Abstract
We aimed to analyse the clinical characteristics of OGI and evaluate the correlation between baseline ocular trauma score (OTS) and visual outcomes in cases with OGI. The charts of 257 OGI patients who had at least six months of follow-up were reviewed retrospectively. Demographics, data about the etiology, localization and size of the OGI, baseline and final best-corrected visual acuity (BCVA) were noted. At the time of approval OTS was calculated and compared with final BCVA. All analysis was performed in both entire study population and our pediatric subgroup. A total of 261 eyes of 257 patients with a mean age of 34.9 ± 19.8 years were enrolled. Globe injury with a mean size of 6.7 ± 4.5 mm was within zone I in 46.7% of the eyes. Older age (p < 0.001, OR = 1.029, 95% CI = 1.015–1.043), higher baseline logMAR BCVA scores (p < 0.001, OR = 4.460, 95% CI = 2.815–7.065), bigger wound size (p < 0.001, OR = 1.159, 95% CI = 1.084–1.240), relative afferent pupillary defect (RAPD) positiveness (p < 0.001, OR = 0.021 95% CI = 0.005–0.087), lower OTS (p < 0.001, OR = 27.034, 95% CI = 6.299–116.021), presence of concomitant retinal detachment (p < 0.001, OR = 0.157, 95% CI = 0.080–0.306), and endophthalmitis (p = 0.045, OR = 0.207, 95% CI = 0.044–0.962) were found to be related to poor visual prognosis. Cases with OGI caused by a sharp object (p = 0.007, OR = 0.204, 95% CI = 0.065–0.641) and those injured by a glass (p = 0.039, OR = 0.229, 95% CI = 0.056–0.931) had more favorable final vision. This study highlights that baseline BCVA, wound size, RAPD, retinal detachment, and OTS were the most significant markers for poor visual outcomes in both the entire population and pediatric subgroup. In cases with OGI, OTS was also found effective in predicting visual prognosis.
Highlights
Birmingham Eye Trauma Terminology (BETT) system provides clinicians with clear definitions of widely used ocular trauma terminology
Minor cases with low cooperation and those in whom best-corrected visual acuity (BCVA) could not be evaluated due to unconsciousness related to major head trauma were deliberately excluded from visual acuity evaluations
Work related injuries accounted for 29.1% of all Open globe injury (OGI), followed by injuries occurred at home (22.2%), in road traffic accidents (14.5%), and during daily sport activities including contact sports accidents and personal injuries occurred with leg stretching bands, pilates resistance cords or a shuttlecock (9.2%)
Summary
Birmingham Eye Trauma Terminology (BETT) system provides clinicians with clear definitions of widely used ocular trauma terminology. Ocular trauma is divided into closed wounds and open eye injury; which is defined as full-thickness damage of the cornea, sclera, or both[9]. Open globe injury (OGI) is an ophthalmologic emergency that requires early recognition and perfect surgical repair. For predicting the visual outcomes at the end of sixth postoperative month in cases with traumatic eye injury, Kuhn et al.[10] firstly suggested the calculation of ocular trauma score (OTS) that might guide clinicians in counseling and treating of such patients. We evaluated the trauma etiology and profile of open eye injuries commonly seen in Turkish patients to find out the prognostic factors affecting the visual prognosis. The correlation between OTS and visual outcomes was analyzed in patients with OGI who underwent surgical intervention in our tertiary referral center. In order to develop an effective approach for decreasing the frequency of OGI that constitutes one of the most common causes of preventable blindness in working population, the need of current information about the mechanisms and causes of OGI is undisputed for a public health and injury prevention perspective
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