The Clinical Features and the Factors Affecting Visual Prognosis in Pediatric Open-Globe Injuries

Abstract

Purpose: To investigate clinical features and factors affecting visual prognosis after pediatric open-globe injuries.Methods: Children with final logMAR-visual acuity (LVA)>0.70 were determined as poor-vision group (group1, n=108) and those with final LVA≤0.70 as good-vision group (group2, n=115). Analyzes were done. Results: Compared to group1, group2 had better initial and final visions (1.21±0.26 vs 0.60±0.28, p<0.001 for initial-LVA; 1.00±0.32 vs 0.30±0.13, p<0.001 for final-LVA), greater ocular trauma score (OTS) (1.72±0.53 vs 3.73±0.61, p=0.025) and smaller injury size (10.4±3.5 vs 5.8±2.4 mm, p=0.002). Globe rupture (37.0% vs 17.4%, p=0.015) and relative afferent pupillary defect (RAPD) (44.4% vs 17.3%, p=0.037) were higher in group1, while penetrating injury (45.4% vs 72.2%, p=0.044), zone 1 involvement (39.8% vs 65.2%, p=0.038) and metal object injury (29.6% vs 51.3%, p=0.041) were higher in group2. Final LVA (for group1 and group2) was negatively correlated with OTS (r=-0.398, p=0.037; r=-0.369, p=0.040), while positively correlated with injury size (r=0.412, p=0.031; r=0.318, p=0.046) and initial LVA (r=0.335, p=0.043; r=0.402, p=0.034). Conclusion: To our knowledge, this is the first study investigating effects of age, time between trauma and surgery, OTS, injury size, follow-up time and initial vision on final poor and good visions in detail. Low OTS, poor initial vision, globe rupture and RAPD were poor prognosis indicators, while small injury size, penetrating injury, zone 1 involvement and metal object injury were good prognosis indicators. Additionally, in both groups final vision worsened as OTS decreased, injury size increased, and initial vision worsened. These prognostic factors may be useful in managing trauma.