Evaluation of Three Ocular Trauma Scores as Prognostic Models in a Cohort of Portuguese Children
DOI:
https://doi.org/10.48560/rspo.33247Keywords:
Child; Eye Injuries/diagnosis, Eye Injuries, Penetrating/diagnosis, Prognosis, Trauma Severity IndicesAbstract
INTRODUCTION: Our purpose was to compare the Ocular Trauma Score (OTS), Pediatric Ocular Trauma Score (POTS) and Modified Pediatric Ocular Trauma Score (MPOTS) as prognostic models of visual outcome after open globe injury in children.METHODS: Retrospective observational study of pediatric patients with ocular trauma requiring surgical treatment. Between August 2008 and December 2022, pediatric patients who presented to the ophthalmology department at a tertiary referral hospital were included. Children with prior ocular diseases affecting visual function, follow-up < 6 months and no medical record of visual acuity (VA) at 6 months follow-up were excluded. Demographics, mechanism and object responsible for the injury, ocular surgery and logMAR VA at presentation, 6 months, 1 year and 2 years of follow-up was collected. The OTS, POTS and MPOTS were determined. A search for possible predictors of visual outcome was also performed.
RESULTS: In total, 28 eyes of 27 patients (44.4% female, 55.6% male) with a median age of 9 years (3 months - 17 years) were included. Poor visual outcome (final logMAR VA ≥ 1) was found in 9 patients (32.1%). Only 3 patients had complete data to determine the OTS and prognostic evaluation for this score was not performed. Correlation between POTS (n=22) and final VA was statistically significant (p-value 0.049), while the correlation of MPOTS (n=22) and final VA was not (p-value 0.543). There was not a significant agreement between POTS and MPOTS in predicting poor visual outcome (p-value 0.134). Univariable analysis found the following predictors of final VA: wound location (p-value 0.027), retinal detachment (p-value <0.001) and delay in surgery >48 hours (p-value 0.014). Retinal detachment correlated with poor visual outcome (p-value 0.026).
CONCLUSION: POTS may be useful in predicting visual outcome after penetrating ocular injury in children, whilst the benefit of MPOTS was not confirmed. OTS may be less practical when evaluating children given the difficulty in obtaining initial VA after open globe injury. Wound location, retinal detachment and delay in surgery (>48 hours) may be good predictors of poor visual outcomes in open globe injury in children.
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