Ocular trauma score as a visual prognostic factor of open globe injuries in a hospital of southern Brazil

Prognostic Factors for Visual Outcomes in Open Globe Injury

“…Deud et al, 8 in 2021, studied OTS as a visual prognostic factor of OGI in southern Brazil and demonstrated agreement between the VA predicted by the OTS and the final VA of patients included in their study. In a study published in 2009, Man and Steel 9 compared the OTS and the classification and regression tree as prognostic models of visual outcome after OGI.…”

“…There is strong evidence that poor initial VA is one of the most important prognostic factors for unfavorable visual outcomes after OGI. [1][2][3][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Han and Yu 12 demonstrated that an initial VA of light perception (LP) or better resulted in an 18.2-fold chance of attaining visual survival, while count fingers or better vision resulted in a 2.81-fold chance of achieving functional success. Good initial VA suggests milder ocular tissue damage, which ensures a better visual outcome.…”

“…9 Globe rupture was shown in many studies to be an important prognostic factor influencing final VA, whereas perforating injury was only included in very limited studies. 1,9,11,17 However, Deud et al 8 found that neither globe rupture nor perforating injury to be considered significant predictors of VA.…”

“…There seems to be a consensus that nondelayed wound closure and comprehensive prophylactic antibiotic treatment at the time of injury may improve final VA following OGI 15 . However, Deud et al 8 and Man and Steel 9 found no significant associations between endophthalmitis and final visual outcomes. In addition, a recent study found that the initial time to operative repair, within a 24-hour time frame, did not result in improved VA for patients with OGI 30 …”

Aspectos médico-legais do olho

“…(15) Segundo análise observacional e retrospectiva de 119 vítimas de trauma ocular aberto em um hospital brasileiro, a acuidade visual no final do estudo concordou com a acuidade prevista pelo Escore de Trauma Ocular, calculado a partir de dados colhidos do prontuário, como idade, sexo, olho acometido e mecanismos específicos do trauma, bem como dados de acuidade visual inicial, presença de ruptura de globo, perfuração, endoftalmite, descolamento de retina e defeito pupilar aferente. (16) Outras análises, realizadas no Chile (17) e na Turquia, (18) demonstraram grande aplicabilidade da ferramenta na área, fornecendo resultados seguros, exceto nos casos de achados clínicos posteriores, como descolamento de retina e hemorragia vítrea. (17)…”