Abstract
Purpose: To assess the relationship and prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with poor final best-corrected visual acuity (BCVA) after surgical repair of open globe injuries (OGI) in adults.Design: Retrospective analysis of data from an ongoing prospective cohort of consecutive patients.Methods: In a tertiary university hospital, 197 eyes of 197 patients were included between 2013 and 2017. NLR and PLR were obtained from pre-operative blood tests to analyze its relationship with poor final BCVA.Results: Severe visual impairment (SVI) was defined as ≤20/200, and was observed in 96 (48.7%) patients after surgical repair of OGI. SVI patients had higher NLR (7.4 ± 6.6 vs. 4.0 ± 3.2, p < 0.001), and PLR (167 ± 92 vs. 139 ± 64; p = 0.021) than non-SVI. NLR ≥ 3.47 and PLR ≥ 112.2 were the best cut-off values for SVI, were univariate risk factors for SVI, and had sensitivity: 69.0, 71.4, and specificity: 63.6, 44.8, respectively. In multivariate analysis, only OTS, athalamia, and hyphema remained as risk factors. NLR had significant correlation with ocular trauma score (OTS) (r = −0.389, p < 0.001) and final BCVA (r = 0.345, p < 0.001).Limitations: Simultaneous trauma in other parts of the body that could influence the laboratory findings.Conclusion: Patients with SVI after a repaired OGI had increased pre-operative NLR and PLR levels. High NLR and PLR are risk factors for SVI in univariate analysis. It is confirmed that low OTS is a risk factor for SVI. High NLR and PLR could be used as a prognostic tool to identify patients at higher risk for SVI after repair of OGI.
Highlights
Open globe injury (OGI) is defined as a full-thickness wound of the eyewall and represents a vision-threatening ocular injury [1, 2]
Risk factors associated with poor final visual acuity (VA) includes poor initial VA, globe rupture, zone 3 injury, the posterior extension of the wound to rectus insertion, presence of relative afferent pupillary defect (RAPD), vitreoretinal trauma, hyphema, cataract, vitreous loss, and low ocular trauma score (OTS) [4,5,6,7,8]
Of the 271 patients included in the cohort, 66 patients younger than 18 years old, and 8 with missing worksheets were excluded; 197 eyes of 197 adult patients were included for analysis, 96 (48.7%) developed severe visual impairment (SVI)
Summary
Open globe injury (OGI) is defined as a full-thickness wound of the eyewall and represents a vision-threatening ocular injury [1, 2]. Risk factors associated with poor final visual acuity (VA) includes poor initial VA, globe rupture, zone 3 injury, the posterior extension of the wound to rectus insertion, presence of relative afferent pupillary defect (RAPD), vitreoretinal trauma, hyphema, cataract, vitreous loss, and low ocular trauma score (OTS) [4,5,6,7,8]. US and ultrasonic biomicroscopy (UBM) are safe and economical methods that can provide valuable information in case of media opacity for the surgical plan elaboration and as predictors for final vision. They are operator dependent, and there is a concern of prolapse of the intraocular tissues, so it should be indicated with caution [13, 14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
