MRI visualization of optic nerve avulsion due to ocular perforation from BB gun projectile

Barnard, Luke; Ajlan, Radwan

doi:10.1016/j.ajoc.2018.06.016

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…MRI detection of ONA is uncommon because optic nerve dural sheaths typically remain attached to the globe, making detection difficult. Barnard and Ajlan 29 described the significance of MRI in identifying ONA after Ball Bearing (BB) gun trauma. They demonstrated that MRI is essential when there is no obvious cause for visual loss following trauma or when conventional ophthalmic diagnostic techniques, such as B-scan ultrasonography, are unable to detect ONA.…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Avulsion: Pattern and Etiologies at a Tertiary Eye Care Center in Saudi Arabia: An 8-Year Retrospective Study

Al Amry,

AlHijji,

Elkhamary

et al. 2023

OPTH

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Purpose Optic nerve avulsion (ONA) is a rare but serious presentation of ocular trauma. This study investigates the presenting characteristics and etiologies of all cases of ONA over an 8-year-period at a tertiary eye care center in the Middle East. Methods The medical records of patients diagnosed with ONA at an Ophthalmic Emergency Department between November 2014 and November 2022 were analyzed in this retrospective cohort study. Data were collected on patient age, sex, affected eye, cause of injury and imaging studies. The best-corrected visual acuity (BCVA) at presentation and at the last follow-up visit, and the duration of follow-up were documented. Results The study sample was comprised of 44 eyes of 43 patients with ONA with median age of 16.5 (9.3–26.8) years ranging from 2 years old to 70 years old. There were (35;79.5%) males and (9; 20.5%) females. Most cases presented with an affected left eye (27; 61.4%) followed by the right eye (16; 36.4%) and only one patient (2.3%) had bilateral ONA. The most common cause of trauma resulting in ONA was a metallic object (8;18.2%). This study demonstrates the value of multi-sequence Magnetic resonance imaging (MRI) in the setting of unexplained vision loss when other modalities are inadequate or inconclusive. Conclusion Ophthalmic morbidity resulting from ONA can be devastating. Metallic object injuries were the most prevalent cause of ONA. The presence of associated media opacities challenges the initial diagnosis of ONA. In the vast majority of cases, the vision ended as no light perception (NLP), indicating permanent vision impairment.

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Section: Discussionmentioning

confidence: 99%

Optic Nerve Avulsion: Pattern and Etiologies at a Tertiary Eye Care Center in Saudi Arabia: An 8-Year Retrospective Study

Al Amry,

AlHijji,

Elkhamary

et al. 2023

OPTH

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“…24 • Hypo-intensities in the posterior globe. 13 • Tearing of the left optic nerve distal to the optic chiasma. High diffusionweighted imaging (DWI) signal of the optic chiasma to the optic tract indicated nerve injury.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

The Utility of Ocular Imaging in Traumatic Optic Nerve Avulsion: A Case Report

Putera¹,

Nusanti²,

Rahmawati³

et al. 2022

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Objective: To describe a detailed presentation and the utility of ocular imaging, both ocular ultrasound and orbital computed tomography (CT), to confirm the diagnosis of traumatic ONA in which megadose steroid would give no advantage. Case Presentation: A five-year-old boy came with a unilateral sudden visual loss after incidentally falling with his left eye struck to a handlebar of a parked bicycle. His left eye had no light perception, ophthalmoplegia, and showing 4+ relative afferent pupillary defect. A hallmark "pit" sign and a pale retina without a tear were noted. B-scan ocular ultrasound displayed retinal step sign, vitreous hemorrhage in front of the optic canal, lamina cribrosa defect, edematous retina, and retracted optic nerve. Orbital computed tomography scan showed a disruption of the optic nerve-globe junction. Steroid infusion was decided not to be given. Conclusion: Ocular imaging, especially ultrasound, along with a thorough examination, is satisfactorily adequate to confirm the diagnosis of traumatic ONA.

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MRI visualization of optic nerve avulsion due to ocular perforation from BB gun projectile

Abstract: To report a case of optic nerve avulsion after a perforating injury by an air-soft/BB gun that was successfully captured with magnetic resonance imaging.

Cited by 2 publications

References 3 publications

Optic Nerve Avulsion: Pattern and Etiologies at a Tertiary Eye Care Center in Saudi Arabia: An 8-Year Retrospective Study

Optic Nerve Avulsion: Pattern and Etiologies at a Tertiary Eye Care Center in Saudi Arabia: An 8-Year Retrospective Study

The Utility of Ocular Imaging in Traumatic Optic Nerve Avulsion: A Case Report

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