Traumatic retrobulbar hematoma: a European multicenter study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Retrobulbar hematoma/hemorrhage (RBH) is a vision-threatening condition requiring prompt diagnosis and timely medical or surgical intervention. Despite its clinical relevance, standardized treatment protocols and well-defined prognostic factors remain lacking. MATERIALS AND METHODS: This retrospective multicenter study included patients treated for posttraumatic RBH between January 2015 and December 2024. Demographic data, comorbidities, antithrombotic therapy, trauma etiology, associated injuries, clinical signs, imaging findings, treatment modalities, and visual outcomes were recorded. Outcomes were classified as complete visual recovery, partial recovery, or blindness. RESULTS: In total, 77 patients (mean age 56 years) were included. Falls were the most common cause of injury, with concomitant body injuries present in 61% of patients and associated ocular injuries in 22%. Computed tomography was the primary imaging modality. RBH was extraconal in most cases, while intraconal involvement was less frequent. Most patients received combined medical and surgical treatment, with lateral canthotomy and cantholysis being the most common surgical approach. Complete visual recovery occurred in 51.9% of patients, partial recovery in 29.9%, and blindness in 10.4%. Intraconal RBH and associated ocular injury were significantly associated with poorer visual outcomes, whereas age, hematoma size, treatment type, timing of intervention, and antithrombotic therapy were not. CONCLUSIONS: RBH is a rare maxillofacial trauma entity that often results in permanent disability. Intraconal localization and concomitant ocular injury are significant predictors of poor prognosis. Early recognition and individualized management are essential to optimize visual outcomes.
Authors: Paolo Boffano, Anssi Lahtinen, Matteo Brucoli, Muhammad Ruslin, Andrea Melle, Panagiotis Stathopoulos, George Kolotouros, Emil Dediol, Boris Kos, Adam Michcik, Łukasz Garbacewicz, Thomas Starch-Jensen, Ivana Mijatov, Branislav V. Bajkin, József Szalma, Lily Pourcelly, Aurélien Louvrier, Eugénie Bertin, Christophe Meyer, Andrii V. Kopchak, Tetiana A. Pavlychuk, Johanna Snäll
Institutions: Università degli Studi del Piemonte Orientale “Amedeo Avogadro”, Hasanuddin University, University of Helsinki, Helsinki University Hospital, University Hospital Dubrava, Gdańsk Medical University, Aalborg University Hospital, University of Novi Sad, Klinički centar Vojvodine, University of Pecs, Université de Franche-Comté, Bogomolets National Medical University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,784
OpenAlex ID: W7165166515