While jogging in the forest, a 45-year-old woman was hit by a tree branch, which penetrated her left eye. She presented to the emergency room with pain and ophthalmoplegia. CT and CT angiography were performed with multiplanar reconstruction and postprocessing for cinematic rendering. The CT images showed an intraocular, retrobulbar, hypoattenuating foreign body (1), which reached the orbital apex without rupturing the globe (Figs 1–3). Cinematic rendering is a modern technique for imaging postprocessing that produces photorealistic presentations that enable three-dimensional visualization of complex anatomic structures (2). In the presented case, the rendering vividly depicted the position of the foreign body in relation to osseous and vascular structures (Fig 3), which was beneficial for preoperative planning, as it indicated the precise entry location of the foreign body (Fig 1).
Figure 1: Cinematic rendering reconstruction of CT image in a 45-year-old woman who was hit by a tree branch, which penetrated her left eye. Arrow shows the entry point of the wooden spur at the level of the lower lid. The entry point was not seen on the standard CT reconstruction.
Figure 2: Sagittal CT angiogram shows the retrobulbar, hypoattenuating foreign body (red arrow) reaching the orbital apex, with an intact globe. Note the air bubble in front of the foreign body (blue arrow).
Figure 3: Lateral view of the cinematic rendering of the CT angiogram shows the intraorbital foreign body reaching the orbital apex, in close proximity to the internal carotid artery. Notice the multiple air bubbles at the floor of the orbit, consistent with the penetrating trauma.
The wooden spur (Fig 4) was retrieved through an intraconal approach after partial clinoidectomy via pterional craniotomy. There was no injury to the carotid artery.
Figure 4: Photograph of the wooden spur after extraction.
References
- 1. . Imaging foreign bodies in head and neck trauma: a pictorial review. Insights Imaging 2021;12(1):20. Crossref, Medline, Google Scholar
- 2. . Introducing cinematic rendering: a novel technique for postprocessing medical imaging data. J Biomed Sci Eng 2016;9(3):170–175. Crossref, Google Scholar
Article History
Received: May 4 2023Revision requested: June 6 2023
Revision received: June 7 2023
Accepted: June 22 2023
Published online: Oct 17 2023
