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669例眼内异物患者视觉预后的临床特征及预后因素

Clinical characteristics and prognostic factors for visual outcome in 669 patients with intraocular foreign bodies.

作者信息

Gao Yu-Zhu, Zhang Yi-Fan, Zhang Ming, Xu Han-Yue, Jin Xu-Rui

机构信息

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.

Duke Global Health Research Institute, 310 Trent Drive, Durham, NC 27710, Box 905119, Durham, NC 27708, USA.

出版信息

Int J Ophthalmol. 2021 May 18;14(5):759-765. doi: 10.18240/ijo.2021.05.18. eCollection 2021.

Abstract

AIM

To describe the clinical characteristics and analyze prognostic factors that influence visual outcome in 669 patients with intraocular foreign bodies (IOFBs).

METHODS

Medical records of 669 patients with IOFBs from West China Hospital were reviewed. Best corrected visual acuity (BCVA) values were recorded using standard Snellen acuity chart and were converted to logarithm of the minimum angle of resolution (logMAR) scale for statistical analysis. The visual outcome was defined by the final BCVA (excellent visual outcome: final BCVA of 20/40 or better; poor visual outcome: final BCVA less than 20/200). Statistical analysis of collected data was performed using IBM SPSS Statistics version 23. A 2-tailed value of less than 0.05 was considered statistically significant throughout the study.

RESULTS

The average age ranged from 1 to 79 years old (mean age, 34.8±12.7 SD) and the majority of patients were men (626, 93.6%). The major cause of ocular injury was hammering (383, 57.2%). Almost all the patients (97.8%) underwent surgeries (97.8%) and the average time interval between injury and surgery was 26.4±322.3d (0-7300), while 327 patients received surgeries within 24h (48.9%) and 590 patients received surgeries within seven days (88.2%) after IOFBs injury. The poor BCVA was associated with older age (=0.013), larger IOFBs size (<0.001), presence of complications (<0.001) and worse presenting BCVA (<0.001). On the contrary, younger age (=0.005), smaller IOFBs size (<0.001), absence of complications (<0.001) and better presenting BCVA (<0.001) were considered to relate to excellent BCVA.

CONCLUSION

Multiple prognostic factors may influence the final visual outcome, including age, size of IOFBs, complications and presenting BCVA. Meanwhile, further education and promotion on eye protection should be taken for the improvement on self-protection and self-health awareness.

摘要

目的

描述669例眼内异物(IOFBs)患者的临床特征,并分析影响其视力预后的因素。

方法

回顾了来自华西医院的669例IOFBs患者的病历。使用标准Snellen视力表记录最佳矫正视力(BCVA)值,并将其转换为最小分辨角对数(logMAR)尺度进行统计分析。视力预后由最终BCVA定义(良好视力预后:最终BCVA为20/40或更好;差视力预后:最终BCVA低于20/200)。使用IBM SPSS Statistics 23版对收集的数据进行统计分析。在整个研究中,双侧P值小于0.05被认为具有统计学意义。

结果

平均年龄为1至79岁(平均年龄34.8±12.7标准差),大多数患者为男性(626例,93.6%)。眼外伤的主要原因是锤击(383例,57.2%)。几乎所有患者(97.8%)都接受了手术,受伤与手术之间的平均时间间隔为26.4±322.3天(0 - 7300天),其中327例患者在24小时内接受了手术(48.9%),590例患者在IOFBs受伤后7天内接受了手术(88.2%)。较差的BCVA与年龄较大(P = 0.013)、IOFBs尺寸较大(P < 0.001)、存在并发症(P < 0.001)以及初始BCVA较差(P < 0.001)相关。相反,年龄较小(P = 0.005)、IOFBs尺寸较小(P < 0.001)、无并发症(P < 0.001)以及初始BCVA较好(P < 0.001)被认为与良好的BCVA相关。

结论

多种预后因素可能影响最终视力预后,包括年龄、IOFBs尺寸、并发症和初始BCVA。同时,应进一步开展眼保护教育和宣传,以提高自我保护和自我健康意识。

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