Predictors of visual outcomes in pediatric open globe injuries

Abstract

To identify predictors of visual outcomes in children with open globe injuries. The medical records of patients (≤18years of age) with open globe injury from 2012 to 2020 at a single institution were retrospectively reviewed. The Pediatric Ocular Trauma Scores (POTS) and Toddler Ocular Trauma Scores (TOTS) were assessed against our cohort. Univariate and multivariate linear regression analysis was performed to identify predictors of visual outcome. A total of 85 eyes of 85 pediatric patients (63 males [74%]) were included. Median patient age was 8.9years. Final best-corrected visual acuity was significantly associated with presenting vision (P=0.0001), age at injury (P=0.02), lens involvement (P<0.0001), retinal detachment (P<0.0001), and location of injury (P<0.0001). In a multivariate linear regression model, only presenting visual acuity and retinal detachment were independent predictors of outcome. When visual acuity was unknown, age at injury, lens involvement, and retinal detachment were independently associated with final visual acuity. POTS and TOTS scores moderately correlated with final best-corrected visual acuity (R2=0.51 and R2=0.53, resp.). We identified patient characteristics predicting visual outcomes in a large US-based cohort of pediatric open globe injuries. POTS and TOTS scores moderately correlated with final visual acuity; however, the small study sizes from which they were derived preclude our identifying which predictors are most important. Development of a more predictive model will require a large multicenter study population or registry.