The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children

Su Jin Park; Byeong Jae Son

doi:10.3341/jkos.2018.59.11.1062

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Park and Son: The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(11): 1062-1070.

Published online: 16 November 2018

DOI: https://doi.org/10.3341/jkos.2018.59.11.1062

The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children

Su Jin Park, MD^1,², Byeong Jae Son, ^1,²

¹Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea.

²Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea.

Address reprint requests to Byeong Jae Son, MD. Department of Ophthalmology, Kyungpook National University Hospital, #130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-200-5806, Fax: 82-53-426-6552, supersbj@daum.net

Received 21 June 2018 Revised 7 August 2018 Accepted 21 October 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We evaluated the prognostic factors of open globe injuries in children and adolescents, and compared the ocular trauma score (OTS) and pediatric penetrating ocular trauma score (POTS).

Methods

We performed a retrospective review of 77 children under 18 years of age who visited our clinic with open globe injuries between May 1993 and April 2014. We investigated the factors that may affect final visual acuity. We also compared the OTS and POTS using receiver operating characteristic curves as a method to predict final visual acuity.

Results

By univariate analysis, an initial visual acuity less than 20/200, globe rupture, wound size greater than 7.0 mm, retinal detachment, lens dislocation, and total number of operations contributed to worse visual outcomes (<20/200). Conversely, central corneal involvement, traumatic cataract, wound size less than 7.0 mm, and initial visual acuity greater than 20/200 were better prognostic indicators (≥20/32). Both OTS and POTS had diagnostic value as a predictor of final visual acuity, although there were no statistically significant differences between the two scoring systems.

Conclusions

Initial visual acuity and wound size are important prognostic factors for the final visual acuity in children and adolescent, following open globe injuries. Both OTS and POTS are reliable prognostic models for open globe injuries in children and adolescents.

Keywords: Ocular trauma score, Open globe injury, Pediatric penetrating ocular trauma score

Figures and Tables

Figure 1

ROC curve analysis for predicting poor vision outcome. ROC curves of OTS (AUC = 0.912) and POTS (AUC = 0.807) for predicting poor vision outcome (final visual acuity < 20/200) in the patients (OTS, POTS: p < 0.001). ROC = receiver operating characteristic; OTS = ocular trauma score; AUC = area under the curve; POTS = pediatric penetrating ocular trauma score.

Figure 2

ROC curve analysis for predicting good vision outcome. ROC curves of OTS (AUC = 0.771) and POTS (AUC = 0.701) for predicting good vision outcome (final visual acuity ≥ 20/32) in the patients (OTS, POTS: p < 0.001). OTS = ocular trauma score; POTS = pediatric penetrating ocular trauma score; ROC = receiver operating characteristic; AUC = area under the curve.

Table 1

OTS variables and scoring

Values are presented as number.

OTS = ocular trauma score; NLP = no light perception; LP = light perception; HM = hand motion.

Table 2

POTS variables and scoring

Values are presented as number.

POTS = pediatric penetrating ocular trauma score; NLP = no light perception; LP = light perception; HM = hand motion.

Table 3

Characteristics of the patients at baseline

Values are presented as mean ± standard deviation (range) or number (%).

Table 4

The injury types

Values are presented as number (%).

Table 5

Initial and final visual acuity

Values are presented as number (%).

NLP = no light perception; LP = light perception; HM = hand motion.

Table 6

Final visual acuity outcomes based on OTS and POTS

Values are presented as number. Jonckheere-Terpastra test: OTS (4.531, p < 0.001), POTS (3.275, p < 0.001).

OTS = ocular trauma score; POTS = pediatric penetrating ocular trauma score; NLP = no light perception; LP = light perception; HM = hand motion.

Table 7

Univariate analysis of potential predictive factors for poor and good visual outcome

Values are presented as mean ± standard deviation or number (%).

CI = confidence interval; VA = visual acuity; OTS = ocular trauma score; POTS = pediatric penetrating ocular trauma score.

^*Fisher's exact test; ^†Chi-square test; ^‡t-test.

Acknowledgement

This work was supported by Biomedical Research Institute grant, Kyungpook National University Hospital (2015).

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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