Morikawa Shohei, Okamoto Yoshifumi, Okamoto Fumiki, Inomoto Naoki, Ishikawa Hiroto, Harimoto Kozo, Ueda Tetsuo, Sakamoto Taiji, Oshika Tetsuro
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Graefes Arch Clin Exp Ophthalmol. 2018 Jul;256(7):1347-1352. doi: 10.1007/s00417-018-3959-z. Epub 2018 Mar 15.
To investigate the clinical characteristics and visual outcomes in patients with fall-related open globe injuries and to evaluate differences between fall-related and non-fall-related open globe injuries in Japan.
A retrospective review of patients with open globe injury who presented to Japan-Clinical Research of Study (J-CREST) hospitals between 2005 and 2015 was enrolled. Clinical information including age, sex, initial visual acuity, final visual acuity, type of injury, status of the crystalline lens, zone of injury, wound length, presence of retinal detachment, proliferative vitreoretinopathy, expulsive hemorrhage, and endophthalmitis was recorded.
A total of 374 eyes were enrolled, of which 120 (32.1%) suffered from fall-related injury with average age of 73.7 ± 15.9 years (range, 11-101 years). A majority of patients were female (55.8%). Of 120 patients with fall-related injury, 109 (90.8%) presented with rupture and 11 (9.2%) with laceration. A multiple regression analysis revealed that final visual acuity was significantly associated with initial visual acuity (r = 0.99, P < 0.001). Compared to non-fall-related open globe injuries, fall-related open globe injuries were associated with elderly age, female sex, poorer initial and final visual acuity, rupture, absence of the lens, larger wound size, retinal detachment, expulsive hemorrhage, and absence of endophthalmitis (P < 0.01).
Fall-related open globe injuries were more frequent in elderly female and accompanied by larger wound lengths and severer ocular complications. Visual outcomes in patients with fall-related open globe injuries were related to initial visual acuity.
探讨跌倒相关开放性眼球损伤患者的临床特征和视觉预后，并评估日本跌倒相关与非跌倒相关开放性眼球损伤之间的差异。
对2005年至2015年间在日本临床研究（J-CREST）医院就诊的开放性眼球损伤患者进行回顾性研究。记录临床信息，包括年龄、性别、初始视力、最终视力、损伤类型、晶状体状态、损伤区域、伤口长度、视网膜脱离情况、增殖性玻璃体视网膜病变、驱逐性出血和眼内炎。
共纳入374只眼，其中120只（32.1%）为跌倒相关损伤，平均年龄为73.7±15.9岁（范围11 - 101岁）。大多数患者为女性（55.8%）。在120例跌倒相关损伤患者中，109例（90.8%）为破裂伤，11例（9.2%）为撕裂伤。多元回归分析显示，最终视力与初始视力显著相关（r = 0.99，P < 0.001）。与非跌倒相关开放性眼球损伤相比，跌倒相关开放性眼球损伤与老年、女性、初始和最终视力较差、破裂伤、晶状体缺失、伤口较大、视网膜脱离、驱逐性出血和无眼内炎相关（P < 0.01）。
跌倒相关开放性眼球损伤在老年女性中更为常见，且伴有较大的伤口长度和更严重的眼部并发症。跌倒相关开放性眼球损伤患者的视觉预后与初始视力有关。
