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开放性眼球损伤的临床特征、视力结果和预后因素。

Clinical Characteristics, Visual Outcomes, and Prognostic Factors of Open Globe Injuries.

机构信息

Department of Ophthalmology, Lithuanian University of Health Sciences, A. Mickevičiaus Str. 9, 44307 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2021 Nov 3;57(11):1198. doi: 10.3390/medicina57111198.

Abstract

: Open globe injuries (OGI) remain an important cause of visual impairment and loss, impacting all ages. A better understanding of the factors influencing visual outcomes is important in an attempt to improve the results of the treatment of OGI patients. The author aimed to contribute to this knowledge with the analysis of clinical characteristics, prognostic factors, and visual outcomes of their cohort of OGI patients. A retrospective medical record review was performed for 160 patients (161 eyes) who sustained an open globe injury between January 2015 and December 2017 and presented to the Hospital of Lithuanian University of Health Sciences. Data analyzed included age, sex, type, cause, place of OGI, initial visual acuity (VA), final best-corrected visual acuity (BCVA), and tissue involvement. Open globe injuries were classified using the Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). Univariate analysis was conducted to evaluate the prognostic factors. The mean age of the patients was 41.9 years. The male-to-female ratio was found to be 8.4:1. The home was the leading place of eye injury (59.6%), followed by an outdoor environment (14.3%) and workplace (11.8%). Penetrating injury accounted for 43.5%, followed by intraocular foreign body injury (39.1%) and globe rupture (13%). Overall, 19.5% of patients regained a good final vision of ≥0.5, but for 48.1% of them, eye trauma resulted in severe visual impairment (BCVA ≤ 0.02). In the univariate analysis, a bad visual outcome of less than 0.02 was correlated with bad initial VA, iris dialysis, hypotony, vitreous hemorrhage, and vitreous prolapse at presentation. Phthisis bulbi was correlated with eyelid laceration, iris prolapse, iris dialysis, hyphema, vitreous prolapse, vitreous hemorrhage, and choroidal rupture at initial examination. : Open globe injury remains an important preventable cause of ocular morbidity. This study provides data indicating that open globe injuries are a significant cause of visual impairment in our research group.

摘要

: 开放性眼球损伤(OGI)仍然是视力损害和丧失的重要原因,影响所有年龄段。更好地了解影响视力结果的因素对于尝试改善 OGI 患者的治疗结果非常重要。作者旨在通过分析其 OGI 患者队列的临床特征、预后因素和视力结果来为此提供知识。 对 2015 年 1 月至 2017 年 12 月期间在立陶宛健康科学大学医院就诊的 160 名(161 只眼)开放性眼球损伤患者进行了回顾性病历审查。分析的数据包括年龄、性别、类型、病因、OGI 发生地点、初始视力(VA)、最终最佳矫正视力(BCVA)和组织受累情况。使用伯明翰眼部创伤术语(BETT)和眼部创伤分类系统(OTCS)对开放性眼球损伤进行分类。进行单因素分析以评估预后因素。 患者的平均年龄为 41.9 岁。男女比例为 8.4:1。家庭是眼部受伤的主要发生地点(59.6%),其次是户外环境(14.3%)和工作场所(11.8%)。穿透性损伤占 43.5%,其次是眼内异物伤(39.1%)和眼球破裂伤(13%)。总体而言,19.5%的患者最终视力恢复良好(≥0.5),但 48.1%的患者因眼外伤导致严重视力损害(BCVA≤0.02)。在单因素分析中,视力结果小于 0.02 与初始 VA 差、虹膜脱离、低眼压、玻璃体积血和玻璃体脱出有关。眼球萎缩与眼睑撕裂伤、虹膜膨出、虹膜脱离、前房积血、玻璃体脱出、玻璃体积血和脉络膜破裂有关。 : 开放性眼球损伤仍然是可预防的眼部发病率的重要原因。本研究提供的数据表明,开放性眼球损伤是我们研究组视力损害的一个重要原因。

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