Prognostic Value of an Ocular Trauma Score in Ocular Firecracker Trauma

Abstract

The aim of this study was to report the incidence and management of ocular firecracker trauma and to assess the predictive value of an Ocular Trauma Score (OTS) in ocular firecracker trauma. The study includes consecutive case study and retrospective analysis of ocular firecracker trauma. Numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating or penetrating injury, retinal detachment, and afferent pupillary defect) at presentation were summated and converted to OTS categories. The likelihood of the final visual acuities in each category were calculated. The sensitivity and specificity of OTS were also determined. Forty-eight patients (54 eyes) were enrolled in the study. Male patients accounted for 85.4%. Of the total patients, 62.5% were younger than 15 years. Bystanders accounted for 47.9%. The average follow up was 18.5±3.6 months. The most common clinical manifestation was ocular penetrating or perforating injury. Of the total number of patients, 53.7% had best-corrected vision, at the time of their last follow up, ranging from 20/50-20/200. The OTS has 100% sensitivity and specificity to predict nonlight perception, light perception/hand motion, and 1/200-19/200. The OTS has 45% sensitivity and 100% specificity to predict vision of 20/200-20/50. The OTS has 100% sensitivity and 65% specificity to predict vision of ≥20/40. The clinical manifestations of ocular firecracker trauma in Zhengzhou are more severe than in other countries, but similar to reports of other cities of comparable size to that in China. The OTS has good predictive value for ocular firecracker trauma with 100% sensitivity and specificity to predict a final vision of nonlight perception, light perception/hand motion, and 1/200-19/200.