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M. A. Slabaugh, M. Shaw, J. Brown, J. Lee; Use of the Ocular Trauma Score in Traumatic Ruptured Globe Injuries in a County Hospital. Invest. Ophthalmol. Vis. Sci. 2008;49(13):618.
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To evaluate the use of the Ocular Trauma Score (OTS) to prognosticate expected final visual acuity in an eye trauma patient.
Retrospective chart review of 131 consecutive open globes (full thickness eye wall injury) presenting to Harborview Medical Center (the primary tertiary care referral center in the greater Seattle area) from October 2005 through December 2006. The OTS provides a probability estimate that an open globe patient will obtain a specific visual acuity range by 6 months post injury. OTS variables used for calculation of a raw score are initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect. The raw score is then stratified into one of 5 categories which state a probability of attaining a range of visual acuity. At least 6 months of follow up exams were available for 62 eyes. At the final follow up visit the best-corrected visual acuity was compared to the expected visual acuity predicted by the Ocular Trauma Classification System (OTCS). Statistical analysis was performed using the Chi-Square test.
62 eyes of 60 patients met the inclusion criteria for calculation of the OTS with all variables recorded at the initial exam and at least 6 months of follow up (mean follow up 11.6 months, range 6 to 21 months). Mean age was 41 years (range 4 to 88 years), 78% (47 patients) were male, 22% (13 patients) were female. Observed visual acuity outcome was not statistically different from expected visual acuity as predicted by the OTS in categories 1,2,3 and 5. There was a statistically significant difference in category 4 eyes (p=.03), likely related to our small sample size in category 4.
The OTS is an accurate predictor of visual acuity outcome in this population of patients sustaining a traumatic ruptured globe injury. The calculation of the OTS during the initial evaluation of the traumatic ruptured globe patient allows the treating ophthalmologist to appropriately counsel the patient regarding prognosis and to assist in treatment decision-making and rehabilitation coordination.
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