Abstract
Purpose: :
To determine visual outcomes and prognostic factors of open globe injuries and to assess the prognostic power of the Ocular Trauma Score (OTS).
Methods: :
Retrospective review of the medical records of all consecutive patients with open globe injury between September 2009 to November 2011. Mechanism of injury, initial visual acuity, presence of afferent pupillary defect, globe rupture, zone of injury, and presence or absence of retinal detachment were analyzed as prognostic indicators of final visual acuity. Open globe injuries were classified into zone 1, 2 and 3 as defined by the Ocular Trauma Classification Group and were designated an OTS category. The final visual acuities were compared to those predicted by the OTS.
Results: :
The study group consisted of 32 consecutive patients. Average age was 50 (range 10-90). Initial visual acuity ranged from NLP to 20/25. In multivariate analysis, zone 3 injuries (> 5mm posterior to the limbus), the presence of retinal detachment, afferent pupillary defect, and globe rupture were related to visual acuity of 20/100 less. For patients in OTS category 1 (worst prognosis), 57% had final visual acuity of NLP, versus 74% predicted by the OTS. Of our patients in category 2, none resulted in NLP vision (27% predicted).
Conclusions: :
We have identified prognostic factors for open globe injury, including the zone of injury, presence of retinal detachment, afferent pupillary defect and globe rupture. Final visual acuity was better than predicted by the ocular trauma score in all categories, which we hypothesize is due to improvements in intraocular surgery.
Keywords: trauma • retinal detachment • retina