J Korean Ophthalmol Soc.  2018 Nov;59(11):1062-1070. 10.3341/jkos.2018.59.11.1062.

The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children

• Park SJ
• Son BJ

• KMID: 2426368
• DOI: http://doi.org/10.3341/jkos.2018.59.11.1062

Abstract

PURPOSE
We evaluated the prognostic factors of open globe injuries in children and adolescents, and compared the ocular trauma score (OTS) and pediatric penetrating ocular trauma score (POTS).
METHODS
We performed a retrospective review of 77 children under 18 years of age who visited our clinic with open globe injuries between May 1993 and April 2014. We investigated the factors that may affect final visual acuity. We also compared the OTS and POTS using receiver operating characteristic curves as a method to predict final visual acuity.
RESULTS
By univariate analysis, an initial visual acuity less than 20/200, globe rupture, wound size greater than 7.0 mm, retinal detachment, lens dislocation, and total number of operations contributed to worse visual outcomes (<20/200). Conversely, central corneal involvement, traumatic cataract, wound size less than 7.0 mm, and initial visual acuity greater than 20/200 were better prognostic indicators (≥20/32). Both OTS and POTS had diagnostic value as a predictor of final visual acuity, although there were no statistically significant differences between the two scoring systems.
CONCLUSIONS
Initial visual acuity and wound size are important prognostic factors for the final visual acuity in children and adolescent, following open globe injuries. Both OTS and POTS are reliable prognostic models for open globe injuries in children and adolescents.

Keyword

Ocular trauma score; Open globe injury; Pediatric penetrating ocular trauma score

MeSH Terms

Adolescent
Cataract
Child*
Humans
Lens Subluxation
Methods
Retinal Detachment
Retrospective Studies
ROC Curve
Rupture
Visual Acuity
Wounds and Injuries

Figure

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  Figure 1 ROC curve analysis for predicting poor vision outcome. ROC curves of OTS (AUC = 0.912) and POTS (AUC = 0.807) for predicting poor vision outcome (final visual acuity < 20/200) in the patients (OTS, POTS: p < 0.001). ROC = receiver operating characteristic; OTS = ocular trauma score; AUC = area under the curve; POTS = pediatric penetrating ocular trauma score.

• 

  Figure 2 ROC curve analysis for predicting good vision outcome. ROC curves of OTS (AUC = 0.771) and POTS (AUC = 0.701) for predicting good vision outcome (final visual acuity ≥ 20/32) in the patients (OTS, POTS: p < 0.001). OTS = ocular trauma score; POTS = pediatric penetrating ocular trauma score; ROC = receiver operating characteristic; AUC = area under the curve.

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