Assessment of anterior segment changes using multimodal imaging in a case of post-traumatic transient myopia
Notice bibliographique
Résumé
A 17-year-old male presented with sudden onset painless diminution of vision in the right eye post blunt trauma to eye with tennis ball 2 days ago. Visual acuity (VA) was 2/60 in the right eye, improving to 6/9 with a refraction of –6.50/–0.50 × 30°, and 6/9 in left eye improving to 6/6 with a refraction of –1DS. Addition of cycloplegic agent did not alter the refractive status. Slit-lamp examination showed shallow anterior chamber with crystalline lens and commotion retinae in right eye, while the left eye was within normal limits. His intraocular pressure was 14 and 20 mm Hg in the right and left eye, respectively. At presentation, there was shallowing of the anterior chamber well demonstrated by ASOCT, UBM, and IOL master (2.55 mm), with an increase in lens thickness (3.92 mm) on A-scan and ciliochoroidal effusion with ciliary body edema and anterior rotation of ciliary processes on UBM [Figure 1 and Table 1], which returned to normal (ACD 3.68 mm and LT 3.63 mm) with improvement in VA to 6/9 on follow-up visit on day 10 [Figure 2]. Left eye was within normal limits [Figure 3].Figure 1: (a) Infrared image of anterior segment of right eye (b) 16 mm radial scan ASOCT (DRI Triton, Topcon Inc., Japan) showing disappearance of ciliary sulcus with increased iris convexity and anterior lens capsular reflection (c) 6 mm ASOCT scan focused at limbus highlighting the angle structures, yellow dotted lines represent the mirror image of the corneal scan, yellow rectangular box showing obliterated ciliary sulcus (d) UBM (Ophthalmic Technologies, Toronto, Canada) showing shallow anterior chamber depth with forward bowing of iris with anteriorly rotated ciliary process (arrowhead) with ciliochoroidal effusion (star)Table 1: Clinical parameters at presentation and follow upFigure 2: At 2 weeks follow up (a) Infrared image of anterior segment of right eye (b) 16 mm radial scan ASOCT (DRI Triton, Topcon Inc., Japan) showing normal ciliary sulcus with iris convexity and anterior lens capsular reflection (c) 6 mm ASOCT scan focused at limbus highlighting the angle structures, yellow dotted lines represent the mirror image of the corneal scan, rectangular box showing reappearance of ciliary sulcus (d) UBM (Ophthalmic Technologies, Toronto, Canada) showing normal anterior chamber depth with normal convexity of iris, disappearance of ciliochoroidal effusionFigure 3: (a) Infrared image of anterior segment of left eye (b) 16 mm radial scan ASOCT (DRI Triton, Topcon Inc., Japan) showing normal ciliary sulcus with iris convexity and anterior lens capsular reflection (c) 6 mm ASOCT scan focused at limbus highlighting the angle structures, yellow dotted lines represent the mirror image of the corneal scan (d) UBM (Ophthalmic Technologies, Toronto, Canada) showing normal anterior chamber depth with normal convexity of irisDiscussion Posttraumatic transient myopia varies between –4.75D and –5.25D.[1,2] Various pathogenic mechanisms include increased anteroposterior thickness of lens,[1] an anterior shift of lens-iris diaphragm,[3] ciliary spasm,[4] and ciliochoroidal effusion with ciliary body edema.[5] The ciliochoroidal effusion and ciliary body edema results in anterior rotation of ciliary body and ciliary processes, resulting in narrowing or disappearance of the ciliary sulcus; reduces the distance between opposing ciliary processes, and slackens the lens zonules which result in increase in lens thickness and anterior shift of lens-iris diaphragm.[1] Use of multimodal imaging complements the clinical findings and helps to better demonstrate the etiology of anterior segment changes post blunt trauma. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».