比较眼外伤评分和小儿眼外伤评分作为两种小儿开放性眼球损伤的预后模型。

Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries.

机构信息

Department of Ophthalmology, University Clinical Centre Maribor, Slovenia.

Department of Ophthalmology, Faculty of Medicine, University of Maribor, Slovenia.

出版信息

Klin Monbl Augenheilkd. 2021 Jan;238(1):67-72. doi: 10.1055/a-1194-5104. Epub 2020 Oct 9.

DOI:10.1055/a-1194-5104

PMID:33036059

Abstract

AIM

To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years.

PATIENTS AND METHODS

A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated.

RESULTS

Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 - 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models.

CONCLUSION

Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.

摘要

目的

比较 19 年间儿童开放性眼球损伤后视觉预后的眼外伤评分（OTS）和儿科眼外伤评分（POTS）两种评分系统。

方法

对 2000 年 1 月至 2019 年 1 月间收治的 36 例 18 岁以下开放性眼球损伤患儿的 36 例患者进行回顾性研究，分别计算 OTS 和 POTS 评分。

结果

两种模型在 1 至 4 类患者之间存在显著差异。使用 OTS 模型，有三分之一的患者处于 1 类和 2 类，而使用 POTS 模型的患者接近 60%。使用 OTS 模型，有近 60%的患者处于 3 类和 4 类，而使用 POTS 模型的患者为 30.6%。在 5 类中，两种模型之间没有差异。比较 OTS 和 POTS 模型在每个类别中最终视力百分比的分布，发现 1 类中最终视力为 20/40 或以上（25%对 50%）以及最终视力为 20/20（0%对 30%）的差异有统计学意义。在 2 类中，两种模型之间 20/40 或以上的最终视力无显著差异，但 OTS 模型的最终视力为 20/20-12.5%，而 POTS 模型的最终视力为 45.5%。在 3 类中，两种模型之间存在显著差异。使用 OTS 模型，60%以上患者的最终视力为 20/40 或以上，而 POTS 模型为 100%；使用 OTS 模型，36.3%患者的最终视力为 20/20，而 POTS 模型为 50%。在 4 类和 5 类中，OTS 和 POTS 模型之间没有差异。

结论

我们的研究并未证实 POTS 的优势。OTS 分类中病例的分布显示两种模型之间存在显著差异，POTS 组的病例分布在较低的分类中较多。在 POTS 组中，前三个类别与 OTS 组相比，最终视力的预后明显更好，这可能是因为 POTS 评分的计算较低。在我们看来，OTS 模型更易于使用，具有更高的预后准确性，应进一步用于儿科病例的咨询。