Annette K Hoskin1,2, Rebecca Low3,4, Parveen Sen5, Chitaranjan Mishra6, Tengku Ain Kamalden7, Fasika Woreta8, Mehul Shah9, Marian Pauly10, Andres Rousselot11, Gangadhara Sundar12, Sundaram Natarajan13, Lisa Keay14,15, Dinesh Visva Gunasekeran4, Stephanie L Watson1, Rupesh Agrawal16. 1. Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia. 2. Lions Eye Institute, The University of Western Australia, Perth, Australia. 3. Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Novena, 308433, Singapore. 4. School of Medicine, National University of Singapore, Kent Ridge, Singapore. 5. Sankara Nethralaya, Chennai, India. 6. Aravind Eye Hospital, Madurai, India. 7. UM Eye Research Centre, University of Malaya, Kuala Lumpur, Malaysia. 8. Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 9. Drashti Nethralaya Eye Hospital, Dahod, India. 10. Giridhar Eye Institute, Kochi, Kerala, India. 11. Consultorios Oftalmológicos Benisek Ascarza, Capital Federal, Buenos Aires, Argentina. 12. National University Hospital, Kent Ridge, Singapore. 13. Aditya Jyot Eye Hospital, Mumbai, India. 14. School of Optometry and Vision Science, UNSW, Sydney, Australia. 15. The George Institute for Global Health, UNSW, Sydney, Australia. 16. Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Novena, 308433, Singapore. Rupesh_agrawal@ttsh.com.sg.
Abstract
PURPOSE: To detail the methodology for a novel ocular trauma registry and utilize the registry to determine the demographics, nature of injury, and associations of severe visual loss for open globe injuries (OGI). METHODS: Thirteen hospitals in 7 countries used International Globe and Adnexal Trauma Epidemiology Study (IGATES) platform. Patients presenting between April 2009 and 2020 with OGI (with or without) adnexal involvement or intraocular foreign body (IOFB) were included. RESULTS: Analyses of presenting and final VA, using "severe vision loss" (VA ≤ 6/60) and "no severe loss" (VA > 6/60), were performed. Four hundred fifty-four (64%) patients had VA < 6/60 at presentation and 327 (44.8%) at final follow-up, with a highly significant association between presenting and final VA (p < 0.0001). From the cohort of 746 patients, 37 were missing VA at presentation and 16 at follow-up and complete clinical data was available for 354 patients. The male to female ratio is 6:1, and mean age 36.0 ± 20.0 years old. Relative afferent pupillary defect (RAPD), zone III injury, IOFB, and eyelid injury at presentation were recorded in 50 (6.7%), 55 (7.8%), 97 (13%), and 87 (11.7%) patients, respectively, and were significantly associated with VA < 6/60 at follow-up. Older age, ≥ 61 years, was associated with 3.39 times (95% CI: 1.95-5.89) higher risk than ≤20-year-old patients (p < 0.0001) and males 0.424 times (95% CI: 0.27-0.70) lower risk than female (p = 0.0001) of severe vision loss (SVL). CONCLUSION: In OGIs from 13 hospitals, female gender, older age, zone III injury, eyelid injury, and IOFB were associated with higher risk of visual outcome of SVL.
PURPOSE: To detail the methodology for a novel ocular trauma registry and utilize the registry to determine the demographics, nature of injury, and associations of severe visual loss for open globe injuries (OGI). METHODS: Thirteen hospitals in 7 countries used International Globe and Adnexal Trauma Epidemiology Study (IGATES) platform. Patients presenting between April 2009 and 2020 with OGI (with or without) adnexal involvement or intraocular foreign body (IOFB) were included. RESULTS: Analyses of presenting and final VA, using "severe vision loss" (VA ≤ 6/60) and "no severe loss" (VA > 6/60), were performed. Four hundred fifty-four (64%) patients had VA < 6/60 at presentation and 327 (44.8%) at final follow-up, with a highly significant association between presenting and final VA (p < 0.0001). From the cohort of 746 patients, 37 were missing VA at presentation and 16 at follow-up and complete clinical data was available for 354 patients. The male to female ratio is 6:1, and mean age 36.0 ± 20.0 years old. Relative afferent pupillary defect (RAPD), zone III injury, IOFB, and eyelid injury at presentation were recorded in 50 (6.7%), 55 (7.8%), 97 (13%), and 87 (11.7%) patients, respectively, and were significantly associated with VA < 6/60 at follow-up. Older age, ≥ 61 years, was associated with 3.39 times (95% CI: 1.95-5.89) higher risk than ≤20-year-old patients (p < 0.0001) and males 0.424 times (95% CI: 0.27-0.70) lower risk than female (p = 0.0001) of severe vision loss (SVL). CONCLUSION: In OGIs from 13 hospitals, female gender, older age, zone III injury, eyelid injury, and IOFB were associated with higher risk of visual outcome of SVL.
Entities:
Keywords:
Ocular trauma; Open globe injury; Prevention; Registry; Vision loss