{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:07:22Z","timestamp":1784293642983,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,8,21]],"date-time":"2017-08-21T00:00:00Z","timestamp":1503273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30EY010608"],"award-info":[{"award-number":["P30EY010608"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to evaluate the sensitivity and specificity of computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) diagnosis of open globes, determine which imaging factors are most predictive of open globe injuries, and evaluate the agreement between neuroradiologist and ophthalmologist readers for diagnosis of open and closed globes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a retrospective cohort study. Patients who presented to Memorial Hermann\u2013Texas Medical Center with suspicion for open globes were reviewed. One neuroradiologist and two ophthalmologists masked to clinical information reviewed <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> images for signs concerning for open globe including change in globe contour, anterior chamber deformation, intraocular air, vitreous hemorrhage, subretinal fluid indicating retinal or choroidal detachment, dislocated or absent lens, intraocular foreign body, and orbital fracture. Using the clinically or surgically confirmed globe status as the true globe status, sensitivity, specificity, and agreement (kappa) were calculated and used to investigate which imaging factors are most predictive of open globe injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 114 patients were included: 35 patients with open globes and 79 patients with closed globes. Specificity was greater than 97% for each reader, and sensitivity ranged from 51% to 77% among readers. The imaging characteristics most consistently used to predict an open globe injury were change in globe contour and vitreous hemorrhage (sensitivity\u00a0= 43% to 57%, specificity\u00a0&gt;\u00a098%). The agreement of impression of open globe between the neuroradiologist and ophthalmologists was good and excellent between ophthalmologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Computed tomography imaging is not absolute, and the sensitivity is still inadequate to be fully relied upon. The <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> imaging findings most predictive of an open globe injury were change in globe contour and vitreous hemorrhage. Clinical examination or surgical exploration remains the most important component in evaluating for a suspected open globe, with <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> imaging as an adjunct.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13249","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T19:02:36Z","timestamp":1498762956000},"page":"1072-1079","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Accuracy of Computed Tomography Imaging Criteria in the Diagnosis of Adult Open Globe Injuries by Neuroradiology and Ophthalmology"],"prefix":"10.1111","volume":"24","author":[{"given":"Eric L.","family":"Crowell","sequence":"first","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"},{"name":"Robert Cizik Eye Clinic Houston TX"},{"name":"Memorial Hermann\u2013Texas Medical Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek A.","family":"Koduri","sequence":"additional","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio P.","family":"Supsupin","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"},{"name":"Memorial Hermann\u2013Texas Medical Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Klinglesmith","sequence":"additional","affiliation":[{"name":"Singleton Associates, PA Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Z.","family":"Chuang","sequence":"additional","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene","family":"Kim","sequence":"additional","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"},{"name":"Robert Cizik Eye Clinic Houston TX"},{"name":"Memorial Hermann\u2013Texas Medical Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Baker","sequence":"additional","affiliation":[{"name":"Robert Cizik Eye Clinic Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"},{"name":"Robert Cizik Eye Clinic Houston TX"},{"name":"Memorial Hermann\u2013Texas Medical Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren S.","family":"Blieden","sequence":"additional","affiliation":[{"name":"Ruiz Department of Ophthalmology and Visual Science McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) Houston TX"},{"name":"Robert Cizik Eye Clinic Houston TX"},{"name":"Memorial Hermann\u2013Texas Medical Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0896-1549(02)00004-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(96)30710-0"},{"key":"e_1_2_8_4_1","unstructured":"Agency for Healthcare and Research Quality.Healthcare Cost and Utilization Project. 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