Purchase this article with an account.
H. L. Takusagawa, A. S. Shah, M. T. Andreoli, C. M. Andreoli, A. V. Turalba; Risk Factors for Phthisis and Pre-Phthisis in Open Globe Injuries. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5320.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate risk factors for developing phthisis or pre-phthisis after open globe injuryBackground: Phthisis bulbi, a disfiguring atrophy of the eye with disorganization of intraocular contents, can occur in a significant number of patients after severe trauma or ocular disease.
This is a retrospective review of 712 patients with open globe injuries and repairs done at the Massachusetts Eye and Ear Infirmary between 1999 to 2008. Univariate analysis was used to find significant differences between patients who developed phthisis or pre-phthisis and the entire study population. Also, a logistic regression model was used to determine risk factors for developing phthisis or pre-phthisis after open globe repair.
Of the 712 patients reviewed with open globe injuries, 39 (5.5%) developed phthisis (n= 29) or pre-phthisis (n=10). Logistic regression showed that Zone III injuries (p = 0.0007) and hyphema (p = <0.0001) are significant risk factors for developing phthisis or pre-phthisis. In addition, statistically significant differences between patients who developed phthisis or pre-phthisis and the entire study population included poor pre-operative visual acuity (p= <0.0001), blunt trauma (p=0.002), zone II or zone III injuries (p = 0.0285 and <0.0001 respectively), hyphema (p = <0.0001) and "squished grape" appearance of the globe on initial head CT (p = 0.0002). It should be noted that while squished grape appearance was more common in patients who developed phthisis or pre-phthisis, only 13.3% (4/30) of patients with squished grape developed phthisis or pre-phthisis.
Risk factors for developing phthisis after open globe injury include zone III injury and hyphema. Patients who develop phthisis or pre-phthisis are more likely to have poor pre-operative visual acuity, blunt trauma, zone II or III injury, hyphema, or squished grape appearance on CT. This information can be used to counsel patients with open globe injuries about their risk of developing phthisis even after successful globe repair.
This PDF is available to Subscribers Only