scholarly journals Open Globe Injuries: Classifications and Prognostic Factors for Functional Outcome

2020 ◽  
Author(s):  
Lukas Reznicek ◽  
Christian S. Mayer ◽  
Ramin Khoramnia ◽  
Jakob Siedlecki ◽  
Benedikt Schworm
Keyword(s):  
Visual Acuity ◽  
Functional Outcome ◽  
Ocular Trauma ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Tertiary Referral Center ◽  
Open Globe ◽  
Department Of Ophthalmology ◽  
Trauma Score ◽  
Open Globe Injuries

Abstract BACKGROUND: Epidemiology and evaluation of posterior segment involvement as a prognostic factor for functional outcome of patients with open globe injuries in a university eye clinic as a tertiary referral center in Southern Germany. METHODS: A retrospective analysis of 151 consecutive patients with open globe injuries who were referred to the department of Ophthalmology of the Technical University of Munich in Germany from 2004 to 2011 was conducted. Visual acuity, epidemiologic data, classification of the injuries including the ocular trauma score (OTS), performed surgeries, post-operative visual acuity and intraocular pressure (IOP) as well as correlation analyses between OTS and post-operative visual acuity were obtained. RESULTS: On total, 147 eyes were included in the study. The mean age of the patients was 42.9±22.2 years, 78.2% were male, 36.7% of injuries occurred in the workplace. Thirty-eight patients (25.9%) had intraocular foreign bodies (IOFB): 84.2% were metal objects, 5.3% organic material and 10.5% glass. On total, 51.7% of the open globe injuries were located in zone I (cornea, cornealscleral limbus), 15.0% in zone II (up to 5 mm posterior the sclerocorneal limbus) and 32.0% in zone III (posterior of zone 2). Affected structures were eyelids (17.7%), cornea (74.8%), iris (63.9%), lens (56.5%), sclera (48.3%), retina (47.6%) and optic nerve (19.7%). Mean preoperative BCVA was 1.304±0.794 logMAR and 1.289±0.729 logMAR after surgery (p=0.780). Patients with involvement of their posterior segment had significantly worse postoperative BCVA scores than patients without (1.523±0.654 logMAR vs. 0.944±0.708 logMAR, p<0.01). CONCLUSIONS: Predictive factors for good visual outcome of open globe injuries are good initial visual acuity and ocular trauma affecting only zone I and II.

scholarly journals Open Globe Injuries: Classifications and Prognostic Factors for Functional Outcome

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1851
Author(s):  
Christian Steffen Mayer ◽  
Lukas Reznicek ◽  
Isabella Diana Baur ◽  
Ramin Khoramnia
Keyword(s):  
Prognostic Factors ◽  
Functional Outcome ◽  
Ocular Trauma ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Open Globe ◽  
Good Visual Outcome ◽  
Corrected Distance Visual Acuity ◽  
Trauma Score ◽  
Open Globe Injuries

This paper explored epidemiology and evaluation of posterior segment involvement as prognostic factors for functional outcome of patients with open globe injuries. A retrospective analysis of 151 patients with open globe injuries was conducted. Pre- and postoperative-corrected distance visual acuity (CDVA), epidemiologic data, classification of the injuries including the ocular trauma score (OTS), performed surgeries, intraocular pressure (IOP) and correlation analyses between OTS and postoperative CDVA were obtained. A total of 147 eyes were included in the study. Mean age was 42.9 ± 22.2 years, 78.2% were male, and 36.7% of injuries occurred in the workplace. Thirty-eight patients (25.9%) had intraocular foreign bodies. Concerning injury location, 51.7% of the injuries were located in zone I (cornea, corneoscleral limbus), 15.0% in zone II (up to 5 mm posterior the sclerocorneal limbus) and 32.0% in zone III (posterior of zone 2). Affected structures were eyelids (17.7%), cornea (74.8%), iris (63.9%), lens (56.5%), sclera (48.3%), retina (47.6%) and optic nerve (19.7%). Mean preoperative CDVA was 1.304 ± 0.794 logMAR and 1.289 ± 0.729 logMAR postoperatively (p = 0.780). Patients with posterior segment involvement had significantly worse postoperative CDVA than patients without (1.523 ± 0.654 logMAR vs. 0.944 ± 0.708 logMAR, p < 0.01). Predictive factors for good visual outcome of open globe injuries are good initial CDVA and ocular trauma affecting only zone I and II.

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

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.

scholarly journals Factors affecting final functional outcomes in open‐globe injuries and use of ocular trauma score as a predictive tool in Nepalese population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saurav M. Shrestha ◽  
Casey L. Anthony ◽  
Grant A. Justin ◽  
Madhu Thapa ◽  
Jyoti B. Shrestha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Predictive Tool ◽  
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. Conclusions 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.

Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries

2020 ◽  
Author(s):  
Dusica Pahor ◽  
Tomaz Gracner
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Prognostic Models ◽  
Ocular Trauma Score ◽  
Open Globe ◽  
Significant Difference ◽  
Trauma Score ◽  
Pediatric Ocular Trauma ◽  
Open Globe Injuries

Abstract Aim To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years. Patients and Methods A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated. Results Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 – 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models. Conclusion Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

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