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

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.

Download Full-text

Predictive factors of visual outcome in open globe injuries in Thailand: a prospective study

Asian Biomedicine ◽

10.5372/1905-7415.0502.040 ◽

2011 ◽

Vol 5 (2) ◽

pp. 289-294

Author(s):

Sunisa Sintuwong ◽

Ruthairat Winitchai

Keyword(s):

Visual Acuity ◽

Length Of Stay ◽

Predictive Factors ◽

Foreign Bodies ◽

Vitreous Hemorrhage ◽

Visual Outcome ◽

Time Duration ◽

Initial Visual Acuity ◽

Open Globe ◽

Open Globe Injuries

AbstractBackground: Eye injuries, especially open globe injuries, cause visual morbidities and socioeconomic burden. It is an urgent task to require 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%) were graduated from primary school and 65.3% were laborers. 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 (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.

Download Full-text

Visual outcome in open globe injuries

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i2.6542 ◽

2012 ◽

Vol 4 (2) ◽

pp. 263-270 ◽

Cited By ~ 3

Author(s):

T Thevi ◽

Z Mimiwati ◽

S C Reddy

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Visual Outcome ◽

Detailed Examination ◽

X Rays ◽

Visual Axis ◽

Initial Visual Acuity ◽

Open Globe ◽

Good Visual Outcome ◽

Open Globe Injuries

Objective: To determine the factors affecting the visual outcome in patients with open globe injuries of eye. Materials and methods: In a prospective interventional study of consecutive patients with open globe injuries, the age, gender, place of injury, object causing injury and safety precautions taken were recorded. A detailed examination of the eye was done with a slit-lamp. X-rays of the orbits were taken in order to determine the presence of a foreign body. The injuries were classified as simple or complicated depending on the involvement of the pupil/iris, lens and retina. Finally, post operative best-corrected visual acuity at last follow up was noted. Results: Fifty-two patients (52 eyes) were included in the study. The mean age of patients was 27.25±12.62 years (range 9-73 years). The majority of injuries occurred in the workplace (36.5%); nail (15.4%) and glass (15.4%) were the most common objects causing injury. Of those with good initial visual acuity, 90% maintained good visual outcome. Patients with corneal lacerations of less than 5 mm had significant good visual outcome. The number of corneal lacerations and visual axis involvement did not affect the visual outcome. Those with corneoscleral lacerations had significantly poor visual outcomes compared to those with corneal or scleral lacerations alone.Conclusion: Predictors of good visual outcome are good initial visual acuity, a corneal laceration wound of less than 5mm, a deep anterior chamber, and simple lacerations. Age, gender, place of injury, object causing injury, presence of hyphema or intraocular foreign body, and the use of safety precautions did not affect the visual outcome.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6542 Nepal J Ophthalmol 2012; 4 (2): 263-270

Download Full-text

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

European Journal of Ophthalmology ◽

10.1177/11206721211000648 ◽

2021 ◽

pp. 112067212110006

Author(s):

Xin Liu ◽

Lufei Wang ◽

Fengjuan Yang ◽

Jia’nan Xie ◽

Jinsong Zhao ◽

...

Keyword(s):

Visual Acuity ◽

Surgical Management ◽

Pediatric Patients ◽

Vitreous Hemorrhage ◽

Visual Outcome ◽

Poor Visual Outcome ◽

Early Vitrectomy ◽

Open Globe ◽

Time From Injury ◽

Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

Download Full-text

Pediatric open-globe injury in a university-based tertiary hospital

European Journal of Ophthalmology ◽

10.1177/1120672118818013 ◽

2018 ◽

Vol 30 (2) ◽

pp. 269-274 ◽

Cited By ~ 2

Author(s):

Faisal AlDahash ◽

Ahmed Mousa ◽

Priscilla W Gikandi ◽

Ahmed M Abu El-Asrar

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Visual Outcome ◽

Tertiary Hospital ◽

Open Globe Injury ◽

Female Ratio ◽

Initial Visual Acuity ◽

Open Globe ◽

Type Of Injury

Background: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. Methods: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. Results: A total of 213 patients were identified. Male–female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. Conclusions: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.

Download Full-text

Effect of time to primary repair on final visual outcome after open globe injury

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311559 ◽

2019 ◽

Vol 103 (10) ◽

pp. 1491-1494 ◽

Cited By ~ 5

Author(s):

Richard J Blanch ◽

Jonathan Bishop ◽

Hedayat Javidi ◽

Philip Ian Murray

Keyword(s):

Visual Acuity ◽

Primary Repair ◽

Demographic Data ◽

Case Series ◽

Visual Outcome ◽

Final Visual Acuity ◽

Visual Outcomes ◽

Open Globe ◽

Final Visual Outcome ◽

Open Globe Injuries

Background/AimHistoric data suggest that open globe injuries should be repaired within 12–24 hours to reduce the risk of endophthalmitis. However, endophthalmitis is uncommon when systemic antibiotic prophylaxis is given. It is not clear whether delayed primary repair impacts visual outcomes in other ways or what is the optimum time to repair. We aimed to examine the effect of time to primary repair on visual outcomes.MethodsThis is a retrospective comparative case series including all open globe injuries presenting to the Birmingham Midland Eye Centre between 1 January 2014 and 15 March 2016. Presenting features, mechanism of injury, visual acuity at 6–12 months and demographic data were examined.Results56 open globe injuries were repaired, of which sufficient data for analysis were available on 52 cases. The mean time to primary repair was 1 day after injury (range 5 hours to 7 days). Final visual acuity at 6–12 months was related to the presenting visual acuity and the Ocular Trauma Score and to the time between injury and primary repair, with a reduction in predicted visual acuity of logarithm of the minimum angle of resolution of 0.37 for every 24 hours of delay (95% CI 0.14 to 0.6).DiscussionOpen globe injuries should be repaired promptly. Presenting visual acuity remains the strongest predictor of outcome; however, delay to primary repair also reduced final visual acuity, and any significant delay from injury to repair is likely to negatively impact final visual outcome.

Download Full-text

Prognostic factors for open-globe injuries: variables for poor visual outcome

Eye ◽

10.1038/s41433-018-0218-9 ◽

2018 ◽

Vol 33 (3) ◽

pp. 392-397 ◽

Cited By ~ 9

Author(s):

Soner Guven ◽

Ali Hakan Durukan ◽

Cuneyt Erdurman ◽

Murat Kucukevcilioglu

Keyword(s):

Prognostic Factors ◽

Visual Outcome ◽

Poor Visual Outcome ◽

Open Globe ◽

Open Globe Injuries

Download Full-text

Clinical analysis and predictive factors associated with improved visual acuity of infectious endophthalmitis

10.21203/rs.3.rs-21285/v1 ◽

2020 ◽

Author(s):

Zhao Gao ◽

Yunda Zhang ◽

Xiaohong Gao ◽

Ximei Zhang ◽

Tao Ma ◽

...

Keyword(s):

Visual Acuity ◽

Logistic Regression ◽

Predictive Factors ◽

Patient Visit ◽

Visit Time ◽

Factors Associated ◽

Open Globe ◽

Infectious Endophthalmitis ◽

Epidemiological Characteristics ◽

Open Globe Injuries

Abstract Background: To describe the clinical characteristics and analyze the predictive factors associated with improved visual acuity of 359 patients with infectious endophthalmitis. Methods: This study retrospectively analyzed 359 eyes of 359 patients with infectious endophthalmitis from January 2014 to December 2018. The findings summarized some epidemiological characteristics of these patients, including age, sex, occupation, patient visit time, etiology, causative organisms, therapy and best-corrected visual acuity (BCVA). Multivariate logistic regression was performed to predict the relative factors of improved visual acuity (VA). Results: Overall, 283(78.83%) patients were male.The mean age was 48.0 ± 18.27 years. Ocular truma, especially the open globe injuries (246, 68.5%) was the most common etiology of infectious endophthalmitis in this study. The etiologies of infectious endophthalmitis were open globe injuries (68.5%), intraocular surgery (22.6%), cornea ulcer-associated causes (6.7%), and endogenous causes (2.2%). In the etiology classification and visual acuity improvement group, the statistically significant difference in factors such as age, sex, patient visit time, pre-therapy VA,etc. The average Logarithm of the Minimum Angle of Resolution (logMAR) BCVA on pre-therapy was 2.28 ± 0.60, and it had significantly improved to 1.67 ± 0.83 on post-therapy (P<0.05). Logistic regression analysis showed that visit time>7 day (P=0.034, OR=0.522, 95%CI: 0.286-0.953),pre-therapy VA≦logMAR 2.3(P=0.032 ,OR=1.809, 95%CI：1.052-3.110 ), etiology of PS (vs. PT; P=0.023, OR=2.100, 95%CI:1.109-3.974) and etiology of CA(vs. PT; P=0.005, OR=0.202, 95%CI:0.066-0.621) were significantly associated with improved VA after adjusting for possible confounding factors. Conclusion: Among the patients with infectious endophthalmitis, middle-aged males, especially farmers and workers, accounted for a large proportion. Open globe injuries was the main cause and gram-positive bacteria was the major causative organisms. The final visual outcomes seem to vary according to the type of endophthalmitis, but early treatment and good initial visual acuity are important factors for visual acuity improvement.

Download Full-text

Open Globe Injuries: Classifications and Prognostic Factors for Functional Outcome

10.21203/rs.3.rs-79471/v1 ◽

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.

Download Full-text

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

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i2.987 ◽

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.

Download Full-text

Small-gauge vitrectomy for advanced diabetic eye disease: outcomes and predictive factors for poor postoperative vision

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v2i3.114 ◽

2020 ◽

Vol 2 (3) ◽

pp. 177-189

Author(s):

Mushawiahti Mustapha ◽

Tan Chim Yoong ◽

Tevanthiran A/L Gobal ◽

Win Inn Chong ◽

Tengku Nadhirah Tengku Zulkeplee ◽

...

Keyword(s):

Predictive Factors ◽

Demographic Data ◽

Visual Outcome ◽

Visual Outcomes ◽

Poor Visual Outcome ◽

Post Surgery ◽

Diabetic Eye Disease ◽

Small Gauge ◽

Anatomical Outcomes

Objective: To evaluate the anatomical and visual outcomes of small-gauge vitrectomy in patients with advance diabetic eye diseases (ADED) and the predictive factors for poor visual outcome. Materials and methods: A retrospective study was conducted from 2009 to 2014. Data at baseline, 6 months, and 12 months post-surgery were collected along with baseline demographic data, indications of surgery, systemic associations, visual and anatomical outcome, and postoperative complications. Poor visual outcomewas defined as visual acuity worse than 6/36. Results: A total of 158 eyes from 133 patients were recruited. Mean age was 54.01 ± 11.57 years and mean follow-up was 9.9 ± 3.7 months. Indications for vitrectomy were vitreous haemorrhage (VH, 77 eyes [48.7%]), tractional retinal detachment (TRD) with macular involvement (75 eyes [47.5%]), and other causes in 6 eyes (3.8%). There was visual improvement in 59.3% of patients, 23.6% worsened, and 17.1% stabilized at 12 months post-surgery. Patients with VH (75.4%) showed significant improvement compared to patients with TRD (48.3%). Successful anatomical outcomes were achieved in VH (98.2%) and TRD (96.7%). However, patients with TRD were found to have a 2.4-fold higher risk of having poor visual outcomes. Conclusion: Small-gauge vitrectomy for ADED resulted in excellent visual and anatomical outcomes. Eyes with TRD were at a higher risk of developing poor visual outcomes.

Download Full-text