Prognostic Factors in Open Globe Injuries

Yıl 2019, Cilt: 1 Sayı: 1, 25 - 31, 23.04.2019

Selda Koyuncu Ayşe Burcu Evin Şingar Ümit Ekşioğlu Firdevs Örnek

Öz

Purpose:  To detect the factors affecting the final visual acuity in open globe injuries.

Material And Methods: Fifty eight eyes of 58 patients who were treated for open globe injuries were analysed prospectively. Factors which are deemed to have effect on visual prognosis were examined statistically.

Results: Forty five patients (%77.6) were male, with a mean age of 29.6 ±19.4. Final visual acuity was 0.1 and lower in 28 (%48.3) cases. The prognostic factors predicting the final visual acuity were initial visual acuity, wound size, mechanism of the injury, presence of relative afferent pupillary defect (RAPD), zone of the injury, anterior chamber finding, lens injury, posterior segment finding, uveal injury  and Ocular Trauma Score . According to multiple retrospective logistic regression analysis, those factors having the highest effect  on final visual acuity were found to be presence of an  RAPD, female gender, old age and large laceration respectively.

Conclusion: Initial examination findings are helpful for predicting the visual outcome in open globe injuries. Therefore, standardization in classification of the initial examination findings is compulsory. 

Anahtar Kelimeler

open globe injury, ocular trauma, penetrating eye injury, visual outcome

Kaynakça

• 1- May DR, Kuhn F, Morris R. The epidemiology of serious eye injuries from the United States Eye Injury Registry. Graefes Arch Clin Exp Ophthalmol. 2000;238:153-157.
• 2- Kuhn F , Morris R , Witherspoon D, et al. A standardized classification of ocular trauma. Ophthalmology .1996 ; 103 : 240-243.
• 3- Pieramici DJ , Sternberg P , Aaberg TM, et al. A system for classifying mechanical injuries of the eye ( globe ) . Am J Ophthalmol. 1997;123 : 820-831.
• 4- Sternberg PJ, De Juan EJ, Michels RG et al. Multivariate analysis of prognostic factors in penetrating ocular injuries. Am J Ophthalmol .1984; 98: 467–72.
• 5- Pieramici DJ, MacCumber MW, Humayun MU, et al. Open globe injuries. Update on types of injuries and visual results. Ophthalmology. 1996; 103:1798–1803.
• 6- Barr CC. Prognostic factors in corneoscleral lacerations. ArchOphthalmol. 1983;101:919–924.
• 7- de Juan E, Sternberg P, Michels R. Penetrating ocular injuries: types of injuries and visual results. Ophthalmology. 1983;90:1318–1322.
• 8- Hutton WL, Fuller DG. Factors influencing final visual results in severely injured eyes. Am J Ophthalmol. 1984;97:715–722.
• 9- Esmali B, Elner SG, Schork A, et al. Visual outcome and ocular survival afte rpenetrating trauma. Ophthalmology. 1995;102:393–400.
• 10- Williams DF, Mieler WF, Abrams GW, et al. Results and prognostic factors in penetrating ocular injuries with retained intraocular foreign bodies. Ophthalmology. 1988;95:911–916.
• 11- Moncreiff WF, Scheribel KJ. Penetrating injuries of the eye: a statistical survey. Am J Ophthalmol. 1945;28:1212– 1220.
• 12- Groessl S, Nanda SK, Mieler WF. Assault-related penetrating ocular injury. Am J Ophthalmol. 1993; 116: 26–33.
• 13- Brinton GS, Aaberg TM, Reeser FH, et al. Surgical results in ocular trauma involving the posterior segment. Am J Ophthalmol. 1982;93:271–278.
• 14- Fujikawa A, Mohamed YH, Kinoshita H,et al. Visual outcomes and prognostic factors in open-globe injuries. BMC Ophthalmol. 2018 Jun 8;18(1):138. 15- Han SB, Yu HG. Visual outcome after open globe injury and its predictive factors in Korea. J Trauma. 2010;69(5):E66–E72.
• 16- Lin H, Lema GM, Yoganathan P. Prognostic indicators of visual acuity after open globe injury and retinal detachment repair. Retina. 2016;36(4):750-757.
• 17- Pieramici DJ, AuEong K, Sternberg PJ, et al. Prognostic significance of a system for classifying mechanical injuries of the eye (globe) in open-globe injuries. J Trauma.
• 2003; 54: 750–754. 18- Martin DF, Meredith TA, Topping TM, et al. Perforating (through and through) injuries of the globe, surgical results with vitrectomy. ArchOphthalmol. 1991;109:951– 956.
• 19- Beshay N, Keay L, Dunn H, et al. The epidemiology of open globe injuries presenting to a tertiary referral eye hospital in Australia. Injury. 2017;48(7):1348–1354.
• 20- Ahmadieh H, Soheilian M, SajjadiH, et al. Vitrectomy in ocular trauma; factors influencing final visual outcome. Retina.1993;13:107—113.
• 21- Stryjewski TP, Andreoli CM, Eliott D. Retinal detachment after open globe injury. Ophthalmology 2014;121:327–333.
• 22- Chiquet C, Zech JC, Gain P, et al. Visual outcome and prognostic factors after magnetic extraction of posterior segment foreign bodies in 40 cases. Br J Ophthalmol. 1998;82(7):801-806.
• 23- Chiquet C, Zech JC, Denis P, et al. Intraocular foreign bodies. Factors influencing final visual outcome. Acta Ophthalmol Scand. 1999 ;77(3):321-325.
• 24- Sternberg P Jr, de Juan E, Michels RG. Penetrating ocular injuries in young patients. Retina. 1984;4:5-8.
• 25- Pavlovic S, Schmidt KG, Tomic Z, et al. Management of intra-ocular foreign bodies impacting or embedded in the retina. Aust N Z J Ophthalmol. 1998;26(3):241-246.
• 26- Gopal L, Banker AS, Deb N, et al. Management of glass intraocular foreign bodies. Retina. 1998;18(3):213220.
• 27- Rofail M, Lee GA, O’Rourke P. Prognostic indicators for open globe injury. Clin Experiment Ophthalmol. 2006;34:783–786.
• 28- Rahman I, Maino A, Devadason D, et al. Open globe injuries: Factors predictive of poor outcome. Eye. 2006; 20: 1336–1341 29- Schmidt GW, Broman AT, Hindman HB, et al. Vision survival after open globe injury predicted by classification and regression tree anal ysis. Ophthalmology. 2008;115(1):202-209.
• 30- Soni NG, Bauza AM, Son JH, et al. Open globe ocular trauma: functional outcome of eyes with no light perception at initial presentation. Retina. 2013;33(2):380–386. 31- Cruvinel-Isaac DL, Ghanem VC, Nascimento MA, et al. Prognostic factors in open globe injuries. Ophthalmologica. 2003; 217: 431–435.
• 32- Kuhn F, Maisiak R, Mann L, et al. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am. 2002 Jun;15(2):163-165.
• 33- Farr AK, Hairston RJ, Humayun MU, et al. Open globe injuries in children: a retrospective analysis. J Pediatr Ophthalmol Strabismus. 2001;38:72-77.
• 34- MacEwen CJ, Baines PS, Desai P. Eye injuries in children: the current picture. Br J Ophthalmol. 1999;83:933936.
• 35- Rostomian K, Thach AB, Isfahani A, et al. Open globe injuries in children. JAAPOS.1998;2:234-238.