Abstract
Purpose :
Closed globe ocular trauma may result in potentially serious injury to vital eye structures. We sought to identify baseline clinical factors associated with ophthalmic complications, including a need for future surgery.
Methods :
We analyzed longitudinal data from the American Academy of Ophthalmology IRIS® Registry. We identified patients with a trauma between 2014 and 2019 and performed time-split Cox regression. Demographic factors and the following baseline features were entered as predictors: corneal edema or opacity, traumatic hyphema (TH), iris/angle injury, lens injury (LI), lens displacement, vitreous hemorrhage (VH), retinal break, retinal detachment (RD), commotio retinae, macular scar, macular hole, choroidal injury, and optic nerve injury. Our outcomes of interest included: RD, glaucoma surgery (GS), and cataract surgery (CS). We performed a univariate regression for each feature and selected features with p <= 0.1 to be included in the multivariate regressions. For anterior segment complications, we used splits at 60 and 180 days following the date of trauma. For RD, we used a split at 60 days.
Results :
A total of 214,163 patients had a trauma diagnosis. The strongest risk factors for CS during the first 60 days were LI (hazard ratio 12.2 95%CI 10.1-14.6), and TH (2.64, 2.32-2.99) (Fig. 1A). The strongest risk factor for GS was TH (8.00, 5.00-12.8), during the first 60 days (Fig. 1B). Baseline TH (4.18, 3.42-5.12), and VH (12.7, 10.3-15.6) were significant risk factors for a subsequent RD and remained significant even after the first 60 days (Fig. 2).
Conclusions :
Baseline characteristics at the time of trauma diagnosis are strongly associated with both anterior and posterior segment complications. Regular, long-term follow up is warranted following ocular trauma.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.