Geographical differences in ophthalmic trauma outcomes and risk factors: the International Globe and Adnexal Trauma Epidemiological Eye Study (IGATES).
Annette K Hoskin, Sean Ng Ming Sheng, Richard J Blanch, Anantharaman Giridhar, Marian Pauly, Mehul Shah, Alok Sen, Yunia Irawati, Eli Pradhan, Jose Romero, Manisha Agarwal, Mohammad Soleimani, Ashok Kumar Grover, Chitaranjan Mishra, Hugo H Ocampo, Anadi Khatri, Sushank Ashok Bhalerao, Purendra Bhasin, Apoorva Ayachit, Prem S Subramanian, Rekha Khandelwal, Sundaram Natarajan, Manavi D Sindal, Shakeen Singh, Nirmal Fredrick T, Jasmin Zvornicanin, Gangadhara Sundar, José Dalma-Weiszhausz, Amer Awan, Dhanashree Ratra, Kasturi Bhatacharjee, Janejit Choovuthayakorn, Samata Sharma, Yogesh Tawdekar, Chaitra Jayadev, Shanti F Boesoirie, Andres M Rousselot, William Rojas-Carabali, Stephanie L Watson, Bernett Lee, Rupesh Agrawal
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Abstract
Objectives: Characterise the international variation in ophthalmic trauma and determine risk factors associated with visual and anatomical outcomes for low-, middle- and high-income countries.
Subjects/methods: Observational multi-centre cohort study using data from the International Globe and Adnexal Trauma Epidemiological Eye Study (IGATES) from April 2014 to August 2023. Data on acute presentations of ophthalmic injury including open/closed globe injury, and/or Adnexal/orbital involvement, and/or intraocular/ intraorbital foreign body were collected and Ocular Trauma Score (OTS) was calculated. A total of 5350 patients (5557 eyes) from 31 centres in 12 countries were included. The main outcome measures included demographics, mechanism and setting of injury, and presenting and final visual outcomes. Descriptive statistics, Kruskal-Wallis tests and multinomial logistic regression (MLR) analysis are presented, with correction performed using the Hochberg method. P values less than 0.005 were significant.
Results: Age, gender, presenting and final best-corrected visual acuity were all strongly associated with country (p < 0.005). Poor final visual outcomes were strongly associated with OTS predictions, type of injury (p < 0.005) and delayed presentation as well as firework injuries. High-income countries (HIC) showing reduced duration to presentation (HIC 5 h) and increased improvement in visual acuity (HIC -0.40) compared to low to middle-income countries (LMICs) (28 h) (-0.19). MLR analysis identified a significant association between countries' income classification and BCVA worse than 6/60, presence of scleral, iris, limbus injury and surgery being undertaken (p < 0.005).
Conclusion: Data from 31 centres internationally identified differences in demographic trends for each country. Age was identified as a risk factor for eye injuries. Low- and middle-income countries were associated with longer delays to presentation, smaller gains in BCVA and poorer visual outcomes. IGATES provides an opportunity to collect global data on ophthalmic trauma to facilitate improved management and prevention strategies.
期刊介绍：
Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists.
Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.
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