Materiały źródłowe

• #1 Eye injury and demographic parameters associated with poor visual outcome Lésion oculaire et paramètres démographiques associés à un faible résultat visuel

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6778009/

  Eye injuries can result in long-term disability, and healthcare providers need better tools to predict outcomes. […] Therefore, a model associated with severe and less severe injuries is examined. […] Poor final visual acuity was the main outcome measure (vision less than 20/200). […] Lens subluxation, vitreous prolapse, vitreous hemorrhage, posterior segment intraocular foreign body, and vitritis were significantly associated with poor final visual acuity. […] The predictive model identified the combination of age over 36, lens subluxation, vitreous prolapse and hemorrhage, vitritis, and macular hemorrhage as the combination most likely to have poor visual acuity. […] This model can be used in clinical practice to evaluate severity and predict final visual acuity in both severe and less severe eye injuries.

• #2 Eye injury and demographic parameters associated with poor visual outcome Lésion oculaire et paramètres démographiques associés à un faible résultat visuel

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6778009/

  Additional studies with larger samples could further verify this model. […] Accurate prognostic tools applied early in the process of care and treatment are helpful for decision making for the ophthalmologist and for informing the injured patient. […] Our study is among the first to propose a multivariate prognostic model that integrates a broad range of eye injury mechanisms and less severe eye injuries.

• #3 Visual outcome after open globe injury: a comparison of two prognostic models—the Ocular Trauma Score and the Classification and Regression Tree | Eye

  https://www.nature.com/articles/eye200916

  To compare the ocular trauma score (OTS) and the classification and regression tree (CART) as prognostic models of visual outcome after open globe injury. […] The variables most predictive of visual loss were an RAPD, poor initial vision, lid laceration, posterior wound, and globe rupture. […] We identified several factors that can help in deciding on the prognostic value of primary globe repair. Both the OTS and CART had high predictive accuracy, but the OTS had higher prognostic accuracy and could be used in counselling patients and in management decision-making. […] Open globe injuries are a major cause of permanent visual impairment and blindness. […] Several studies have suggested that the factors that significantly predict visual outcome after open globe injuries are initial visual acuity, presence of a relative afferent pupillary defect (RAPD), mechanism of injury, wound location, adnexal trauma, lens damage, hyphaema, vitreous haemorrhage, and retinal detachment.

• #4 Open globe injuries: factors predictive of poor outcome | Eye

  https://www.nature.com/articles/6702099

  Despite advances in ocular and orbital imaging, instrumentation, materials, and surgical procedures, the management of open globe injuries continues to pose difficult management dilemmas. […] From this retrospective study, we have identified several factors that may aid the clinician in deciding on the prognostic value of primary repair. Blunt injuries associated with adnexal trauma, with poor initial visual acuity, the presence of an RAPD or retinal detachment, and the absence of a red reflex are associated with a significantly higher rate of subsequent enucleation. […] Initial VA has been shown in many studies to be a key factor in predicting the rate of enucleation and, thus, poor visual outcome. […] We confirm that a visual acuity of worse than 6/60 has a significantly inferior outcome than visual acuities of 6/60 or better, and is, therefore, a strong predictor of eventual enucleation.

• #5 Epidemiology of Ocular Trauma and Predictive Modeling of Visual Outcom | RMHP

  https://www.dovepress.com/epidemiology-of-ocular-trauma-and-predictive-modeling-of-visual-outcom-peer-reviewed-fulltext-article-RMHP

  Ocular trauma is a visually and economically devastating cause of visual loss. This study investigated the prevalence and clinical characteristics of ocular trauma in central and northern China, and assessed prognostic factors. […] Ocular structural damage and surgical complications, along with the number of surgeries, were important factors affecting the visual prognosis. […] Individuals at high risk should be given extra care, as traumatic and surgical complications are the main prognostic factors. […] The final VA ranged from 0 to 3.00 logMAR with a mean of 1.10 0.43 logMAR. […] The univariable linear regression results demonstrated that worse visual outcomes were significantly associated with open globe injury, worse initial VA, alcohol intake at injury, surgical complications, hypertension, diabetes, endophthalmitis, retinal detachment, choroidal detachment, ciliary detachment, vitreous hemorrhage, and undergoing multiple surgeries.

• #6 Epidemiology of Ocular Trauma and Predictive Modeling of Visual Outcom | RMHP

  https://www.dovepress.com/epidemiology-of-ocular-trauma-and-predictive-modeling-of-visual-outcom-peer-reviewed-fulltext-article-RMHP

  In the multivariable analysis, only worse initial VA, surgical complications, endophthalmitis, retinal detachment, choroidal detachment, ciliary body detachment, and 4 or more surgeries remained significantly associated with worse final VA. […] Among these, endophthalmitis had the greatest impact on visual prognosis. […] In all three models, surgical complications, number of surgeries, retinal detachment, and endophthalmitis emerged as significant factors influencing visual outcomes. […] The visual outcomes for trauma patients in this study were suboptimal, with only 51 individuals achieving a final VA of 0.30 logMAR or higher. […] Our findings, in line with established consensus, highlight that many eye injuries are preventable through public awareness, parental supervision, workplace protective measures, and strict firework regulations.

• #7 Visual outcome after open globe injury: a comparison of two prognostic models—the Ocular Trauma Score and the Classification and Regression Tree | Eye

  https://www.nature.com/articles/eye200916

  The OTS model used six variables (initial visual acuity, an RAPD, globe rupture, endophthalmitis, perforating injury, and retinal detachment) to predict the visual outcome of patients after ocular trauma. […] The OTS provided the treating ophthalmologist with realistic expectations of the visual potential of an open globe injury and thus in deciding among various management plans. […] In this study, the OTS had a higher prognostic accuracy than the CART model to predict correctly visual survival (LP or better) vs no vision (NPL or enucleation), and minimal to severe visual loss (3/60 or better) vs profound visual loss (worse than 3/60).

• #8 Development, comparison, and internal validation of prediction models to determine the visual prognosis of patients with open globe injuries using machine learning approaches | BMC Medical Informatics and Decision Making | Full Text

  https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02520-4

  The most illuminating set of features can be chosen by plotting the random forests interpretation of feature importance. […] The study has some limitations and precautions. The data were collected from only one eye hospital from one city. Therefore, it is suggested that data be collected from several centers in different geographical locations, and external verification will have better performance and reliability. […] Successful initial repair and subsequent visual rehabilitation is a challenge for ophthalmic trauma surgeons. […] Numerous studies have been evaluated the significant factors affecting final visual outcome in OGI previously. […] The study aimed to evaluate and compare the efficacy of different ML algorithms regarding the prediction of the final VA in patients with OGI.

• #9 Pattern and clinical profile of patients with ocular trauma presenting to the emergency department of a teaching hospital in India: A prospective observational study | 2024, Volume 24, Issue 2 | Turkish Journal of Emergency Medicine

  https://turkjemergmed.com/full-text/876

  A total of 180 patients data were included for final analysis. […] The vision was not affected in most of the cases (n = 125 [69.4%]) with a visual acuity of 6/18. […] The majority (n = 120 [67%]) of the patients had an OTS of grade-4, followed by grade-2 (n = 22 [12%]). […] The vision remains unimpaired in most of the victims, as indicated by a majority achieving an OTS grade of 4, signifying a favorable visual prognosis. […] The initial OTS score following OT was documented to be a good predictor of visual prognosis and was first introduced by Kuhn et al. […] A follow up evaluation was done for all 22 patients at 6 months after initial interventions. The study found the predictive accuracy of OTS to be 77.27%. Out of 22 OGI patients, the visual outcomes of 17 patients were accurately predicted: Two patients with a better visual outcome and three patients with a worse outcome.

• #10 An interpretable model predicts visual outcomes of no light perception eyes after open globe injury – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36596662/

  The visual outcome of open globe injury (OGI)-no light perception (NLP) eyes is unpredictable traditionally. This study aimed to develop a model to predict the visual outcomes of vitrectomy surgery in OGI-NLP eyes using a machine learning algorithm and to provide an interpretable system for the prediction results. […] VisionGo has achieved an accurate and reliable prediction in visual outcome after vitrectomy for OGI-NLP eyes.

• #11 Development, comparison, and internal validation of prediction models to determine the visual prognosis of patients with open globe injuries using machine learning approaches | BMC Medical Informatics and Decision Making | Full Text

  https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02520-4

  Open globe injuries (OGI) represent a main preventable reason for blindness and visual impairment, particularly in developing countries. The goal of this study is evaluating key variables affecting the prognosis of open globe injuries and validating internally and comparing different machine learning models to estimate final visual acuity. […] The artificial neural network (ANN) model had the best accuracy to predict the final VA. […] As classic and ensemble ML models were compared, results shows that the ANN model was the best. […] Excellent predictive accuracy was shown by the open globe injury model developed in this study, which should be helpful to provide clinical advice to patients and making clinical decisions concerning the management of open globe injuries. […] The findings demonstrated that there is little correlation between the predictive features.

• #12

  https://journals.lww.com/ijo/fulltext/2022/08000/new_model_for_the_prediction_of_visual_outcomes_in.57.aspx

  Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. […] Visual outcomes significantly improved after operation, and the outcomes did not differ between closed- and open-globe injuries (P = 0.162). […] TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. […] Ocular trauma does not receive adequate attention in many areas globally owing to poor infrastructure, untrained human resources, and variable outcomes. […] Pediatric ocular trauma might result in life-long visual disability, thus posing a burden to the health-care system and society.

• #13

  https://journals.lww.com/ijo/fulltext/2022/08000/new_model_for_the_prediction_of_visual_outcomes_in.57.aspx

  Precise visual prognosis is a key challenge in eye trauma treatment in pediatric cases. […] Different scoring methods available for ocular trauma evaluation can help health-care providers appropriately predict vision-related outcomes. […] However, the OTS demonstrated a low accuracy in children owing to its inability to obtain accurate VA; thus, instruments should be developed specifically for pediatric patients. […] The Pediatric penetrating OTS (POTS) involves the exclusion of the initially calculated VA and afferent pupil defect serving as prognostic factors and the inclusion of wound location and age as new variables. […] However, POTSs drawback that it is less effective in high-risk trauma cases has been reported. […] The TOTS and POTS exhibited limitations in those with poor prognosis. […] TOTS, as a novel predictive score, is more reliable than the POTS, but less specific and sensitive in high-risk (OTS-1 and POTS-1) cases.

• #14 Open globe injuries: factors predictive of poor outcome | Eye

  https://www.nature.com/articles/6702099

  The presence of an RAPD was highly significant in predicting outcome. If present, the outcome was significantly worse than if not present. […] The rate of enucleation in our series of 107 open globe injuries was 13/107 (12%) patients. […] Statistically significant risk factors present on initial presentation associated with eventual enucleation include a blunt mechanism of injury, the absence of a red reflex, the presence of a lid laceration, and an RAPD. […] In certain situations, primary enucleation should be considered the treatment of choice.

• #15 Ocular trauma among patients attending a tertiary teaching hospital in Zimbabwe | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0292392

  A total of 863 patients (1007 eyes) were identified to have experienced ocular trauma of one kind or another, with the youth (1835 years) reporting with most cases (331, 38.4%). […] Patients with open-globe injuries were about 10 times more likely to develop blindness than those with closed-globe injuries after adjusting for age and gender, and this was statistically significant (ARR = 9.65, 95% CI: 5.5316.84, p 0.001). […] The prevalence of distance vision impairment due to ocular trauma was 60.1% (95% CI: 56.8%-63.4%), with majority resulting in blindness (22.0%, 95% CI: 19.4%-24.9%). […] Notably, it was observed in this study that patients with open-globe injuries were approximately ten times more likely to develop blindness compared to those with closed-globe injuries, even after adjusting for age and gender (ARR = 9.65, 95% CI: 5.5316.84, p 0.001).

• #16 Ocular trauma among patients attending a tertiary teaching hospital in Zimbabwe | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0292392

  The prevalence of vision impairment due to ocular trauma, on the other hand, was 60.1% which is quite remarkable given the detrimental effect (loss of livelihood, educational and occupational opportunities, quality of life, among others) vision impairment has on the individual and society at large. […] Blindness was the leading cause of vision impairment from ocular trauma, which suggested late presentation to the facility and the severity of the impact of trauma on the eye. […] A chi-square test revealed that there was a statistically significant difference between vision impairment patterns between patients with open-globe injuries and closed-globe injuries (X2 = 100.98, df = 4, p 0.001). […] Multinomial regression analysis further revealed that compared to patients with closed-globe injury, those with open-globe injury were 3 times more likely to develop mild vision impairment (ARR = 2.92, 95% CI: 1.814.69, p 0.001), 4 times more likely to develop both moderate (ARR = 3.55, 95% CI: 2.315.33, p 0.001) and severe vision impairment (ARR = 3.59, 95% CI: 1.309.89, p = 0.01) and 10 times more likely to develop blindness (ARR = 9.65, 95% CI: 5.5316.84, p 0.001) after adjusting for age and gender. […] There is a high prevalence of avoidable open-globe injuries in Zimbabwe with blunt trauma being the most significant cause.

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