Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries

Dusica Pahor; Tomaz Gracner

doi:10.1055/a-1194-5104

Klinische Monatsblätter für Augenheilkunde, Inhaltsverzeichnis

Klin Monbl Augenheilkd 2021; 238(01): 67-72
DOI: 10.1055/a-1194-5104

Klinische Studie

Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries

Artikel in mehreren Sprachen: English | deutsch

Dusica Pahor

¹Department of Ophthalmology, University Clinical Centre Maribor, Slovenia

²Department of Ophthalmology, Faculty of Medicine, University of Maribor, Slovenia

,

Tomaz Gracner

¹Department of Ophthalmology, University Clinical Centre Maribor, Slovenia

› Institutsangaben

Abstract

Aim To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years.

Patients and Methods A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated.

Results Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 – 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models.

Conclusion Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.

Key words

trauma - Ocular Trauma Score - Pediatric Ocular Trauma Score - open-globe injury - prognosis - child

Volltext

Referenzen

References/Literatur
1 Wang NK, Chen YP, Yeung L. et al. Traumatic pediatric retinal detachment following open globe injury. Ophthalmologica 2007; 21: 255-263
2 LaRosche GR, McIntyre L, Schertzer RM. Epidemiology of severe injuries in childhood. Ophthalmology 1998; 95: 1603-1607
3 Strahlman E, Elman M, Daub E. et al. Causes of pediatric eye injuries. A population-based study. Arch Ophthalmol 1990; 108: 603-606
4 Niiranen M, Raivio I. Eye injuries in children. Br J Ophthalmol 1981; 65: 436-438
5 Sternberg P, de Juan E, Michels RG. Penetrating ocular injuries in young patients. Initial injuries and visual results. Retina 1984; 4: 5-8
6 Sarrazin L, Averbukh E, Hapert M. et al. Traumatic pediatric retinal detachment: a comparison between open and closed globe injuries. Am J Ophthalmol 2004; 137: 1042-1049
7 Prevent Blindness America. The scope of the eye injury problem. 2010 Im Internet (Stand: 7.10.2010): http://www.preventblindness.org/sites/default/files/national/documents/fact_sheetsFS93_ScopeEyeInjury.pdf
8 Farr AK, Hairston RJ, Humayun MU. et al. Open globe injuries in children: a retrospective analysis. J Pediatr Ophthalmol Strabismus 2001; 38: 72-77
9 Parver LM, Dannenberg AL, Blacklow B. et al. Characteristic and causes of penetrating eye injuries reported to the National Eye Trauma Registry, 1985–91. Public Health Rep 1993; 108: 625-632
10 Thylefors B. Epidemiological patterns of ocular trauma. Aust N Z J Ophthalmol 1992; 20: 95-98
11 Desai P, MacEven CJ, Baines P. et al. Incidence of cases of ocular trauma admitted to hospital and incidence of blinding outcome. Br J Ophthalmol 1996; 80: 592-596
12 Wong TY, Tielsch JM. A population-based study on the incidence of severe ocular trauma in Singapore. Am J Ophthalmol 1999; 128: 345-351
13 Klopfer J, Tielsch JM, Vitale S. et al. Ocular trauma in the United States. Eye injuries resulting in hospitalization, 1984 through 1987. Arch Ophthalmol 1992; 119: 838-842
14 Fong LP. Eye injuries in Victoria, Australia. Med J Aust 1995; 162: 64-68
15 Yu Wai Man C, Steel D. Visual outcome after open globe injury: a comparison of two prognostic models – the ocular trauma score and the classification and regression tree. Eye (Lond) 2010; 24: 84-89
16 Rahman I, Maino A, Devadason D. et al. Open globe injuries: factors predictive of poor outcome. Eye (Lond) 2006; 20: 1336-1341
17 Dannenberg AL, Parver LM, Fowler CJ. Penetrating eye injuries related to assault. The National Eye Trauma System Register. Arch Ophthalmol 1992; 110: 849-852
18 Dannenberg AL, Parver LM, Brechner RJ. et al. Penetrating eye injuries in the workplace. The National Eye Trauma System Register. Arch Ophthalmol 1992; 110: 843-848
19 Ligget PE, Pince KJ, Barlow W. et al. Ocular trauma in an urban population. Review of 1132 cases. Ophthalmology 1990; 97: 581-584
20 Strahlman E, Sommer A. The epidemiology of sports-related ocular trauma. Int Ophthalmol Clin 1988; 28: 199-202
21 Négrel AD, Thylefors B. The global impact of the eye injuries. Ophthalmic Epidemiol 1998; 5: 143-169
22 Gilbert CM, Soong HK, Hirst LW. A two-year prospective study of penetrating ocular trauma at Wilmer Ophthalmological Institute. Ann Ophthalmol 1987; 19: 104-106
23 Schrader WF. [Epidemiology of open globe eye injuries: analysis of 1026 cases in 18 years]. Klin Monatsbl Augenheilkd 2004; 221: 629-635
24 Kuhn F, Morris R, Witherspoon D. et al. A standardized classification of ocular trauma. Ophthalmology 1996; 103: 240-243
25 Kuhn F, Maisiak R, Mann L. et al. The ocular trauma score. Ophthalmol Clin North Am 2002; 15: 163-165 vi doi:10.1016/s0896-1549(02)00007-x
26 Acar U, Tol OY, Acar DE. et al. A new ocular trauma score in pediatric penetrating eye injuries. Eye (Lond) 2011; 25: 370-374
27 Brophy M, Sinclair SA, Hostetler SG. et al. Pediatric eye injury-related hospitalizations in the United States. Pediatrics 2006; 117: 1263-1271
28 Tok O, Tok L, Ozkaya D. et al. Epidemiological characteristics and visual outcome after open globe injuries in children. J AAPOS 2011; 15: 556-561
29 Pahor D. Die Berechnung des “Ocular Trauma Score” für die Prognose von offenen Augenverletzungen bei Kindern. Spektrum Augenheilkd 2010; 24: 214-219
30 Zhu L, Wu Z, Dong F. et al. Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries. Injury 2015; 46: 1828-1833
31 Shah MA, Shah SM, Applewar A. et al. Ocular trauma score as a predictor of final visual outcome in traumatic cataract cases in pediatric patients. J Cataract Refract Surg 2012; 38: 959-965
32 Morgan AM, Kasahara N. Comparative evolution of the prognostic value between the Ocular Trauma Score and the Pediatric Penetrating Ocular Trauma Score. J Craniofac Surg 2018; 29: 1776-1779
33 Bunting H, Stephens D, Mireskandari K. Prediction of visual outcomes after open globe injury in children: a 17-year Canadian experience. J AAPOS 2013; 17: 43-48
34 Unver YB, Acar N, Kapran Z. et al. Visual predictive value of the ocular trauma score in children. Br J Ophthalmol 2008; 92: 1122-1124
35 Ram J, Verma N, Gupta N. et al. Effect of penetrating and blunt ocular trauma on the outcome of traumatic cataract in children in northern India. J Trauma Acute Care Surg 2012; 73: 726-730
36 Schörkhuber MM, Wackernagel W, Riedl R. et al. Ocular Trauma Scores in paediatric open globe injuries. Br J Ophthalmol 2014; 98: 664-668
37 Awidi A, Kraus CL. A comparison of ocular trauma scores in pediatric population. BMC Res Notes 2019; 12: 569 doi:10.1186/s13104-019-4602-8
38 Yaşa D, Erdem ZG, Ürdem U. et al. Pediatric traumatic retinal detachment: clinical features, prognostic factors, and surgical outcomes. J Ophthalmol 2018; 2018: 9186237 doi:10.1155/2018/9186237
39 Baxter RJ, Hodgkins PR, Calder I. et al. Visual outcome of childhood anterior perforating eye injuries: prognostic indicators. Eye (Lond) 1994; 8: 349-352
40 Uysal Y, Mutlu FM, Sobaci G. Ocular trauma score in childhood open-globe injuries. J Trauma 2008; 65: 1284-1286