Journal article
The Ocular Trauma Score Underestimates Visual Recovery for the Most Severe Open Globe Injuries
Ophthalmology retina, Vol.7(7), pp.612-619
07/2023
DOI: 10.1016/j.oret.2023.01.021
PMID: 36746350
Abstract
To compare visual outcomes after open globe injury (OGI) to those predicted by the Ocular Trauma Score (OTS), and to investigate the effect of treatment with pars plana vitrectomy (PPV) DESIGN: Retrospective cohort study SUBJECTS: Patients presenting with OGI to an academic U.S. ophthalmology department from 2017 to 2020 METHODS: Best-corrected visual acuity (VA) measurements at the most recent follow-up were compared to final VA predicted by the OTS, based on pre-operative injury characteristics. The most recently measured VA of patients treated with PPV during initial OGI repair (Primary PPV group) were compared to patients treated with PPV after initial OGI repair (Secondary PPV group) and patients never treated with PPV (No PPV group).
Best-corrected visual acuity (VA) in the injured eye at last follow-up; secondary outcome measures included the occurrence of VH at any time, occurrence of RD at any time, rates of additional surgery, and rates of enucleation.
One-hundred thirty-three subjects with OGI were identified and analyzed. The overall rate of PPV was 32%. Predictors of worse VA at last follow-up included older age (P=0.047) and worse presenting VA (P<0.001). VA outcomes for eyes in OTS Categories 2-5 did not significantly differ from OTS predictions. However, eyes in OTS Category 1 had a higher likelihood of last follow-up VA of light perception to hand motion (46% in the study cohort vs. 15% predicted by the OTS, P=0.004) and lower likelihood of no light perception (33% vs 74%, P<0.001). The Secondary PPV group had the worst VA at presentation among the three groups (P=0.016), but VA at last follow-up did not significantly differ between the study groups (P=0.338).
The most severe OGIs (i.e., OTS Category 1) had better visual outcomes than predicted by the published OTS expectations, and secondary PPV was associated with significant visual improvement despite poor prognostic predictions. Evaluation by a vitreoretinal surgeon should be considered for all patients with severe OGI, especially those in OTS Category 1.
Details
- Title: Subtitle
- The Ocular Trauma Score Underestimates Visual Recovery for the Most Severe Open Globe Injuries
- Creators
- Eli A Perez - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, PFP 11196-J, Iowa City, IA 52242, USADavid A Ramirez - University of IowaJared D Peterson - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, PFP 11196-J, Iowa City, IA 52242, USAElaine M Binkley - University of IowaH Culver Boldt - University of IowaKaren M Gehrs - University of IowaIan C Han - University of IowaStephen R Russell - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, PFP 11196-J, Iowa City, IA 52242, USAElliott H Sohn - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, PFP 11196-J, Iowa City, IA 52242, USAScott A Larson - University of IowaJonathan F Russell - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, PFP 11196-J, Iowa City, IA 52242, USA. Electronic address: jonathan-russell@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Ophthalmology retina, Vol.7(7), pp.612-619
- DOI
- 10.1016/j.oret.2023.01.021
- PMID
- 36746350
- eISSN
- 2468-6530
- Grant note
- DOI: 10.13039/100008893, name: University of Iowa
- Language
- English
- Electronic publication date
- 02/04/2023
- Date published
- 07/2023
- Academic Unit
- Fraternal Order of Eagles Diabetes Research Center; Ophthalmology and Visual Sciences
- Record Identifier
- 9984365060102771
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