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

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.

Prognostic value of Ocular Trauma Score and pediatric Penetrating Ocular Trauma Score in predicting the visual prognosis following ocular injury

“…In their study, Awidi et al [ 16 ] concluded that POTS correlated better with the final VA in the pediatric population than OTS. However, our results were in coherence with a recent study by Pahor D et al [ 17 ], which concluded that OTS is a better predictor of visual prognosis in ocular trauma patients while POTS grossly underestimated the visual potential.…”

Comparison of Two Scoring Systems in Pediatric Open Globe Injuries

“…When the epidemiological data in this study were evaluated, was found that most of the children who were admitted to the hospital due to ocular trauma were male. This finding is consistent with many case series in the literature 9,10 . The main reason for this is that boys are more active than girls and are less cautious in dangerous situations.…”

“…The success of both trauma scoring systems in predicting visual outcome was evaluated comparatively in different studies, and conflicting results were obtained. Two different studies conducted by Pahor et al 9 and Morgan et al 10 suggested that the success of both scoring systems in predicting visual outcome was similar and POTS did not have any additional contribution. However, different studies conducted by Awidi et al 3 and Shah et al 11 reported that the success of POTS in predicting visual outcome was better than OTS.…”

“…This finding is consistent with many case series in the literature. 9,10 The main reason for this is that boys are more active than girls and are less cautious in dangerous situations. When the injury patterns of children are evaluated, noteworthy that the leading etiological cause is the sharp tools that are frequently used in daily life, such as knives, scissors, and pencils.…”

Spectrum of orbital injuries with special reference to road traffic accidents

“…Among them, 35 patients were <18 years old (70%) and 15 patients were >18 years old (30%). Similar numbers of cases were included in studies conducted by Morgan et al, Kasahara et al, Pahor et al to compare ocular trauma score and pediatric ocular trauma score [11,12] . Out of the 50 patients, 20 were categorized under POTS due to penetrating ocular injury.…”