Visual and ocular morbidity in severe open-globe injuries presenting to a regional eye centre in New Zealand.
Clin Exp Ophthalmol
; 47(4): 469-477, 2019 05.
Article
en En
| MEDLINE
| ID: mdl-30414237
ABSTRACT
IMPORTANCE Open-globe injuries (OGI) are a leading cause of monocular blindness world-wide with considerable cost to the individual and society. BACKGROUND:
To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand.DESIGN:
Retrospective study.PARTICIPANTS:
A total of 385 eyes of 381 patients over a 10-year period.METHODS:
Eligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes. MAIN OUTCOMEMEASURES:
Complications of injury, visual acuity at 3 months and final follow-up, and final status of the eye.RESULTS:
The estimated annual incidence of OGI was 2.8 per 100 000. Working-age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over-represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%) and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test P < 0.001). CONCLUSIONS AND RELEVANCE The incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at-risk groups to target with education and prevention strategies.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Agudeza Visual
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Lesiones Oculares Penetrantes
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Oftalmopatías
Tipo de estudio:
Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Clin Exp Ophthalmol
Asunto de la revista:
OFTALMOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Nueva Zelanda