Lima-Gómez Virgilio, Blanco-Hernández Dulce Milagros Razo
División de Investigación, Hospital Juárez de México, Secretaría de Salud, México, D.F., Mexico.
Cir Cir. 2010 Jul-Aug;78(4):302-9.
Ocular trauma (OT) is a common cause of monocular blindness and visual impairment worldwide. The Ocular Trauma Score (OTS) is a scale that estimates visual function that an injured eye can achieve 6 months after OT. In a sample population, the OTS may be useful to compare the expected functional result with the result of therapeutic interventions in OT. We undertook this study to identify the expected effect of treatment on the rate of visual deficiency 6 months after OT.
The rate of eyes with trauma-related visual deficiency (best corrected visual acuity <20/40) at the time of diagnosis was compared with that estimated 6 months later using the OTS (95% confidence intervals, CI).
We evaluated 742 patients; 46% had visual deficiency initially (95% CI 43-50.2) and 32.1% would demonstrate it 6 months later (95% CI 28.7-35.4, p <0.001, OR 0.54). The rate changed from 29.1 to 18% in closed-globe (CG) trauma and from 84.3 to 63% in open-globe (OG) trauma.
Treating OT would reduce the proportion of visual deficiency by 14.5 percentage points (11 in CG, 21.3 in OG trauma). Up to 66% of the injured eyes could reach normal vision. OT prevention requires enhancement because a high rate of eyes would remain disabled despite receiving the best available treatment.
眼外伤（OT）是全球单眼失明和视力损害的常见原因。眼外伤评分（OTS）是一种评估眼外伤后6个月受伤眼睛可达到的视觉功能的量表。在一个样本群体中，OTS可能有助于将预期功能结果与眼外伤治疗干预结果进行比较。我们进行这项研究以确定治疗对眼外伤后6个月视力缺陷发生率的预期效果。
将诊断时与外伤相关的视力缺陷（最佳矫正视力<20/40）的眼的发生率与6个月后使用OTS估计的发生率进行比较（95%置信区间，CI）。
我们评估了742例患者；最初有46%的患者存在视力缺陷（95%CI 43-50.2），6个月后有32.1%的患者会出现视力缺陷（95%CI 28.7-35.4，p<0.001，OR 0.54）。闭合眼球（CG）外伤的发生率从29.1%变为18%，开放眼球（OG）外伤的发生率从84.3%变为63%。
治疗眼外伤可使视力缺陷比例降低14.5个百分点（CG外伤降低11个百分点，OG外伤降低21.3个百分点）。高达66%的受伤眼睛可达到正常视力。由于尽管接受了最佳治疗仍有很高比例的眼睛会致残，因此需要加强眼外伤预防。
