Malek I, Sayadi J, Zerei N, Mekni M, El Amri K, Zgolli H, Chebbi A, Nacef L
Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
Service C d'ophtalmologie, Faculté de médecine de Tunis, Institut Hedi Rais d'ophtalmologie, Université Tunis El Manar, Tunis, Tunisia.
J Fr Ophtalmol. 2020 Sep;43(7):604-610. doi: 10.1016/j.jfo.2019.10.024. Epub 2020 Jul 4.
Childhood ocular trauma is a preventable cause of visual impairment and blindness worldwide. The purpose of our study was to determine demographic, etiologic, and clinical characteristics, visual outcome, and factors affecting visual prognosis in children with open globe injuries (OGI) and to analyze the predictive value of ocular trauma scoring systems for OGI in children.
We conducted a retrospective study enrolling 120 pediatric patients hospitalized for OGI from January 2010 to March 2017. Age, gender, date of trauma, time between trauma and presentation, place and circumstances of injury, etiology, visual acuity (VA), wound location and type of injury based on the Birmingham Eye Trauma Terminology, and the clinical signs were recorded. We recorded the number of surgical procedures performed, complications and visual outcomes.
The mean age was 7.38 years. In all, 62.5% of the patients were male, and 37.5% were female. The gender ratio was observed to decrease with increasing age. The mean time interval between injury and consultation was 22.80±42.68hours. Injuries usually occurred at home (80%) followed by playgrounds and sports venues (8.3%), the street (6.7%) and school (5%). All of the OGI's were accidental, and the main context was play (70%). The most common traumas were penetrating injury (60.8%) and metal (30%) objects. Penetrating trauma accounted for 68.3% of cases, followed by rupture (27.5%) and intraocular foreign body (IOFB) (7.5%). Initial VA was<1/10 in 59.2% of cases, and the point of entry was the cornea in 65.8% of cases. Final VA was<1/10 in 39.69% of all cases. FVA was significantly correlated with BCVA prior to the surgery, mechanism of the trauma, wound location and size, and other associated lesions. The Ocular Trauma Score (OTS) and the Pediatric Ocular Trauma Score (POTS) were significantly correlated with final VA.
OGI's in children occurs most frequently in school-age boys. Prognosis is determined by presenting visual acuity, trauma score, and wound severity and location.
儿童眼外伤是全球可预防的视力损害和失明的原因。我们研究的目的是确定开放性眼球损伤（OGI）患儿的人口统计学、病因学和临床特征、视力预后以及影响视力预后的因素，并分析儿童OGI眼外伤评分系统的预测价值。
我们进行了一项回顾性研究，纳入了2010年1月至2017年3月因OGI住院的120例儿科患者。记录年龄、性别、外伤日期、外伤与就诊之间的时间、受伤地点和情况、病因、视力（VA）、基于伯明翰眼外伤术语的伤口位置和损伤类型以及临床体征。我们记录了手术操作的次数、并发症和视力结果。
平均年龄为7.38岁。总体而言，62.5%的患者为男性，37.5%为女性。观察到性别比随年龄增长而降低。受伤与会诊之间的平均时间间隔为22.80±42.68小时。损伤通常发生在家中（80%），其次是操场和体育场馆（8.3%）、街道（6.7%）和学校（5%）。所有OGI均为意外事故，主要背景是玩耍（70%）。最常见的外伤是穿透伤（60.8%）和金属（30%）物体。穿透伤占病例的68.3%，其次是破裂（27.5%）和眼内异物（IOFB）（7.5%）。59.2%的病例初始视力<1/10，65.8%的病例伤口入口在角膜。所有病例中39.69%的最终视力<1/10。最终视力与术前最佳矫正视力、外伤机制、伤口位置和大小以及其他相关病变显著相关。眼外伤评分（OTS）和儿童眼外伤评分（POTS）与最终视力显著相关。
儿童OGI最常发生在学龄男孩中。预后由就诊时的视力、外伤评分以及伤口严重程度和位置决定。
