Abstract
Purpose :
To evaluate demographics, prognostic factors, and clinical outcomes of open globe injuries referred to a level 1 trauma center and to determine association between complications and OTS score and visual acuity.
Methods :
A retrospective review was done of all patients diagnosed with traumatic open globes at LAC+USC Medical Center from August 2019 through August 2022. Demographic data included sex, age, and ethnicity/race of patients. Ocular trauma details included mechanism of injury and associated factors, complications, Ocular Trauma Scores (OTS), and visual acuities (VA). The associations between visual outcomes and demographic data, and visual outcomes and ocular trauma details were assessed with Fisher’s Exact Test and Chi-Squared analyses respectively.
Results :
Ninety-five patients with traumatic open globes were included in the study (average age of 42.7 ± 14.6). The majority were male (n = 87, 91.6%) and Hispanic/Latino (n = 66, 69.5%). Other case demographics and characteristics are categorized in Table 1. Seventeen (17.9%) cases included extraocular injuries and were significantly correlated with poor final visual acuity (for the purposes of our study, defined as worse than 20/200) (p = 0.0084). Of the 72 cases (75.8%) with pre-intervention visual acuities recorded, 23.1% had an OTS score of 1, 34.7% had a score of 2, 14.7% had a score of 3, 2.1% had a score of 4, and 1.1% had a score of 5. OTS scores were found to be highly predictive of final visual acuities (p = 0.0084). Nearly all patients chose to pursue surgical intervention, with the exception of 6 patients. The most common complications seen included traumatic cataract, hyphema, vitreous hemorrhage, and retinal detachment. The most common sequelae included corneal scarring, changes in intraocular pressure, and choroidal injury. There was no significant association found between the presence of complications/sequelae and OTS score (df = 8, χ2 = 0.75) or with visual acuity (df = 16, χ2 = 0.037).
Conclusions :
Our study demonstrated that OTS scores remain the most valuable tool for final visual prognosis in ocular trauma patients. However, our data also demonstrated that extraocular involvement in open globe injuries also plays an important role in the final visual prognosis, and could be considered as an additional factor alongside the OTS score.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.