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Gao X, Zhang Q, Wang F, Li X, Ma C, Li Y, Zhao X, Zhang H. Wound size and location affect the prognosis of penetrating ocular injury. BMC Ophthalmol 2023; 23:257. [PMID: 37286942 DOI: 10.1186/s12886-023-03015-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/03/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Ocular trauma is a leading cause of vision loss. Penetrating ocular injury is a major type of open globe injury(OGI), while its epidemiology and clinical characteristics are still uncertain. The aim of this study is to reveal the prevalence and prognostic factors of penetrating ocular injury in the Shandong province. METHODS A retrospective study of penetrating ocular injury was performed at the Second Hospital of Shandong University, from January 2010 to December 2019. Demographic information, injury causes, ocular trauma types, and initial and final visual acuity(VA) were analyzed. To obtain more precise characteristics of penetrating injury, the eye global was divided into three zones and analyzed. RESULTS Among 210 OGI, there are 83 penetrating injuries which account for 39.5% of all. In addition, the final VA of 59 penetrating injuries recovered to 0.1 or better, which possesses the highest frequency among OGI. In order to research the relationship between the wound location and the final VA, we took 74 cases of penetrating injuries without retina or optic nerve damage for analysis. Results show that 62 were male and 12 were female. The average age was 36.01 ± 14.15. The most frequent occupation is the worker followed by the peasant. Statistics show that there is an obvious deviation in the Ocular trauma score (OTS) predicting the final VA and the actual final VA in the 45-65 score group (p < 0.05). Results suggest that the commonest penetrating injury zone is zone III (32 cases, 43.8%). Zone III, which is farthest from the center of the visual axis, has the largest improvement of the final VA (p = 0.0001). On the contrary, there is no statistical difference in the visual improvement in zone I and zone I + II that involves the injury of the central visual axis. CONCLUSION This study describes the epidemiology and clinical characteristics of patients hospitalized for penetrating ocular injury without retina damage in Shandong province. It can be concluded that larger size and closer location to the visual axis of damage are accompanied by worse prognosis improvement. The study provides a better understanding of the disease and enlightenment for the prediction of visual prognosis.
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Affiliation(s)
- Xue Gao
- Department of Ophthalmology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China
| | - Qiuqiu Zhang
- Department of Ophthalmology, Zaozhuang Municipal Hospital, Shandong, Zaozhuang, 27710, China
| | - Fang Wang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
| | - Xuewei Li
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
- Weifang Medical University, Shandong, 261000, Weifang, P.R. China
| | - Chunli Ma
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yixiao Li
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
- Department of Ophthalmology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China
| | - Xiaofei Zhao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
| | - Han Zhang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
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Hoskin AK, Fliotsos MJ, Rousselot A, Ng SMS, Justin GA, Blanch R, Colyer MH, Shukla B, Natarajan S, Kuhn F, Sundar G, Woreta FA, Watson SL, Agrawal R. Globe and Adnexal Trauma Terminology Survey. JAMA Ophthalmol 2022; 140:819-826. [PMID: 35862061 DOI: 10.1001/jamaophthalmol.2022.2594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Ocular trauma terminology should be periodically updated to enable comprehensive capturing and monitoring of ocular trauma in clinical and research settings. Objective To update terminology for globe and adnexal trauma. Design, Setting, and Participants A 2-round modified Delphi survey was conducted from January 1 to July 31, 2021, using an expert panel, including 69 ophthalmologists identified through their membership in ophthalmology (globe and adnexal trauma) societies. Consensus was defined as at least 67% expert agreement. A steering committee developed questions after identifying gaps in the current terminology via a targeted literature review. Round 1 sought consensus on existing and newly proposed terminology, and round 2 focused on unresolved questions from round 1. Experts included ophthalmologists who had managed, on average, 52 globe or adnexal trauma cases throughout their careers and/or published a total of 5 or more globe or adnexal trauma-related peer-reviewed articles. Main Outcomes and Measures Expert consensus on ocular and adnexal terms. Results A total of 69 experts participated in and completed round 1 of the survey. All 69 participants who completed round 1 were asked to complete round 2, and 58 responses were received. Consensus was reached for 18 of 25 questions (72%) in round 1 and 4 of 7 questions (57%) in round 2. Existing Birmingham Eye Trauma Terminology system terminology achieved consensus of 84% (58 of 69 experts) in round 1 and 97% (56 of 58 experts) in round 2. Experts agreed on the need for further refinement of the definition of zones of injury (55 of 69 [80%]), as the zone affected can have a substantial effect on visual and functional outcomes. There was consensus that the mechanism of injury (52 of 69 [75%]) and status of the lacrimal canaliculi (54 of 69 [78%]), nasolacrimal ducts (48 of 69 [69%]), lens (46 of 58 [80%]), retina (42 of 58 [73%]), and central and paracentral cornea (47 of 58 [81%]) be included in the revised terminology. Conclusions and Relevance There was consensus (defined as at least 67% expert agreement) on continued use of the existing Birmingham Eye Trauma Terminology system definitions and that additional terms are required to update the current ocular trauma terminology.
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Affiliation(s)
| | - Michael J Fliotsos
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrés Rousselot
- Consultorios Oftalmológicos Benisek Ascarza, Buenos Aires, Argentina
| | | | - Grant A Justin
- Duke Eye Centre, Duke University Hospital, Durham, North Carolina
| | - Richard Blanch
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, United Kingdom.,Department of Ophthalmology, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom.,Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Marcus H Colyer
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Bhartendu Shukla
- Department of Ophthalmology, Gajra Raja Medical College, Gwalior, India.,Regional Institute of Ophthalmology, Bhopal, India.,Ratan Jyoti Netralaya Ophthalmic Institute, Gwalior, India
| | | | - Ferenc Kuhn
- Helen Keller Foundation for Research and Education, Birmingham, Alabama.,Department of Ophthalmology, University of Pécs Medical School, Pécs, Hungary
| | - Gangadhara Sundar
- Orbit & Oculofacial Surgery, Department of Ophthalmology, National University Hospital of Singapore, Singapore.,Department of Pediatrics, National University Hospital of Singapore, Singapore
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Singapore, Singapore.,Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.,Duke National University of Singapore Medical School, Singapore, Singapore Eye Research Institute, Singapore
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