Mayer Christian Steffen, Reznicek Lukas, Baur Isabella Diana, Khoramnia Ramin
Department of Ophthalmology, Heidelberg University, 69120 Heidelberg, Germany.
Department of Ophthalmology, Ludwig-Maximilians-University, 80336 Munich, Germany.
Diagnostics (Basel). 2021 Oct 8;11(10):1851. doi: 10.3390/diagnostics11101851.
This paper explored epidemiology and evaluation of posterior segment involvement as prognostic factors for functional outcome of patients with open globe injuries. A retrospective analysis of 151 patients with open globe injuries was conducted. Pre- and postoperative-corrected distance visual acuity (CDVA), epidemiologic data, classification of the injuries including the ocular trauma score (OTS), performed surgeries, intraocular pressure (IOP) and correlation analyses between OTS and postoperative CDVA were obtained. A total of 147 eyes were included in the study. Mean age was 42.9 ± 22.2 years, 78.2% were male, and 36.7% of injuries occurred in the workplace. Thirty-eight patients (25.9%) had intraocular foreign bodies. Concerning injury location, 51.7% of the injuries were located in zone I (cornea, corneoscleral limbus), 15.0% in zone II (up to 5 mm posterior the sclerocorneal limbus) and 32.0% in zone III (posterior of zone 2). Affected structures were eyelids (17.7%), cornea (74.8%), iris (63.9%), lens (56.5%), sclera (48.3%), retina (47.6%) and optic nerve (19.7%). Mean preoperative CDVA was 1.304 ± 0.794 logMAR and 1.289 ± 0.729 logMAR postoperatively ( = 0.780). Patients with posterior segment involvement had significantly worse postoperative CDVA than patients without (1.523 ± 0.654 logMAR vs. 0.944 ± 0.708 logMAR, < 0.01). Predictive factors for good visual outcome of open globe injuries are good initial CDVA and ocular trauma affecting only zone I and II.
本文探讨了开放性眼球损伤患者后段受累情况的流行病学及其作为功能预后因素的评估。对151例开放性眼球损伤患者进行了回顾性分析。获取了术前和术后矫正远视力（CDVA）、流行病学数据、损伤分类（包括眼外伤评分（OTS））、所施行的手术、眼压（IOP）以及OTS与术后CDVA之间的相关性分析。本研究共纳入147只眼。平均年龄为42.9±22.2岁，78.2%为男性，36.7%的损伤发生在工作场所。38例患者（25.9%）有眼内异物。关于损伤部位，51.7%的损伤位于I区（角膜、角巩膜缘），15.0%位于II区（角巩膜缘后5mm以内），32.0%位于III区（II区后方）。受累结构包括眼睑（17.7%）、角膜（74.8%）、虹膜（63.9%）、晶状体（56.5%）、巩膜（48.3%）、视网膜（47.6%）和视神经（19.7%）。术前平均CDVA为1.304±0.794 logMAR，术后为1.289±0.729 logMAR（P = 0.780）。后段受累的患者术后CDVA明显比未受累患者差（1.523±0.654 logMAR对0.944±0.708 logMAR，P<0.01）。开放性眼球损伤良好视觉预后的预测因素是初始CDVA良好以及仅累及I区和II区的眼外伤。
