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日本开放性眼球损伤的临床特征与预后

Clinical characteristics and outcomes of open globe injuries in Japan.

作者信息

Okamoto Yoshifumi, Morikawa Shohei, Okamoto Fumiki, Inomoto Naoki, Ishikawa Hiroto, Ueda Tetsuo, Sakamoto Taiji, Sugitani Kazuhiko, Oshika Tetsuro

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.

Department of Ophthalmology, Mito Kyodo General Hospital, Mito, Ibaraki, Japan.

出版信息

Jpn J Ophthalmol. 2019 Jan;63(1):109-118. doi: 10.1007/s10384-018-0638-x. Epub 2018 Nov 8.

Abstract

PURPOSE

To describe the epidemiology and clinical outcomes of open globe injuries (OGIs) in Japan over 10 years, and examine preoperative factors influencing the visual prognosis after surgery.

STUDY DESIGN

Retrospective, observational, multicenter case-series study.

METHODS

Patients' data were entered into a computerized database for review and statistical analyses. The following parameters were assessed; age, gender, initial and final visual acuity, duration between onset and surgery, presence of lens in the eye, characteristics of injury, presence of ocular complications, and number of surgeries.

RESULTS

The records of 374 eyes with OGI were enrolled. The average age of the patients was 56.8 ± 22.1 years, and the majority of patients were men (73.5%). Compared to the overall cohort, work-related OGI was the most common, associated with significantly better final visual acuity, whereas patients with fall-down OGI showed significantly worse final visual acuity (P < 0.05). Among the types of injury, both the initial and final visual acuity were significantly worse in the rupture group than in the laceration group. Multiple liner regression analyses revealed that the final visual acuity was significantly associated with initial visual acuity, type of injury (rupture), retinal detachment, and proliferative vitreoretinopathy.

CONCLUSION

To predict the visual outcome in patients with OGI, ophthalmologists need to pay attention not only to the initial visual acuity but also to initial ocular conditions, such as the presence of ocular complications.

摘要

目的

描述日本10年间开放性眼球损伤(OGI)的流行病学情况及临床结局,并探讨影响术后视力预后的术前因素。

研究设计

回顾性、观察性、多中心病例系列研究。

方法

将患者数据录入计算机数据库进行回顾和统计分析。评估以下参数:年龄、性别、初始和最终视力、受伤至手术的时间、眼内晶状体情况、损伤特征、眼部并发症情况以及手术次数。

结果

纳入374例OGI患者的眼部记录。患者平均年龄为56.8±22.1岁,大多数患者为男性(73.5%)。与总体队列相比,工作相关的OGI最为常见,其最终视力明显更好,而跌倒所致OGI患者的最终视力明显更差(P<0.05)。在损伤类型中,破裂组的初始和最终视力均明显低于撕裂伤组。多元线性回归分析显示,最终视力与初始视力、损伤类型(破裂)、视网膜脱离和增殖性玻璃体视网膜病变显著相关。

结论

为预测OGI患者的视力结局,眼科医生不仅要关注初始视力,还需关注初始眼部情况,如眼部并发症的存在。

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