دورية أكاديمية
The Ocular Trauma Score Underestimates Visual Recovery for the Most Severe Open-Globe Injuries.
| العنوان: | The Ocular Trauma Score Underestimates Visual Recovery for the Most Severe Open-Globe Injuries. |
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| المؤلفون: | Perez EA; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Ramirez DA; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Peterson JD; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Binkley EM; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Boldt HC; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Gehrs KM; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Han IC; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Russell SR; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Sohn EH; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Larson SA; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Russell JF; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa. Electronic address: jonathan-russell@uiowa.edu. |
| المصدر: | Ophthalmology. Retina [Ophthalmol Retina] 2023 Jul; Vol. 7 (7), pp. 612-619. Date of Electronic Publication: 2023 Feb 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Published by Elsevier Inc. on behalf of American Academy of Ophthalmology Country of Publication: United States NLM ID: 101695048 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-6530 (Electronic) Linking ISSN: 24686530 NLM ISO Abbreviation: Ophthalmol Retina Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Published by Elsevier Inc. on behalf of American Academy of Ophthalmology, [2017]- |
| مواضيع طبية MeSH: | Eye Injuries*/diagnosis , Eye Injuries*/surgery , Eye Injuries*/epidemiology, Humans ; United States ; Retrospective Studies ; Trauma Severity Indices ; Prognosis ; Visual Acuity |
| مستخلص: | Purpose: To compare visual outcomes after open-globe injury (OGI) with those predicted by the Ocular Trauma Score (OTS), and to investigate the effect of treatment with pars plana vitrectomy (PPV). Design: Retrospective cohort study. Subjects: Patients presenting with OGI to an academic United States ophthalmology department from 2017 to 2020. Methods: Best-corrected visual acuity (VA) measurements at the most recent follow-up were compared with final VA predicted by the OTS, based on preoperative injury characteristics. The most recently measured VA of patients treated with PPV during initial OGI repair (primary PPV group) was compared with patients treated with PPV after initial OGI repair (secondary PPV group) and patients never treated with PPV (No PPV group). Main Outcome Measures: Best-corrected VA in the injured eye at last follow-up; secondary outcome measures included the occurrence of vitreous hemorrhage at any time, occurrence of retinal detachment at any time, rates of additional surgery, and rates of enucleation. Results: One-hundred and thirty-three subjects with OGI were identified and analyzed. The overall rate of PPV was 32%. Predictors of worse VA at last follow-up included older age (P = 0.047) and worse presenting VA (P < 0.001). Visual acuity outcomes for eyes in OTS categories 2 to 5 did not significantly differ from OTS predictions. However, eyes in OTS category 1 had a higher likelihood of last follow-up VA of light perception (LP) to hand motion (46% in the study cohort vs. 15% predicted by the OTS, P = 0.004) and a lower likelihood of no LP (33% vs. 74%, P < 0.001). The secondary PPV group had the worst VA at presentation among the 3 groups (P = 0.016), but VA at last follow-up did not significantly differ between the study groups (P = 0.338). Conclusions: The most severe OGIs (i.e., OTS category 1) had better visual outcomes than predicted by the published OTS expectations, and secondary PPV was associated with significant visual improvement despite poor prognostic predictions. Evaluation by a vitreoretinal surgeon should be considered for all patients with severe OGI, especially those in OTS category 1. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Ocular Trauma Score; Ocular trauma; Open-globe injury; Pars plana vitrectomy |
| تواريخ الأحداث: | Date Created: 20230206 Date Completed: 20230710 Latest Revision: 20231116 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.oret.2023.01.021 |
| PMID: | 36746350 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2468-6530 |
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| DOI: | 10.1016/j.oret.2023.01.021 |