Prognostic Factors For Open Globe Injuries And Correlation Of Ocular Trauma Score In 298 Inpatients

Objective To investigate prognostic factors that influence the final visual acuity(VA)and to correlate the ocular trauma score(OTS)with the final VA in open globe injuries(OGIs).Methods 1.A consecutive selection review of 298(314 eyes)OGIs admitted to Tianjin Medical University General Hospital was carried out from January 1,2010,till December 31,2014.The clinical data including gender,age,occupation,eye involved,presentation interval and injury time,duration of hospitalization,cause and place of injury,type of injury,initial visual acuity(VA),zone of injury,clinical signs,follow-up data,management and final VA were retrospectively analyzed.2.A final VA<0.1 was considered as poor outcome and ≥0.1 as good outcome.3.Type of injury,initial VA,zone of injury,symptoms of eye injuries were analyzed for risk predictors with univariate analysis and multivariate logistic regression analysis.4.In 314 injured eyes,certain numerical value rendered to the OTS variables at presentation were converted into OTS categories.The likelihood of the final VAs in the OTS categories were calculated.The correlation between OTS and the final VA were examined by rank correlation.Results 1.The ratio of male to female was 5:1.High-risk age group was the young age group(30-40 years old).Mean age of males(43.09±17.44 years)was significantly lower than that of females(54.67±24.34 years)(t=3.939,P=0.001).2.According to univariate analysis results,the following parameters were risk factors of visual outcome: initial VA(P=0.000),zone of injury(P=0.000),relative afferent pupillary defect(RAPD)(P=0.002),retinal detachment(RD)(P=0.002),vitreous hemorrhage(P=0.000),hyphema(P=0.000),lens injury(P=0.000),endophthalmitis(P=0.014).3.However,multivariate logistic regression analyses revealed that initial VA(P=0.000,OR=8.329,95%CI=3.310-20.959),RAPD(P=0.023,OR=4.788,95%CI=1.241-18.478),zone of injury(P=0.000,OR=2.709,95%CI=1.577-4.653)were the most risk factors for final visual outcome.4.The final VA was 0.5 in the OTS-1 in 0 eye,and also the final VA was NLP in the OTS 5 in 0 eye.The OTS correlated with final VA(r=0.998,P=0.000).Conclusion 1.Initial VA,zone of injury and RAPD are the most significant prognostic factors for visual outcome in open globe injuries.2.The OTS was of great importance for patients and ophthalmologists.