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G.W. Schmidt, H. Hindman, A.T. Broman, M.P. Grant; Visual Preservation After Open Globe Injury: Initial Vision and rAPD Are Independent Predictors of Outcome . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1465.
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To assist ophthalmologists in counseling and managing ocular trauma patients, this study determines clinical factors predictive of visual preservation after open globe injury.
A retrospective cohort review of 224 patients who presented to the Wilmer Eye Institute with open globe injuries from January 2001 to December 2004 was conducted.
Outcome was divided into two categories: visual preservation (with final visual acuity ranging from 20/20 to light perception) and blindness (enucleation/evisceration/NLP). We hypothesized that initial visual acuity, rAPD, wound mechanism, wound length, wound location, cause of injury, orbital fracture, lid laceration, retinal detachment, ciliochoroidal hemorrhage, hyphema, vitreous hemorrhage, uveal prolapse, lens damage, gender, and age were each predictors of visual preservation. Univariate analysis shows the factors in Table 1 (except age and gender) are associated with outcome.
In multivariate models, where all above covariates where included, initial visual acuity (OR=16.2, p=0.003) and presence of a rAPD (OR=5.0, p=0.05) were most predictive of visual preservation after open globe injury.
Poor initial vision and the presence of a rAPD independently predict enucleation after open globe injury. This analysis provides prognostic information that can assist in deciding the value of primary repair after open globe injury. By identifying poor prognostic factors, unnecessary surgical procedures can be prevented after open globe injury.
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