Ocular Trauma Score in Siderosis Bulbi With Retained Intraocular Foreign Body

Abstract

The purpose of this study was to investigate the clinical characteristic and visual outcome of siderosis bulbi with retained intraocular foreign body (IOFB) and to validate the predictive value of the Ocular Trauma Score (OTS) in siderosis bulbi. Certain numerical values rendered to the OTS variables at present were summated (Table 1) and converted into 5 OTS categories as performed in the OTS study. The prognostic value of OTS was first assessed in cases of siderosis bulbi resulting from a chemical reaction of retained IOFBs. Twenty-four eyes of 24 patients diagnosed with siderosis bulbi who underwent surgery between 2007 and 2013 at our medical centre were reviewed. Due to patients’ ignorance in ocular injuries, delayed presentation by the patient (54.17%) and no history of trauma (16.67%) were the most common cause of siderosis bulbi with IOFB retention. The main symptom of all these patients was impaired vision. The most common complications were cataract (23/24, 95.83%), followed by retinal pigmentary degeneration (15/22, 68.18%), iris heterochromia (14/24, 58.33%), pupillary mydriasis (10/21, 47.62%), secondary glaucoma (6/24, 25.00%), relative afferent pupillary defect (6/24, 25.00%), and retinal detachment (3/24, 12.50%). IOFBs were removed in 22 eyes (91.67%), except 2 enucleated eyes with absolute glaucoma (8.33%). Among all the patients (24 eyes), the best-corrected visual acuity improved in 63.64%, unchanged in 18.18% and deteriorated in 18.18% after surgical intervention. No statistically significant difference was found between the categorical distributions of our patients and those in the OTS study group.Further promotion and education on eye protection are needed to minimize visual loss from siderosis bulbi. The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of siderosis bulbi resulting from a chemical reaction of retained IOFBs.

Prognostic value of ocular trauma score for open globe injuries associated with metallic intraocular foreign bodies

“…Results from Unal et al [ 6 ] were similar to those in this OTS study, except for OTS category 2; results from Purtskhvanidze et al [ 7 ] were similar to those in this OTS study, except for OTS category 1. Results from the study by Zhu et al [ 8 ] were similar to those in this OTS study in all categories.…”

“…However, it had been validated in only a few subgroups of patients with IOFBs. Unal et al [ 6 ] reported the prognostic value of OTS in cases of deadly weapon-related open-globe injuries with IOFB, Purtskhvanidze et al [ 7 ] in rotating wire brush injuries with IOFB, and Zhu et al [ 8 ] in siderosis bulbi with retained IOFB. Although all of them were associated with IOFBs, the mechanism of injury, presenting clinical characteristics, and distribution of OTS scores were very different among these studies.…”

“…More than 2000 cases from the United States and Hungarian Eye Injury Registries were analyzed and > 100 variables were evaluated to identify the best predictors of outcome at 6 months after injury [ 3 ]. OTS has been widely used for this purpose in open and closed globe trauma [ 4 , 5 ], however, only a few studies have evaluated the prognostic value of OTS in patients with retained intraocular foreign bodies (IOFBs) [ 6 – 8 ].…”

Posterior Segment Intraocular Foreign Body: Extraction Surgical Techniques, Timing, and Indications for Vitrectomy

“…The remaining value determines the Ocular Trauma Score which is stratified into five categories and they reflect the probability of obtaining a range of specific visual acuity at 6 months (Table 3). The use of OTS is an excellent prognostic tool to predict the visual acuity after ocular trauma [8, 23–25]. …”

Siderosis bulbi resulting from an intraocular metalic foreign body: case report

“…The disappearance of symptoms and signs of siderosis following removal of the foreign body has been reported, however, if the iron foreign is left in the eye, or even when it is removed it may cause permanent visual loss. 9 Moreover, complications following surgery are rather common as postoperative retinal detachment and proliferative vitreoretinopathy. The mass of the intraocular foreign body is a prognostic factor due to its higher kinetic energy, which can cause more damage to the eye tissues.…”