Abstract
Purpose :
Traumatic pediatric open globe injuries often vary in their presentation and can result in poor visual outcomes after surgical repair. The current ocular trauma scoring system used to predict final visual acuity (VA) for adult injuries has been modified for pediatric patients (POTS), but there is need for data on its predictive ability. This study aims to investigate the presentations of pediatric open globe injuries, as well as explore the predictive ability of the POTS score.
Methods :
Retrospective chart review of all pediatric patients at Children’s Medical Center in Dallas, Texas that underwent surgical repair of open globe injuries between 2011-2021 (n=152). Each patient’s POTS category was calculated based on their age, initial VA, zone of injury, and concurrent pathologies at presentation.
Results :
Patients were, on average, 8.55 years old, with 74.34% being male and 25.66% being female. Most injuries were penetrating injuries (90.79%), and a majority (51.32%) of injuries occurred in Zone 1 of the eye involving the bulbar conjunctiva, sclera, or cornea. 38.16% of our patients had a final VA worse than 1/200, 28.29% had a final VA between 1/200 and 20/50, and 33.55% had vision recovery of 20/40 or better.
About three-quarters of injured eyes had poor prognostic factors at presentation and fell into POTS category 1 (53.41%) or category 2 (22.37%). Correlation analysis between POTS raw scores, POTS category, and final VA showed significant correlations between POTS raw score and final VA (r=0.512, p=1.54e-11), and between POTS category and final VA (r=0.501, p=4.99e-11). However, when analyzing the variables incorporated into the POTS score on patients’ final VA, our data showed that only initial VA (p<0.001), zone of injury (p=0.009), presence of hyphema (p<0.001), retinal detachment (p<0.001), and vitreous hemorrhage (p<0.001) were significantly correlated with final VA.
Conclusions :
Our study found that the majority of pediatric open globe patients are boys with penetrating injuries and injuries to Zone 1 of the eye. Though the POTS system showed a strong correlation between the POTS category and a patient’s final VA, it underestimated the final VA in approximately one-third of our patients. This may be due to the incorporation of factors not significantly correlated with a patient’s final VA in the calculation of the POTS score/category.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.