Borjan Ivan, Pleština-Borjan Ivna, Stanić Robert, Znaor Ljubo, Petrovski Beáta Éva, Petrovski Goran
Department of Ophthalmology, University Hospital Center Split, Spinciceva 1, Split, 21000, Croatia.
School of Medicine, University of Split, Soltanska 2, Split, 21000, Croatia.
Int J Retina Vitreous. 2025 Jul 1;11(1):72. doi: 10.1186/s40942-025-00696-z.
Open globe injuries (OGI) are the most severe and sight-treating ocular traumas encountered in ophthalmology. The purpose of the study is to analyze the characteristics and prognostic factors of OGI and to evaluate the prognostic value of the Ocular Trauma Score (OTS) in predicting final visual outcome.
A retrospective study analyzing OGI in 56 patients referred to the Eye Clinic, University Hospital Centre Split, Croatia, was conducted between January 2020 and January 2023. The characteristics of OGI and other relevant factors contributing to the final visual outcome were analyzed. The comparison between the final visual outcomes predicted by OTS system and those observed in the study was performed. Non-parametric statistical methods (Wilcoxon, Kruskal-Wallis and chi-square tests) with the Bonferroni correction for multiple comparisons were used in statistical analysis.
The average age of patients was 45 years; 48 (86%) were males and 8 (14%) females. Most of the patients (68%) were admitted to the hospital and treated within 6 h after the injury. Most of the injuries (88%) occurred during leisure time and most often were located in zone 2 (46%). Penetrating injuries were the most frequent injury type (52%), while globe rupture was present in 16 (29%) patients. The posterior segment was affected in 27 (48%) patients. In 16 (29%) patients, final BCVA reached ≥ 0.5. The worst final BCVA- NLP was most commonly experienced in patients with globe rupture (38%). Poor final BCVA was statistically significantly associated with worse initial BCVA (P < 0.001), globe rupture (P < 0.001), lower OTS category (P < 0.001), and the presence of RAPD (P < 0.001). The final visual results were comparable with predicted visual outcome by OTS.
The study cohort from Croatia showed that the most important factors in the prognosis of final BCVA in OGI were initial BCVA, injury type, RAPD, localization and extent of the wound, and appropriate, timely surgical treatment in specialized institutions with experienced surgeons. Furthermore, our study findings are mostly consistent with those of the international OTS group and support the view that OTS is a reliable predictor of the final visual outcome.
开放性眼球损伤（OGI）是眼科中最严重且影响视力的眼外伤。本研究的目的是分析OGI的特征和预后因素，并评估眼外伤评分（OTS）在预测最终视力结局方面的预后价值。
对2020年1月至2023年1月期间转诊至克罗地亚斯普利特大学医院中心眼科诊所的56例OGI患者进行回顾性研究。分析了OGI的特征以及其他影响最终视力结局的相关因素。对OTS系统预测的最终视力结局与本研究中观察到的结局进行了比较。统计分析采用非参数统计方法（Wilcoxon检验、Kruskal-Wallis检验和卡方检验），并采用Bonferroni校正进行多重比较。
患者的平均年龄为45岁；48例（86%）为男性，8例（14%）为女性。大多数患者（68%）在受伤后6小时内入院并接受治疗。大多数损伤（88%）发生在休闲时间，且最常位于2区（46%）。穿透性损伤是最常见的损伤类型（52%），16例（29%）患者存在眼球破裂。27例（48%）患者的眼后段受到影响。16例（29%）患者的最终最佳矫正视力（BCVA）≥0.5。最终BCVA最差为无光感（NLP）最常见于眼球破裂患者（38%）。最终BCVA差在统计学上与初始BCVA差（P<0.001）、眼球破裂（P<0.001）、OTS分类较低（P<0.001）以及存在相对性传入性瞳孔障碍（RAPD）（P<0.001）显著相关。最终视力结果与OTS预测的视力结局相当。
来自克罗地亚的研究队列表明，OGI患者最终BCVA预后的最重要因素是初始BCVA、损伤类型、RAPD、伤口的位置和范围，以及在有经验外科医生的专业机构进行适当、及时的手术治疗。此外，我们的研究结果大多与国际OTS组的结果一致，并支持OTS是最终视力结局可靠预测指标的观点。
