Open-globe injuries in Palestine: epidemiology and factors associated with profound visual loss at St. John Eye Hospital, Jerusalem Riyad Banayot St. John Eye Hospital, Jerusalem, Palestine

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.

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Risk factors and prognosis of pediatric open globe injuries without initial light perception

Ophthalmologica ◽

10.1159/000513337 ◽

2020 ◽

Author(s):

Xin Wen ◽

Miner Yuan ◽

Cheng Li ◽

Chongde Long ◽

Zhaohui Yuan ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Silicone Oil ◽

Vitreoretinal Surgery ◽

Light Perception ◽

Open Globe ◽

Intraocular Hemorrhage ◽

Control Study ◽

Better Than ◽

Open Globe Injuries

Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p＜0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p＜0.001) and anatomic success (OR=4.515, p＜0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.

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