Abstract
Purpose :
This study aims to evaluate the effectiveness of visual evoked potential (VEP) and ocular trauma score (OTS) in predicting visual potential among cases of globe trauma not involving the optic nerve.
Methods :
Clinical data from eye globe injury cases that underwent a flash VEP examination between January 1st, 2000, and May 30th, 2021, were analyzed. Inclusion criteria encompassed eyes that completed a flash VEP within 48 hours of arrival, pre-surgical intervention, and maintained a follow-up of at least one year. Exclusions were made for patients with head trauma or documented optic nerve injuries. Abnormal VEP parameters were defined as signal amplitudes <7 µV and latencies >120ms. OTS was computed for cases with all relevant parameters. Penetrating injuries were categorized by extent (1-cornea/anterior chamber, 2-lens/iris, 3-vitreous cavity, 4-retina).
Results :
A total of 85 eyes in 85 patients met the inclusion criteria, with a mean age of 31.9±20.6 (range 3-85 years), and 82.4% of patients were male. Baseline mean logMAR best corrected visual acuity (BCVA) was 2.48±1.69 and follow-up was 2.36±1.89 (p=0.663). OTS was computed for 64 eyes (75.3%), with a mean OTS of 61.5±26.3. OTS correlated inversely with ocular penetration extent (Spearman’s rho -0.672, p<0.0001), VEP signal amplitude (Spearman’s rho -0.320, p=0.025), and LogMAR change in BCVA at follow-up (Spearman’s rho -2.87, p=0.022). VEP baseline latency did not correlate with visual improvement, but VEP signal amplitude inversely correlated with maintaining or improving visual acuity at follow-up (Spearman’s rho -0.249, p=0.042). Positive predictive value for normal VEP predicting maintained or improved visual acuity was 75.6%, with a negative predictive value of 21.3%. In 12 eyes with no recordable VEP signal, final BCVA was no light perception in 7/12, light perception in 4/12, and hand motion in 1/12.
Conclusions :
In cases of traumatic eye injuries confined to the globe, VEP amplitude is more affected than latency. Patients with attenuated amplitudes exhibit greater visual acuity improvement at follow-up. OTS correlates with visual improvement and could serve as a reliable substitute for VEP, aiding in predicting visual outcomes and guiding management decisions.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.