The relationship between computed tomography findings and ocular trauma and pediatric ocular trauma scores in pediatric globe injuries: Does imaging have prognostic and diagnostic value?

Abstract

BACKGROUND: The aim of this study is to assess the relationship between computed tomography (CT) findings in open globe injuries (OGIs) in pediatric patients and the pediatric ocular trauma score (POTS) and OTS in pediatric ocular trauma. METHODS: In 34 pediatric patients with OGI, CT findings were categorized into nine main categories: Scleral irregularity, lens dislocation, abnormal vitreous density, choroid-retinal layer thickening, preseptal thickness increase, intraocular foreign body and air, vitreous hemorrhage, retinal detachment, and perforation. The relationship between different types and numbers of CT findings and the POTS and OTS was evaluated. RESULTS: The mean age of trauma was 6.6±3.1. Of the patients, 9 (26.5%) were female and 25 (73.5%) were male. The most common CT findings are scleral irregularity and increased preseptal thickness (47.1%). In univariate analysis, a P<0.05 was found between 16 patients with 1 or less CT findings (median POTS value 80 [71.25–90.0]) and 11 patients with 2 or 3 CT findings (median POTS value 60 [15–70]). A P<0.05 was found between 16 patients with 1 or less CT findings (median POTS value 80 [71.25–90.0]) and 7 patients with 4 or more CT findings (median POTS value 45 [25–80]). A P > 0.05 was found between 11 patients with 2 or 3 CT findings (median POTS value 60 [15–70]) and 7 patients with 4 or more CT findings (median POTS value 45 [25–80]). No significant difference was found between the number of CT findings and OTS stages. While POTS was significant (P<0.05) in patients with abnormal vitreous density (median 45 [30–69.6]), OTS value was not significant (P>0.05). There was no significant difference between POTS and OTS in other CT findings. CONCLUSION: The number of CT findings may assist in predicting POTS and, consequently, estimating visual prognosis in pediatric patients with OGI. In emergency situations where, sufficient clinical data are unavailable, the objective findings from CT may help in assessing the severity of ocular trauma and potentially predicting long-term visual outcomes.