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D. Xing, M. Pham, M. A. Zarbin, N. Bhagat; Prognostic Value of Ocular Trauma Score in Traumatic Ruptured Globe Injuries. Invest. Ophthalmol. Vis. Sci. 2007;48(13):710.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the prognostic value of the ocular trauma score (OTS) in assessing final visual outcome in traumatic ruptured globes (RG).
Retrospective chart review of 358 eyes with traumatic ruptured globes that presented to University Hospital (UH) between 1998-2006. OTS variables (initial visual acuity, globe rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect) were available in 170 eyes. OTS raw scores were calculated and converted to the appropriate OTS categories (Category 1=worst prognosis). Final observed visual acuity (VA) of RG patients after treatment was recorded and compared with the expected VA as predicted by the Ocular trauma classification system (OTCS). Statistical analysis was performed using the Chi-Square Test and Fischer Exact Test as appropriate. No patients fit the criteria for OTS categories 4 or 5.
There were 170 patients with a mean age of 35 years (range, 3 to 91 years), and mean follow up of 8.5 months (range, 1 day to 88 months). Observed final VA was better than expected VA in all OTS categories (p<0.001) (Table 1). More eyes with RAPD than eyes without RAPD had final VA of NLP (18 eyes vs. 1 eye respectively), (p<0.001). This is in concordance with intra-category analysis: OTS category 1 had 16 eyes with RAPD and 1 eye without APD with final VA of NLP (p=0.07), while OTS category 2 had 2 eyes with RAPD and no eyes without RAPD with final VA of NLP (p=0.003). Intra-category analysis of enucleations did not find a significant difference between RAPD and non-RAPD eyes in OTS categories 1 and 2 (p=0.266, p=0.94 respectively). Enucleation occurred more frequently in OTS category 1 than other categories combined (p<0.001). No eyes in OTS category 3 had RAPD or were enucleated (Table 1).Table 1:
The observed final VA of RG patients in all categories evaluated in this study were significantly better than OTCS prediction. Results were consistent with the trend set forth by OTCS. Our data suggests that RAPD is an independent risk factor for poor visual outcome (NLP), but not for enucleation. OTS categorization is a better predictor of enucleation.
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