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Tomasz Stryjewski, Katarzyna Brodowska, Evangelia Papavasileiou, Yewlin Chee, Dean Eliott; Validation of the RD-OGI score as an effective tool for predicting retinal detachment after open globe injury.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4797.
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© ARVO (1962-2015); The Authors (2016-present)
The RD-OGI Score is a clinical prediction model that was derived based on 893 open globe patients for predicting the risk of retinal detachment after open globe trauma. This study sought to validate the RD-OGI Score in an independent patient cohort to improve clinical decision-making.
A validation cohort was established by retrospectively reviewing the outcomes of 231 open globe injuries who presented to Eye Trauma Service of the Massachusetts Eye and Ear Infirmary (MEEI) from 1 January 2012 to 31 January 2014 with open globe injury. Logistic regression was undertaken to evaluate optimal predictive value of RD-OGI Score. The sensitivity, the specificity, positive predictive value (PPV), negative predictive value (NPV) and probability of RD development were assessed for each RD-OGI Score cutpoint. RD-OGI Scores were stratified into three risk classes: Low Risk, Moderate Risk, and High Risk of RD development. Kaplan-Meier survival analysis for time to RD was plotted. A log-rank test was used to test differences in survival experience between risk classes.
A total of 66 eyes were ultimately diagnosed with RD after open globe trauma in the validation cohort at 365 days. Regression modeling indicated that RD-OGI Score performs the best in predicting RD for the 30-day follow-up time point (AUC=0.939, AIC=108.8). However, this Score also performed extremely well at every other time point. The Low Risk Class was designated to be RD-OGI Scores of 0-1.5 and none of the patients developed RD in Low Risk Class over 365 days. Moderate Risk Class was designated as RD-OGI Scores 2.0 through 4.0 with a probability of RD of 11-20% at all time points, and High Risk Class at scores 4.5 through 7.5 with probability 66-78% at all time points.
The RD-OGI score can reliably predict the future development of detachment based on clinical variables that are seen at the time of initial presentation after traumatic injury.
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