Comparative Evaluation of the Prognostic Value Between the Ocular Trauma Score and the Pediatric Penetrating Ocular Trauma Score

Abstract

Controversy exists about the utility of the Ocular Trauma Score (OTS) in children. A new score was developed specifically for children—the Pediatric Penetrating Ocular Trauma Score (POTS)—which proved to be of prognostic value in young patients with penetrating eye injuries. The purpose of the study was to compare the prognostic value of OTS and POTS in children with open-globe injuries in a cohort of Brazilian children. This was a retrospective, interventional case series and included 37 children with open-globe injuries seen at the Santa Casa de Sao Paulo Emergency Service. Mean age was 8.0 ± 3.9 years; 28 were male and 9 female. All patients were reviewed on the basis of time and circumstance of injury, time of surgery, type of penetrating injury, initial and final visual acuity (VA), and concomitant eye disease. Both OTS and POTS categories were calculated based on specific variables. The final achieved VA was compared with the predicted VA for both scores with Kendall's test for significant association; the agreement between the predicted VA for both OTS and POTS was accessed with the Cohen kappa coefficient. The association between OTS and achieved VA was good (Kendall Tau-b = 0.511, P = 0.001), as well as between POTS and achieved VA (Kendall Tau-b = 0.422, P = 0.002). The agreement between the predicted VA for OTS and POTS was fair (kappa = 0.400). In conclusion, in this small cohort of Brazilian children with open-globe injuries, there was no superiority of one score over the other and both OTS and POTS underestimated the potential best-corrected VA after treatment.

Comparison of Two Scoring Systems in Pediatric Open Globe Injuries

“…This result is not surprising given the distribution of wound locations. Similar result has been demonstrated by Morgan et al 10 The most important disadvantage of this study is the insufficient number of patients included in this study. For this reason, similar studies with the participation of more centers and more patients may allow the difference between the two scoring systems to be understood.…”

Epidemiology of pediatric eye injuries requiring hospitalization in rural areas of Wenzhou and Changsha, China: a 10-year retrospective study

“…Some studies have verified the reliability and predictability of this assessment system [12]. Several studies have reported that the OTS can be utilized to accurately predict outcomes [22,31,32]. However, Oiticica et al [33] found that the OTS had limited value in predicting long-term VA in children.…”

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

“…Morgan et al demonstrated in their study that the POTS model was not superior to the OTS model in predicting retention of vision in children with open globe ocular injury [32].…”