Saurav M Shrestha1,2, Casey L Anthony3, Grant A Justin4,5, Madhu Thapa6, Jyoti B Shrestha6, Anadi Khatri7,8, Annette K Hoskin9,10, Rupesh Agrawal11,12,13. 1. B.P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. saurav.stha1025@gmail.com. 2. Department of Vitreoretina, Mechi Eye Hospital, Birtamode, Nepal. saurav.stha1025@gmail.com. 3. School of Medicine, Emory University, Atlanta, GA, USA. 4. Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA. 5. Department of Surgery, Uniformed Services University of the Health Science, Bethesda, MD, USA. 6. B.P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. 7. Department of Vitreoretinal services, Birat Eye Hospital, Biratnagar, Nepal. 8. Department of Ophthalmology, Birat Medical College and Teaching Hospital, Biratngar, Nepal. 9. Save Sight Institute, University of Sydney, Sydney, Australia. 10. Lions Eye Institute, University of Western Australia, Perth, Australia. 11. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore. 12. Singapore Eye Research Institute, Singapore, Singapore. 13. Moorfields Eye Hospital, NHS Foundation Trust, London, UK.
Abstract
BACKGROUND: Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. METHODS: Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. RESULTS: Seventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was < 6 hours (30 patients, 41 %). Thirty-seven eyes (51 %) had zone I trauma, followed by twenty eyes (27 %) with zone II, and sixteen eyes (22 %) with zone III trauma. Sixty-five patients (90 %) were managed surgically, and fifty (68 %) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60 % of the eyes with OGI of various zones. CONCLUSIONS: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.
BACKGROUND:Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. METHODS:Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. RESULTS: Seventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was < 6 hours (30 patients, 41 %). Thirty-seven eyes (51 %) had zone I trauma, followed by twenty eyes (27 %) with zone II, and sixteen eyes (22 %) with zone III trauma. Sixty-five patients (90 %) were managed surgically, and fifty (68 %) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60 % of the eyes with OGI of various zones. CONCLUSIONS: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.
Authors: L B Brilliant; R P Pokhrel; N C Grasset; J M Lepkowski; A Kolstad; W Hawks; R Pararajasegaram; G E Brilliant; S Gilbert; S R Shrestha Journal: Bull World Health Organ Date: 1985 Impact factor: 9.408