Diagnostic value of the anterior chamber depth of a globe on CT for detecting open-globe injury

To determine the diagnostic value of the anterior chamber depth (ACD) of a globe as seen on CT for detecting open-globe injury. We enrolled 28 patients with unilateral open-globe injury confirmed by surgery and 28 controls with other types of orbital trauma. The diagnostic value of the difference of the ACDs between globes was evaluated by ROC analysis. The diagnostic performance of the following CT findings suggesting open-globe injury was also determined from independent analysis by two readers, i.e. change in the ACD and the globe contour, obvious volume loss of the globe, dislocated/deformed lens, intraocular foreign body/air and intraocular haemorrhage. The ACD measurements were possible only in 15 patients with open-globe injuries. A difference in the ACDs≥0.4 mm resulted in 0.85 of the area under the ROC curve with a sensitivity of 73% and specificity of 100% (p=0.0001). The presence of one or more of the CT findings had a sensitivity of 92%, specificity of 85% and diagnostic accuracy of 89%. Change in the ACD is a helpful CT finding for detecting open-globe injury. A difference in the ACDs ≥0.4 mm is a helpful diagnostic criterion with excellent specificity. (orig.)