Risk factors for poor outcomes in patients with open-globe injuries

Figures & data

Table 1 A summary of risk factors determined to be associated with outcomes in the earlier OGI studies

References	Outcome assessed	Risk factors associated with outcome
Agrawal et al^Citation4	VA	APD, pre-op VA, blunt trauma, extent of trauma, traumatic cataract, hyphema, vitreous loss, vitreoretinal trauma, zone III injury
Agrawal et al^Citation5	VA	APD, zone III injury, vitreoretinal trauma
Al-Mezaine et al^Citation6	VA, RD, hypotony	Age, initial VA, mechanism of injury, location and extent of damage, endophthalmitis
Andreoli and Andreoli^Citation7	Follow-up surgery, VA	OTS, pre-repair VA, retinal hemorrhage, vitrectomy, lensectomy, multiple surgeries, APD, age, scleral laceration, RD
Emami-Naeini et al^Citation8	VA	Fall-related mechanism, zone III injury, NLP
Feng et al^Citation9	NLP	Ciliary body damage, RD, choroidal damage
Feng et al^Citation10	NLP	Rupture, scleral wound >10 mm, ciliary body damage, severe intraocular hemorrhage, closed funnel retinal detachment or retinal prolapse, choroidal damage
Kuhn et al^Citation11	Blindness (VA worse than 20/200)	Age, location of injury, mechanism of injury, OS, type of injury, involvement of posterior segment
Kuhn et al^Citation12	VA	OTS
Yu Wai Man and Steel^Citation13	VA	APD, initial VA, lid laceration, posterior wound, globe rupture, OTS
Rao et al^Citation14	VA	Initial VA, hyphema, zone and length of injury, RD, vitreous hemorrhage
Savar et al^Citation15	Enucleation	Rupture
Soni et al^Citation16	VA	Recovery of some vision on POD1, PPV, zone II injury
Yalcin Tök et al^Citation17	VA	Initial VA, vitreous prolapse, RD
Knyazer et al^Citation18	Vision retained (≥CF) or poor–no vision (≤HM)	Presenting acuity, eyelid injury, iris deformity, lens damage, ocular hypotonia, coexisting injuries, low OTS (<2)
Agrawal et al^Citation19	VA	TL between the injury and surgery, pre-op VA, mode of injury

Abbreviations: APD, afferent pupillary defect; CF, counting fingers; HM, hand motion; NLP, no light perception; OGI, open-globe injury; OTS, ocular trauma score; OS, left eye; pre-op, preoperative; POD1, postoperative day 1; PPV, pars plana vitrectomy; RD, retinal detachment; VA, visual acuity; TL, time lapse.

Table 2 VA rank for statistical analysis

Rank	Snellen	Rank	Snellen
1	20/20	12	20/300
2	20/25	13	20/400
3	20/30	14	6/200
4	20/40	15	5/200
5	20/50	16	4/200
6	20/60	17	3/200
7	20/70	18	CF (2/200)
8	20/80	19	1/200
9	20/100	20	HM
10	20/150	21	LP
11	20/200	22	NLP

Abbreviations: CF, counting fingers; HM, hand motion; LP, light perception; NLP, no light perception; VA, visual acuity.

Table 3 Method for calculating OTS

Calculating the OTS raw points
Variable	Raw points
Initial vision
NLP	60
LP/HM	70
1/200–19/200	80
20/200–20/50	90
≥20/40	100
Rupture	−23
Endophthalmitis	−17
Perforating injury	−14
Retinal detachment	−11
Afferent pupillary defect	−10
Conversion of raw points into OTS category
Sum of raw points	OTS
0–44	1
45–65	2
66–80	3
81–91	4
92–100	5

Abbreviations: LP, light perception; HM, hand motion; NLP, no light perception; OTS, ocular trauma score.

Table 4 Outcomes for patients who presented with no light perception VA

Patient	Final VA	Total number of surgeries	Enucleation
1	HM	3	No
2	LP	2	No
3	NLP	1	No
4	NLP	5	Yes
5	NLP	3	Yes
6	NLP	2	Yes

Abbreviations: HM, hand motion; LP, light perception; NLP, no light perception; VA, visual acuity.

Table 5 Age-adjusted associations between preoperative risk factors and postoperative outcomes

Predictor variable	Outcome variable
	MRAS	BCVA final rank	Enucleation
Pre-op BCVA rank	P=0.001 (+ association)	P<0.001 (+ association)	P=0.039 (+ association)
Calculated OTS	P=0.024 (− association)	P<0001 (− association)	P=0.041 (− association)
Zone I injury	P=0.452 (no association)	P=0.417 (no association)	P=0.569 (no association)
TL: injury to surgery (hours)	P=0.867 (no association)	P=0.611 (no association)	P=0.517 (no association)

Note: The associations between predictor and outcome variables that were statistically significant are highlighted in bold.

Abbreviations: BCVA, best-corrected visual acuity; MRAS, monthly rate of additional surgeries; OTS, ocular trauma score; pre-op, preoperative; TL, time lapse.

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