机械性眼外伤的临床特征及眼外伤评分的应用

Mao Chun-jie, Yan Hua

Department of Ophthalmology, General Hospital, Tianjin Medical University, Tianjin 300052, China.

Zhonghua Yan Ke Za Zhi. 2012 May;48(5):432-5.

OBJECTIVE

To summarize clinical characteristics of mechanical ocular injury and to analyze the role of ocular trauma score (OTS) in the estimation of final visual acuity.

METHODS

All cases of ocular trauma admitted to the Department of Ophthalmology from January 2009 to December 2010 were retrospectively reviewed. Data extracted included laterality of the injured eye, gender, age, presenting time, cause, ocular trauma classification, initial and final visual acuity. These injuries were classified by ocular trauma classification system (OTCS). We also used the OTS in evaluating the final visual outcome. Comparisons between groups for discontinuous variables were analyzed using rank-sum test. Rank correlation was used in analysis between initial visual acuity and final visual acuity or between final visual acuity and OTS. Chi-square test was used to analyze variables, such as age, cause, type and visual acuity. Comparison of ages between male and female was analyzed by using t-test.

RESULTS

Of the 168 eyes, there were 106 open globe injury (OGI) and 62 closed globe injury (CGI). There were 140 males (85.71%) and 22 females (14.29%). Presenting time median of OGI and CGI was 5 h and 10 h respectively, and there was significant difference between these two different injuries (Z = -2.547, P = 0.011). The high-risk age group was the young age group (100 eyes, 59.52%), vs. the middle age group (46 eyes, 27.38%) and the elder age group (22 eyes, 13.10%). Occupation-related injury (70 eyes) was the most common cause and mainly resulted in OGI (54/70). Initial and final visual acuities in CGI were better than those of OGI (χ(2) = 37.847, P = 0.000; χ(2) = 44.428, P = 0.000). Initial visual acuity was correlated with final visual acuity (r = 0.858, P = 0.000). Final visual acuity was significantly correlated with total score (r = 0.870, P = 0.000) and OTS (r = 0.869, P = 0.000).

CONCLUSIONS

In this group of mechanical ocular trauma patients, male is more common than the female. Main type of injury is OGI and presenting time of OGI is earlier than that of CGI. The high-risk age group is the young. Main cause of injury is occupation-related injury. Initial and final visual acuities in CGI are better than those in OGI. OTS calculated at initial examination may be a useful parameter for the estimation of prognosis.

目的

总结机械性眼外伤的临床特征，并分析眼外伤评分（OTS）在预估最终视力方面的作用。

方法

回顾性分析2009年1月至2010年12月眼科收治的所有眼外伤病例。提取的数据包括患眼侧别、性别、年龄、就诊时间、病因、眼外伤分类、初始视力和最终视力。这些损伤采用眼外伤分类系统（OTCS）进行分类。我们还使用OTS评估最终视觉结果。对于不连续变量，采用秩和检验分析组间差异。初始视力与最终视力之间或最终视力与OTS之间的分析采用秩相关。采用卡方检验分析年龄、病因、类型和视力等变量。采用t检验分析男性和女性之间的年龄差异。

结果

168只眼中，开放性眼球损伤（OGI）106只，闭合性眼球损伤（CGI）62只。男性140例（85.71%），女性22例（14.29%）。OGI和CGI的就诊时间中位数分别为5小时和10小时，这两种不同损伤之间存在显著差异（Z = -2.547，P = 0.011）。高危年龄组为青年组（100只眼，59.52%），中年组（46只眼，27.38%）和老年组（22只眼，13.10%）。职业相关损伤（70只眼）是最常见的病因，主要导致OGI（54/70）。CGI的初始视力和最终视力均优于OGI（χ(2) = 37.847，P = 0.000；χ(2) = 44.428，P = 0.000）。初始视力与最终视力相关（r = 0.858，P = 0.000）。最终视力与总分（r = 0.870，P = 0.000）和OTS（r = 0.869，P = 0.000）显著相关。