Epidemiology, clinical characteristics and visual outcomes of patients with intraocular foreign bodies in Southwest China: A 10-year review

Introduction: Intraocular foreign bodies (IOFBs) are a serious subset of open-globe injury that can result in visual loss. This study analyzed the epidemiology, clinical characteristics and visual outcomes of patients with IOFBs in Southwest China. Methods: This retrospective study comprised 1176 patients with the primary diagnosis of IOFBs who resided in Sichuan Province over a 10-year period. All data were collected from medical records and analyzed statistically. Results: The annual incidence for IOFBs was 0.14 per 100,000 (95% CI 0.12–0.16 per 100,000) people in Southwest China. In that period, IOFBs accounted for 22.3% of all open-globe injuries. Working-age male patients accounted for 79.1% of all IOFBs patients and there had significant differences in age distributions between genders(P<0.001). Metallic IOFBs was the most common (74.6%) IOFB, but there were significant differences in the materials of IOFBs between adults and children of different age groups (P<0.001). At discharge, 277 (23.6%) patients had increased visual acuity (VA) and 95 (8.0%) had no light perception. Initial visual acuity (VA) < 20/200 (OR, 5.5; P<0.001), increasing wound size (OR, 1.3; P=0.004), IOFBs in the posterior segment (OR, 2.6; P=0.002) and existing complications (traumatic cataract, endophthalmitis, retinal detachment or retinal break) were independent risk factors for final VA < 20/200. Conclusion: The incidence of IOFBs in Southwest China differed from global statistics. Adults and children had different clinical characteristics. Thus, their prevention strategies should be different.

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Clinical Characteristics and Visual Outcomes in Patients with Intralenticular Foreign Bodies with Self-Sealing Corneal Penetrating Wounds

Journal of Ophthalmology ◽

10.1155/2021/6613205 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Zhitao Su ◽

Yuanqi Wang ◽

Quanyong Yi ◽

Lin Lin ◽

Kairan Lai ◽

...

Keyword(s):

Visual Acuity ◽

Clinical Characteristics ◽

Foreign Bodies ◽

Late Complications ◽

Posterior Capsule ◽

Posterior Chamber ◽

Anterior Capsule ◽

Penetrating Wounds ◽

Iol Implantation ◽

Visual Outcomes

Purpose. Siderosis bulbi may occur as a result of retained intralenticular foreign bodies (ILFBs) that were missed during examination in patients with self-sealing wounds and without a significant decrease in visual acuity. This study aimed to explore the clinical characteristics and visual outcomes of ILFBs with self-sealing corneal penetrating wounds. Methods. Fifteen eyes of 15 patients with ILFBs and self-sealing corneal penetrating wounds, seen between October 2014 and September 2019, were retrospectively analyzed. Data regarding the patient demographics, clinical features, surgical procedure, and initial and final best-corrected visual acuity (BCVA) were analyzed. Results. All patients were male with a mean age of 41 years. The foreign bodies passed through the cornea, sometimes through the iris, through the anterior capsule, and finally localized in the lens. All ILFBs were pointed and metallic objects and were successfully removed with phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Anterior capsule violation was found in three eyes, but no posterior capsule rupture was found. The IOL was placed in a capsule bag in all the cases. The BCVA ranged from 20/200 to 20/25 preoperatively and improved to between 20/32 and 20/20 at the last follow-up visit. The IOLs were well-centered. Apart from posterior capsule opacity in four eyes, no other postoperative complications were found. Conclusions. In patients with a pointed metallic ILFB and self-sealing corneal penetrating wounds (with or without cataracts), early diagnosis and removal of the metallic ILFB combined with lens removal and IOL implantation may avoid late complications and achieve good visual outcomes.

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Brief communication (Original). Visual outcome in open globe injuries in Thailand: a prospective study

Asian Biomedicine ◽

10.5372/1905-7415.0504.070 ◽

2011 ◽

Vol 5 (4) ◽

pp. 531-536

Author(s):

Sunisa Sintuwong ◽

Ruthairat Winitchai

Keyword(s):

Visual Acuity ◽

Length Of Stay ◽

Predictive Factors ◽

Foreign Bodies ◽

Visual Outcome ◽

Time Duration ◽

Poor Visual Outcome ◽

Initial Visual Acuity ◽

Open Globe ◽

Open Globe Injuries

AbstractBackground: Eye injuries, especially open globe injuries, cause visual morbidities and socioeconomic burden. It is urgent have good database and stakeholder involvement for open globe injuries.Objectives: Investigate the epidemiology and predictive factors of visual outcome in open globe injuries in an industrial area in Thailand.Methods: Consecutive cases of in-patient open globe injuries in Mettapracharak Eye Centre between February 2009 and January 2010 were examined. Patients were interviewed at first visit and followed-up for six months. The Birmingham Eye Trauma Terminology was used to classify types of injuries. Demographic data, cost of treatment, length of stay, and predictive factors (initial visual acuity, presence of relative afferent pupillary defect, hyphema, vitreous hemorrhage, intraocular foreign bodies, retinal detachment, time-duration to surgery, and wound length) were assessed.Results: Fifty-two out of 60 eyes were included. Most (82.7%) of patients were men and average age was 34.1 years (range: 8-68 years). About half (51.9%) graduated from primary school and 65.3% were labourers. Most patients had not used protective devices. The endophthalmitis rate was 13.5%, and panophthalmitis rate was 5.8%. The enucleation rate was 9.6%. The median length of stay was nine days. Poor initial visual acuity and intraocular foreign bodies were significant predictive factors of poor visual outcome (p <0.05).Conclusion: Open globe injuries caused visual morbidity especially in young adult male, laborers with low education. Initial visual acuity and intraocular foreign bodies were significant predictive factors of poor visual outcome.

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Prognostic Factors and Epidemiology of Open Globe Injuries from Western Sydney: A Twelve-Year Review

10.21203/rs.3.rs-294147/v1 ◽

2021 ◽

Author(s):

Haochi Ho ◽

Jane Foo ◽

Yi-Chiao Li ◽

Samantha Bobba ◽

Christopher Go ◽

...

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Retinal Detachment ◽

Case Series ◽

Final Visual Acuity ◽

Ocular Injury ◽

Visual Outcomes ◽

Globe Rupture ◽

Open Globe ◽

Open Globe Injuries

Abstract BackgroundTo identify prognostic factors determining final visual outcome following open globe injuries.MethodsRetrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities.ResultsA total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p < 0.001), globe rupture (p < 0.001), retinal detachment (p < 0.001), Zone III wounds (p < 0.001), hyphema (p=0.003), lens expulsion (p = 0.003) and vitreous hemorrhage (p < 0.001). Multivariate analysis demonstrated presenting visual acuity (p < 0.001), globe rupture (p = 0.013) and retinal detachment (p = 0.011) as being statistically significant for predicting poor visual outcomes. The presence of lid laceration (p = 0.197) and uveal prolapse (p = 0.667) were not significantly associated with the final visual acuity. ConclusionsPoor presenting visual acuity, globe rupture and retinal detachment are the most important prognostic factors determining final visual acuity following open globe injury.

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Intraocular Foreign Bodies: Clinical Characteristics and Prognostic Factors Influencing Visual Outcome and Globe Survival in 373 Eyes

Journal of Ophthalmology ◽

10.1155/2019/5208092 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yang Liu ◽

Shuang Wang ◽

Ying Li ◽

Qiaoyun Gong ◽

Guanfang Su ◽

...

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Clinical Characteristics ◽

Foreign Bodies ◽

Vitreous Hemorrhage ◽

Visual Outcome ◽

Ocular Injury ◽

Factors Influencing ◽

Retinal Breaks ◽

Wound Length

Aim. To describe epidemiologic and clinical characteristics and prognostic factors influencing visual outcome after intraocular foreign bodies (IOFBs) injury. Methods. Medical records of 370 patients (373 eyes) with IOFBs were reviewed to identify the factors influencing visual acuity by univariate and multivariate analyses. Results. The majority of patients (97.0%) were men, with a mean age of 38.1 years. The most common cause of ocular injury was hammering (52.6%); magnetic IOFBs occurred in 84.7% of these cases. Factors associated with poor visual outcome (defined as <1.3 logMAR) included the following: age ≥50 years (P=0.046); worse presenting visual acuity (P<0.001); complications of retinal breaks (P=0.006) and endophthalmitis (P=0.032); vitrectomy (P=0.035); and intraocular C3F8 gas tamponade (P=0.038). Excellent visual outcome (defined as ≥0.5 logMAR) was associated with age <50 years (P=0.003); better presenting visual acuity (PVA) (P<0.001); wound length <4 mm (P=0.005); absence of vitreous hemorrhage (P=0.026) and retinal breaks (P<0.001); nonvitrectomy surgery (P=0.043); and use of balanced saline (P=0.029). Conclusions. Multiple prognostic factors were identified that may predict visual outcome and globe survival after IOFBs injury. Age, initial presenting visual acuity, wound length, complications (vitreous hemorrhage, retinal breaks, and endophthalmitis), surgical approach, and intraocular tamponade were significant predictors of visual outcome.

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Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome

Journal of Ophthalmology ◽

10.1155/2021/9933403 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Yanyan Liang ◽

Shuang Liang ◽

Xiaoli Liu ◽

Danyan Liu ◽

Jialiang Duan

Keyword(s):

Risk Factors ◽

Study Design ◽

Clinical Characteristics ◽

Foreign Bodies ◽

Visual Outcome ◽

Factors Affecting ◽

Visual Outcomes ◽

Entrance Wound ◽

Wound Length ◽

Capsule Rupture

Objective. To investigate the clinical characteristics and factors affecting visual outcome in patients with intraocular foreign bodies (IOFBs) and determine the risk factors for the development of endophthalmitis. Study Design. A retrospective case-series study design was adopted. Subjects. In total, 242 patients (242 eyes) who were hospitalized and underwent surgical treatment for IOFB at the Second Hospital of Hebei Medical University between January 1, 2008, and December 31, 2019, were included. Methods. The demographic data, cause of injury, characteristics of IOFBs, postinjury ocular manifestations, and surgical details of the subjects were collected, and the factors affecting visual outcome and endophthalmitis development were analyzed. Results. The most common cause of IOFBs was the propulsion of foreign bodies into the eye due to hammering (149 cases, 61.57%), followed by foreign body penetration (57 cases, 23.55%). Most of the subjects were young adult men who sustained injuries in the work environment. Poorer visual outcomes were found in subjects with initial presenting symptoms visual acuity (PVA) < 0.1, largest IOFB diameter ≥ 3 mm, IOFBs located in the posterior segment, wound length > 5 mm, entrance wound length larger than the largest IOFB diameter, concomitant retinal detachment, concomitant vitreous hemorrhage, concomitant endophthalmitis, and concomitant proliferative vitreoretinopathy (PVR). Factors related to the development of endophthalmitis included lens capsule rupture, time of stage 1 repair surgery ≥ 24 h after trauma, removal of IOFBs ≥ 24 h after trauma, and nonadministration of intravitreal antibiotic injection. Conclusion. Among patients with IOFBs, initial PVA < 0.1, entrance wound length larger than the largest IOFB diameter, concomitant endophthalmitis, and concomitant PVR were risk factors for poor visual outcomes. Lens capsule rupture was a risk factor for endophthalmitis development, and the administration of intravitreal antibiotic injection was a protective factor against endophthalmitis development.

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Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

Journal of VitreoRetinal Diseases ◽

10.1177/2474126418759764 ◽

2018 ◽

Vol 2 (2) ◽

pp. 79-86

Author(s):

Razek Georges Coussa ◽

Fares Antaki ◽

Ali Dirani ◽

Thomas Cordahi ◽

Radwan Ajlan ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Foreign Bodies ◽

Anterior Segment ◽

Posterior Segment ◽

Long Term Results ◽

Open Globe ◽

Pars Plana

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

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Factors Affecting Final Functional Outcomes in Open-Globe Injuries and Use of Ocular Trauma Score in Nepalese population

10.21203/rs.3.rs-86664/v1 ◽

2020 ◽

Author(s):

Saurav Man Shrestha ◽

Casey Leigh Anthony ◽

Justin A. Grant ◽

Madhu Thapa ◽

Jyoti Baba Shrestha ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Delayed Presentation ◽

Ocular Trauma Score ◽

Visual Outcomes ◽

Open Globe ◽

The Mean ◽

Trauma Score ◽

Open Globe Injuries

Abstract Background: Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods: Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results: Seventy-three eyes of 72 patients were examined. 76% were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was <6 hours (30 patients, 41%). Thirty-seven eyes (51%) had zone I trauma, followed by twenty eyes (27%) with zone II, and sixteen eyes (22%) with zone III trauma. Sixty-five patients (90%) were managed surgically, and fifty (68%) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60% of the eyes with OGI of various zones (p<0.05). Conclusion: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

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Epidemiological and clinical characteristics of non-severe and severe pediatric and adult COVID-19 patients across different geographical regions in the early phase of pandemic: a systematic review and meta-analysis of observational studies

Journal of Investigative Medicine ◽

10.1136/jim-2021-001858 ◽

2021 ◽

pp. jim-2021-001858

Author(s):

Pearleen Ee Yong Chua ◽

Shimoni Urvish Shah ◽

Hao Gui ◽

Jiayun Koh ◽

Jyoti Somani ◽

...

Keyword(s):

Early Phase ◽

Clinical Characteristics ◽

Distress Syndrome ◽

Meta Analysis ◽

White Blood Cells ◽

Age Groups ◽

Geographical Regions ◽

Meta Review ◽

Adults And Children ◽

Response Increase

This systematic and meta-review aimed to compare clinical presentation, outcomes, and care management among patients with COVID-19 during the early phase of the pandemic. A total of 77 peer-reviewed publications were identified between January 1, 2020 and April 9, 2020 from PubMed, Google Scholar, and Chinese Medical Journal databases. Subsequently, meta-analysis of 40 non-overlapping studies, comprising of 4844 patients from seven countries, was conducted to see differences in clinical characteristics and laboratory outcomes across patients from different geographical regions (Wuhan, other parts of China and outside China), severity (non-severe, severe and fatal) and age groups (adults and children). Patients from Wuhan had a higher mean age (54.3 years) and rates of dyspnea (39.5%) compared with patients from other parts of China and outside China. Myalgia, fatigue, acute respiratory distress syndrome (ARDS) and fatalities were also significantly more prevalent among Wuhan patients. A significant dose–response increase in prevalence of diabetes, D-dimer, white blood cells, neutrophil levels and ARDS was seen from non-severe to severe and fatal outcomes. A significant increase in mean duration of symptom onset to admission was seen between non-severe cases (4.2 days) and severe and fatal cases (6.3 days and 8.8 days, respectively). Proportion of asymptomatic cases was higher in children (20%) compared with adults (2.4%). In conclusion, patients with COVID-19 from Wuhan displayed more severe clinical disease during the early phase of the pandemic, while disease severity was significantly lesser among pediatric cases. This review suggests that biomarkers at admission may be useful for prognosis among patients with COVID-19.

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Open-globe-injury: A single center Spanish retrospective 5-year cohort study

European Journal of Ophthalmology ◽

10.1177/1120672120962039 ◽

2020 ◽

pp. 112067212096203

Author(s):

Elena Guzmán-Almagro ◽

Guillermo Fernandez-Sanz ◽

Diana Herrero-Escudero ◽

Inés Contreras ◽

Julio González Martín-Moro

Keyword(s):

Visual Acuity ◽

Penetrating Trauma ◽

Good Prognosis ◽

Interquartile Range ◽

Final Visual Acuity ◽

Open Globe Injury ◽

Visual Outcomes ◽

Work Related ◽

Open Globe ◽

Senior Women

Purpose: To review and analyze the epidemiological profile, clinical characteristics and visual outcomes in patients attended for traumatic open globe injury (OGI) at our hospital over a 5-year period. Design: Retrospective chart review study. Methods: Retrospective analysis of all patients attended at Fundación Jiménez Díaz University Hospital for OGI between 2011 and 2015. Data from 104 patients including demographics, ocular examination, medical and surgical treatment, visual outcomes, and complications were analyzed. Results: Most patients were male (79.8%) and the median age at the time of injury was 41 years (interquartile range 31.5–58 years). Work-related accidents represent more than half of the cases and their main mechanism was penetrating trauma or foreign body. This type of accident had good prognosis (median final visual acuity in decimal scale 0.8; interquartile range 0.4–1). Falls were the second most common cause of OGI, predominantly affecting senior women (50%), with a high incidence of ocular rupture (50%) and associating a poor visual prognosis (median final visual acuity 0.01; interquartile range 0–0.5). There was a strong correlation (0.75; p < 0.001) between ocular trauma score (OTS) and final best corrected visual acuity. Conclusions: Two different patterns of OGI were identified in our sample. Work-related trauma in young males was the most common form of OGI and was associated with good prognosis. However, falls in senior women were associated with poor prognosis.

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