Open globe injuries in a croatian cohort: characteristics and prognostic value of the ocular trauma score in predicting the final visual outcome.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.