Analysis of Prognostic Factors in Open GLO be Injury

Abstract

Objective To evaluate prognostic factors for visual outcome in open globe injury involving the variables of a system for classifying mechanical injuries of the eye and the additional variables.Methods Medical records of 68 consecutive patients with open globe injury were retrospectively reviewed. Specific variables of a system for classifying mechanical injuries of the eye were analyzed: the types of injury (defined by the mechanism of injury), grade of injury (defined by initial visual acuity), zone of injury (defined by the location of the wound), and relative afferent pupillary defect. Additional variables, such as wound length, retinal detachment, endophthalmitis, and elapsed time between the injury and presentation were also included in the analysis.Final visual outcome were recorded.Data were analyzed for predictors with univariate analysis and multivariate logistic regression analysis.Results After a follow up of 6 months, 31 eyes (45.59% ) achieved visual acuity 0.1 or better, 37 eyes (54.41%) achieved visual acuity worse than 0.1.According to univariate analysis results, the following parameters were predictors of visual outcome: grade of injury (P=0.000), zone of injury (P=0.005), afferent pupillary response (P<0.024), wound length (P=0.001), and retinal detachment (P=0.002), time delay of visiting(P= 0.025).However, multivariate logistic regression analyses revealed that grade of injury (P=0.002; odds ratio, 6.040; 95% confidence interval, 1.884-19.362) and relative afferent pupillary defect (P=0.046; odds ratio, 4.871; 95% confidence interval, 1.102-23.683) was the only significant factors for visual outcome.Conclusions Grade of injury and relative afferent pupillary defect are significant prognostic factors for visual outcome in open globe injury .The classification system becomes useful prognostic tool for visual outcome in open globe injury. Key words: Open globe injury; Prognosis; Visual acuity; Classification