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土耳其某三级转诊中心开放性眼外伤的病因和视觉预后结果。

Etiology and Visual Prognosis in Open Globe Injuries: Results of A Tertiary Referral Center in Turkey.

机构信息

Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey.

出版信息

Sci Rep. 2019 Nov 29;9(1):17977. doi: 10.1038/s41598-019-54598-w.

Abstract

We aimed to analyse the clinical characteristics of OGI and evaluate the correlation between baseline ocular trauma score (OTS) and visual outcomes in cases with OGI. The charts of 257 OGI patients who had at least six months of follow-up were reviewed retrospectively. Demographics, data about the etiology, localization and size of the OGI, baseline and final best-corrected visual acuity (BCVA) were noted. At the time of approval OTS was calculated and compared with final BCVA. All analysis was performed in both entire study population and our pediatric subgroup. A total of 261 eyes of 257 patients with a mean age of 34.9 ± 19.8 years were enrolled. Globe injury with a mean size of 6.7 ± 4.5 mm was within zone I in 46.7% of the eyes. Older age (p < 0.001, OR = 1.029, 95% CI = 1.015-1.043), higher baseline logMAR BCVA scores (p < 0.001, OR = 4.460, 95% CI = 2.815-7.065), bigger wound size (p < 0.001, OR = 1.159, 95% CI = 1.084-1.240), relative afferent pupillary defect (RAPD) positiveness (p < 0.001, OR = 0.021 95% CI = 0.005-0.087), lower OTS (p < 0.001, OR = 27.034, 95% CI = 6.299-116.021), presence of concomitant retinal detachment (p < 0.001, OR = 0.157, 95% CI = 0.080-0.306), and endophthalmitis (p = 0.045, OR = 0.207, 95% CI = 0.044-0.962) were found to be related to poor visual prognosis. Cases with OGI caused by a sharp object (p = 0.007, OR = 0.204, 95% CI = 0.065-0.641) and those injured by a glass (p = 0.039, OR = 0.229, 95% CI = 0.056-0.931) had more favorable final vision. This study highlights that baseline BCVA, wound size, RAPD, retinal detachment, and OTS were the most significant markers for poor visual outcomes in both the entire population and pediatric subgroup. In cases with OGI, OTS was also found effective in predicting visual prognosis.

摘要

我们旨在分析 OGI 的临床特征,并评估基线眼外伤评分(OTS)与 OGI 病例视力结果之间的相关性。回顾性分析了 257 例至少随访 6 个月的 OGI 患者的图表。记录了人口统计学数据、病因、OGI 的定位和大小、基线和最终最佳矫正视力(BCVA)。在获得批准时计算了 OTS 并与最终 BCVA 进行了比较。所有分析均在整个研究人群和我们的儿科亚组中进行。共纳入 257 例患者的 261 只眼,平均年龄为 34.9±19.8 岁。球内损伤的平均大小为 6.7±4.5mm,在 46.7%的眼中位于 I 区。年龄较大(p<0.001,OR=1.029,95%CI=1.015-1.043)、基线 logMAR BCVA 评分较高(p<0.001,OR=4.460,95%CI=2.815-7.065)、伤口较大(p<0.001,OR=1.159,95%CI=1.084-1.240)、相对传入性瞳孔缺陷(RAPD)阳性(p<0.001,OR=0.021,95%CI=0.005-0.087)、OTS 较低(p<0.001,OR=27.034,95%CI=6.299-116.021)、伴有视网膜脱离(p<0.001,OR=0.157,95%CI=0.080-0.306)和眼内炎(p=0.045,OR=0.207,95%CI=0.044-0.962)与视力预后不良有关。由锐器(p=0.007,OR=0.204,95%CI=0.065-0.641)和玻璃(p=0.039,OR=0.229,95%CI=0.056-0.931)引起的 OGI 病例的最终视力更好。本研究强调,在整个人群和儿科亚组中,基线 BCVA、伤口大小、RAPD、视网膜脱离和 OTS 是视力预后不良的最重要标志物。在 OGI 病例中,OTS 也被发现可有效预测视力预后。

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