Clinical Ophthalmology (Jan 2023)

Open Globe Injury in a Tertiary Hospital of Northern Thailand: No Vision Survival and Ocular Trauma Score

  • Porapaktham T,
  • Choovuthayakorn J,
  • Nanegrungsunk O,
  • Phinyo P,
  • Tanasombatkul K,
  • Watanachai N,
  • Kunavisarut P,
  • Chaikitmongkol V,
  • Patikulsila D

Journal volume & issue
Vol. Volume 17
pp. 365 – 373

Abstract

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Tuangprot Porapaktham,1 Janejit Choovuthayakorn,1 Onnisa Nanegrungsunk,1 Phichayut Phinyo,2– 4 Krittai Tanasombatkul,2,3 Nawat Watanachai,1 Paradee Kunavisarut,1 Voraporn Chaikitmongkol,1 Direk Patikulsila1 1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Musculoskeletal Science and Translational Research (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCorrespondence: Janejit Choovuthayakorn, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand, Tel +66 53 935512, Fax +66 53 936121, Email [email protected]: To determine characteristics and factors associated with no vision survival (included no light perception, enucleation, and evisceration) following open globe injury (OGI) and to correlate the proportion of final vision to predictive values of ocular trauma score (OTS).Patients and Methods: The medical records of consecutive patients diagnosed as OGI between January 2015 and December 2020 were retrospectively reviewed. Data collected included demographics, mechanisms and modes of injuries, ophthalmic presentations, managements, and visual outcomes at the final visit.Results: Three hundred and seventy-one patients with a mean (standard deviation, SD) age of 44.0 (17.4) years were included. Male with workplace injury was the most frequent scenario. High-velocity metallic objects were the predominant causative materials. Following treatments, fifty-six eyes (14.9%) obtained no vision survival. Factors associated with no vision survival following OGI were low presenting vision, globe perforation, larger wound, presence of relative afferent pupillary defect, retinal detachment, and vitreous hemorrhage. Compared to OTS predictive values, eyes in OTS categories 1 and 2 had a lower proportion of no vision survival.Conclusion: This study identified the importance of workplace injuries. Overall, there were comparable final visions between OTS and this study. However, a reduced proportion of no vision survival among severely injured eyes signifies the challenges of OGI management.Keywords: open globe injury, visual outcomes, characteristics, no vision survival

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