons (14.3%) needed three or more operations. Eighteen (36.7%) of the 49 patients with penetrating ocular trauma and with 6 months follow-up had a final visual acuity of less than 1/20, 21 (42.9%) had a visual acuity of more than 5/10, and 3 (6.1%) underwent enucleation. Among the 67 patients, 61 had a follow-up time of more than 6 months, regardless of their history of penetrating ocular trauma. Eighteen of them (29.5%) had a final visual acuity of less than 1/20, 8 (13.1%) had a visual acuity between 2/10 and 4/10, and 22 (52.5%) had a visual acuity of more than 5/10. CONCLUSIONS: Because motor vehicle accidents can cause severe ocular trauma, it would be helpful for drivers to be more careful and aware of motor vehicle regulations. There seems to be a great need of enforcement of seatbelt laws in Greece.

Fluorescein and indocyanine green angiographic findings in congenital optic disk pit associated with macular detachment.

PURPOSE: To investigate the pattern of congenital optic disk pits associated with maculopathy using indocyanine green angiography (ICG) and fluorescein angiography (FA). METHODS: Seventeen consecutive patients with unilateral congenital optic disk pit complicated by maculopathy were prospectively enrolled in the study. Complete ophthalmologic examination, color stereophotography, red-free photography, FA, and ICG angiography were performed on all patients during their first examination in our department. RESULTS: Absolute hypofluorescence of the optic disk pit was noted in all eyes on ICG angiography. On the contrary, all eyes showed early hypofluorescence and late staining of the optic pit on FA. All 17 eyes presented a delineated late hyperfluorescence corresponding to the area of macular elevation on both ICG angiography and FA. The intensity of the hyperfluorescence was milder in cases with long-standing maculopathy. CONCLUSION: Imaging of congenital optic disk pits associated or not with macular elevation using ICG angiography has not been reported in the literature. The increased hyperfluorescence in the late phases of the macular elevation in the studied eyes could be attributed to leakage of indocyanine or fluorescein dye into the schisis cavity and the subretinal fluid.