Background: 

To analyze the final visual acuity (VA) of neuro-ophthalmologic injuries (NOI) in combat ocular trauma and to study the association of NOI with systemic neurologic injury (SNI) and traumatic brain injury (TBI).

Methods: 

The Walter Reed Ocular Trauma Database was reviewed. Inclusion criteria were any US service member and Department of Defense civilians who suffered NOI, SNI, or TBI in Operation Iraqi Freedom or Operation Enduring Freedom. The primary outcome measure was the rate of poor final VA in patients with an NOI with secondary outcome measures the rate of SNI and TBI. in patients with NOI.

Results: 

One hundred seventy-eight (20.00%) of 890 eyes had an NOI. Optic nerve injury was observed in 79 (44.38%) eyes, other cranial nerve injury in 68 (38.20%), Horner syndrome in 4 (2.25%), diplopia in 45 (25.28%), and ptosis in 13 (7.30%). In patients with NOI, 76 (42.69%) eyes had a final VA less than 20/200. In injured eyes (n = 359) of patients (n = 251) with TBI, 154 eyes (34.26%) had a final VA less than 20/200. In multivariate analysis, optic nerve injury (P < 0.001), unlike TBI (P = 0.47), was associated with final VA less than 20/200. SNI (n = 229) had a statistically significant association (odds ratio 29.8, 95% confidence interval 19.2–47.8, P < 0.001) with NOI. Optic nerve injury and cranial nerve injury were associated with TBI and SNI (all, P < 0.001).

Conclusion: 

Optic nerve injury and cranial nerve injury are associated with TBI and SNI. Optic nerve injury, but not TBI or cranial nerve injury, is associated with a poor final VA.

中文翻译：

---

伊拉克自由行动和持久自由行动中的全身性神经系统损伤或颅脑外伤性眼科损伤。

背景： 

分析在战斗眼外伤中的神经眼科损伤（NOI）的最终视力（VA），并研究NOI与全身性神经损伤（SNI）和脑外伤（TBI）的关联。

方法： 

沃尔特·里德眼外伤数据库进行了审查。入选标准是在“伊拉克自由行动”或“持久自由行动”中遭受NOI，SNI或TBI侵害的任何美国军人和国防部平民。主要结局指标是NOI患者的最终VA不良率，次要结局指标是SNI和TBI。在NOI患者中。

结果： 

890眼中的一百七十八（20.00％）有NOI。观察到视神经损伤79眼（44.38％），其他颅神经损伤68例（38.20％），霍纳综合征4眼（2.25％），复视45眼（25.28％），上睑下垂13眼（7.30％）。在NOI患者中，有76（42.69％）眼的最终视力低于20/200。在TBI患者（n = 251）的受伤眼（n = 359）中，有154眼（34.26％）的最终VA小于20/200。在多变量分析中，与TBI（P = 0.47）不同，视神经损伤（P <0.001）与最终VA小于20/200有关。SNI（n = 229 ）与NOI有统计学意义的关联（优势比29.8，95％置信区间19.2-47.8，P <0.001）。视神经损伤和颅神经损伤与TBI和SNI相关（所有，P <0.001）。

结论： 

视神经损伤和颅神经损伤与TBI和SNI有关。视神经损伤而不是TBI或颅神经损伤与最终VA差有关。