Travis Bales1, Tyler Ogden1, Harpal S Sandhu2,3. 1. University of Louisville School of Medicine (Graduated Student), 301 E. Muhammad Ali Blvd, Louisville, KY, 40202, USA. 2. University of Louisville School of Medicine (Graduated Student), 301 E. Muhammad Ali Blvd, Louisville, KY, 40202, USA. harpal.sandhu@louisville.edu. 3. Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, 40202, USA. harpal.sandhu@louisville.edu.
Abstract
PURPOSE: Retinal detachment (RD) is a vision-threatening complication of open globe injuries (OGI). This study sought to assess clinical, radiographic, and intraoperative risk factors for RD after OGI. A secondary goal was to test the retinal detachment after open globe injury (RD-OGI) score. METHODS: Records of patients undergoing OGI repair at a single trauma center over 3 years were reviewed using a retrospective case series design. Eyes that were enucleated or lost to follow up within 30 days of OGI without evidence of RD were excluded. Potential risk factors for RD development were assessed by logistic regression or chi-square tests were appropriate and were entered into a multivariate logistic regression if significant on univariate analysis. Risk of RD for each eye was categorized by its RD-OGI score. RESULTS: Seventy-three eyes (72 patients) were included. In univariate analysis, afferent pupillary defect, worse visual acuity, posterior injury, vitreous hemorrhage, and posterior segment volume loss (PSVL) on CT were strong predictors of RD. In multivariate analysis, only PSVL on CT (adjusted OR 10.8, P = 0.025) maintained a statistically significant association with RD risk. At 1 year, 5% of low-risk eyes, 20% of moderate-risk eyes, and 67% of high-risk eyes developed RD. These rates were not significantly different from the RD-OGI derivation or validation cohorts (P = 0.90 and P = 0.67, respectively). CONCLUSION: PSVL on CT increases the risk of RD after OGI. The RD-OGI Score was a good prognostic tool for assessing RD risk after OGI in this population.
PURPOSE:Retinal detachment (RD) is a vision-threatening complication of open globe injuries (OGI). This study sought to assess clinical, radiographic, and intraoperative risk factors for RD after OGI. A secondary goal was to test the retinal detachment after open globe injury (RD-OGI) score. METHODS: Records of patients undergoing OGI repair at a single trauma center over 3 years were reviewed using a retrospective case series design. Eyes that were enucleated or lost to follow up within 30 days of OGI without evidence of RD were excluded. Potential risk factors for RD development were assessed by logistic regression or chi-square tests were appropriate and were entered into a multivariate logistic regression if significant on univariate analysis. Risk of RD for each eye was categorized by its RD-OGI score. RESULTS: Seventy-three eyes (72 patients) were included. In univariate analysis, afferent pupillary defect, worse visual acuity, posterior injury, vitreous hemorrhage, and posterior segment volume loss (PSVL) on CT were strong predictors of RD. In multivariate analysis, only PSVL on CT (adjusted OR 10.8, P = 0.025) maintained a statistically significant association with RD risk. At 1 year, 5% of low-risk eyes, 20% of moderate-risk eyes, and 67% of high-risk eyes developed RD. These rates were not significantly different from the RD-OGI derivation or validation cohorts (P = 0.90 and P = 0.67, respectively). CONCLUSION: PSVL on CT increases the risk of RD after OGI. The RD-OGI Score was a good prognostic tool for assessing RD risk after OGI in this population.
Entities:
Keywords:
Open globe; Orbital CT; Traumatic retinal detachment
Authors: Sebastian P Lesniak; Alain Bauza; Jung H Son; Marco A Zarbin; Paul Langer; Suquin Guo; Rudolph S Wagner; Neelakshi Bhagat Journal: J Pediatr Ophthalmol Strabismus Date: 2011-07-19 Impact factor: 1.402
Authors: Ferenc Kuhn; Richard Maisiak; LoRetta Mann; Viktória Mester; Robert Morris; C Douglas Witherspoon Journal: Ophthalmol Clin North Am Date: 2002-06