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Tan SI, Hoskin AK, Khatri A, Dave VP, Bhalerao S, Romero J, Agrawal R. Prognostic factors of open-globe injuries: A review. Indian J Ophthalmol 2023; 71:3587-3594. [PMID: 37991288 PMCID: PMC10788744 DOI: 10.4103/ijo.ijo_1496_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 11/23/2023] Open
Abstract
Open-globe injuries (OGI) can lead to significant visual impairment. The Ocular Trauma Score (OTS) is the most widely recognized tool for predicting visual outcomes. This review aimed to identify prognostic factors and assess the effectiveness of the OTS in predicting visual outcomes. Twenty-one articles published on PubMed and Google Scholar were analyzed. Initial visual acuity and the zone of injury were found to be the most significant prognostic factors for OGI. Other significant prognostic factors include retinal detachment/involvement, relative afferent pupillary defect, vitreous hemorrhage, vitreous prolapse, type of injury, hyphema, lens involvement, and duration from incidence of OGI to vitrectomy. Of the 21 studies evaluated, 11 investigated the effectiveness of OTS. Four studies concluded that OTS was effective overall, while six studies suggested that it was only useful in certain OGI categories. Thus, there is a need for further research to develop an optimized ocular trauma prognosticating system.
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Affiliation(s)
- Sze Ing Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Annette K Hoskin
- Save Sight Institute, The University of Sydney, Australia
- Lions Eye Institute, The University of Western Australia, Australia
| | - Anadi Khatri
- Department of Ophthalmology, Birat Aankha Aspatal, Biratnagar, Nepal
- Department of Opthalmology, Byers Eye Institute at Stanford, Stanford University, Palo Alto, USA
| | - Vivek P Dave
- Department of Ocular Immunology, Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sushank Bhalerao
- Shantilal Shanghvi Cornea Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Jose Romero
- Department of Ocular Trauma, Unidad Nacional de Oftalmologia de Guatemala, Guatemala, USA
| | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Singapore Eye Research Institute, Singapore
- Duke‐NUS Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Watanachai N, Choovuthayakorn J, Nanegrungsunk O, Phinyo P, Chokesuwattanaskul S, Tanasombatkul K, Hansapinyo L, Upaphong P, Porapaktham T, Sangkaew A, Apivatthakakul A, Kunavisarut P, Chaikitmongkol V, Patikulsila D. Intraocular foreign body: Characteristics, visual outcomes, and predictive values of ocular trauma score. Heliyon 2023; 9:e20640. [PMID: 37842556 PMCID: PMC10568348 DOI: 10.1016/j.heliyon.2023.e20640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Retained intraocular foreign body (IOFB) remains an important cause of acquired visual impairment. The visual prognosis following treatments for eyes with retained IOFB was observed to be distinct from other mechanisms of open globe injury due to the specific nature and associated circumstances. This study evaluated the risk behaviors, visual results, and predictive values of Ocular Trauma Score (OTS) in determining visual outcomes in patients with IOFB that were not related to terrorism. Methods Medical records of patients who underwent surgical interventions between January 2015 and December 2020 were retrospectively reviewed. Results A total of one hundred and sixty-one patients (162 eyes) were recruited. The patients had a mean (standard deviation) age of 47.6 (14.0) years with working male predominance (93.2%). The majority of patients were injured by activities related to grass trimming (63.4%) and metallic objects were the main materials causing injuries (75.7%). Following treatments, the proportion of eyes having vision worse than 20/400 decreased from 126 eyes (77.8%) to 55 eyes (33.9%) at final visit. Ocular trauma score (OTS) had a high potential prediction for final vision in eyes in OTS categories 4 and 5. However, the discordance of final visual acuity distribution was observed in some subgroups of eyes in OTS categories 1 to 3. Conclusion This study highlights the significance of IOFB related eye injuries in a tertiary care setting. Decision making on treatments should be carefully considered, particularly in eyes in lower OTS categories, in light of a rise in the proportion of patients who experience improved vision after IOFB removal.
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Affiliation(s)
- Nawat Watanachai
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
| | | | - Onnisa Nanegrungsunk
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Phichayut Phinyo
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Susama Chokesuwattanaskul
- Center of Excellence for Cornea and Stem Cell Transplantation, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Krittai Tanasombatkul
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand
| | - Linda Hansapinyo
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Phit Upaphong
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
| | | | - Apisara Sangkaew
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
| | | | - Paradee Kunavisarut
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
| | | | - Direk Patikulsila
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand
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Motamed Shariati M, Hosseini SM, Hashemi Javaheri Z. Traumatic subconjunctival lens dislocation. Clin Case Rep 2023; 11:e8098. [PMID: 37867547 PMCID: PMC10587644 DOI: 10.1002/ccr3.8098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/02/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Traumatic crystallin lens dislocation is a common complication following open globe injuries. Wound repair, lensectomy, and prophylactic antibiotic administration are essentials in the management.
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Gius I, Tozzi L, De Biasi CS, Pizzolon T, Parolini B, Frisina R. Artificial iris: state of the art. J Cataract Refract Surg 2023; 49:430-437. [PMID: 36719472 DOI: 10.1097/j.jcrs.0000000000001147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
Surgical correction of traumatic aniridia aims to improve the quality of vision, compartmentalize the anterior and posterior chamber, and re-establish a satisfying cosmetic appearance. Various types of prosthetic iris devices (PIDs) are available, which differ in technical difficulty of implant and design: artificial iris (AI)-intraocular lens prosthesis, endocapsular capsular tension ring-based PID, and customized AI. The choice depends on the preexisting clinical condition after severe ocular trauma and on patient functional and cosmetic expectations. This systematic review of the literature compared anatomical and functional outcomes of various types of PIDs. Of 185 articles found in the literature, 70 fulfilled the eligibility criteria. 5 subgroups of PIDs were Ophtec, artificial iris from Ophtec BV, Morcher GmbH, HumanOptics AG, and other prosthesis. Both glare and aesthetic outcome improved postoperatively; in comparison with other PIDs, intraocular pressure rise was higher in the Morcher group (40%), whereas prosthesis dislocation was higher in the Ophtec group (39%).
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Affiliation(s)
- Irene Gius
- From the Department of Ophthalmology, University of Padova, Padova, Italy (Gius); Department of Ophthalmology, Pordenone Hospital, Pordenone, Italy (Tozzi, De Biasi); Department of Ophthalmology, "Ca Foncello" Hospital, Treviso, Italy (Pizzolon); Ophthalmology, Eye Care Clinic, Brescia, Italy (Parolini); Ophthalmology-Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy (Frisina)
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Characteristics and Outcomes of Electric Bicycle-Related Open-Globe Injuries in a Tertiary Hospital in North China. J Craniofac Surg 2023; 34:561-563. [PMID: 36730435 DOI: 10.1097/scs.0000000000009131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/15/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim was to describe the characteristics and outcomes of patients treated for electric bicycle-related open-globe injuries (OGIs). METHODS A retrospective chart review of all patients who presented with electric bicycle-related OGIs was performed at the Hebei Eye Hospital in North China between January 2012 and December 2018. Demographic data, injury type, presenting clinical examination findings, best-corrected visual acuity (BCVA), secondary ocular complications, necessary surgical procedures and long-term outcome data were recorded. RESULTS Twenty-six patients with electric bicycle-related OGIs met the inclusion criteria and were enrolled in the study. Eighteen of the 26 patients (69.2%) were males. the average age of these patients was 44.0 years old. The injuries peaked in winter in the hour between 15:00 and 20:00. Among the patients, 23 (88.5%) were farm workers, 2 (7.7%) were industrial workers, 1 (3.8%) was student. The types of OGIs were 23 ruptures (88.5%), 3 penetrating injuries (11.5%). Data on zone of injuries included 1 zone I injuries (3.8%), 12 zone II injuries (46.2%), 13 zone III injuries (50.0%). Nine eyes (34.6%) had traumatic cataract, 24 eyes (92.3%) had vitreous hemorrhage, 20 eyes (79.9%) had retinal detachment, 19 eyes (73.1%) had choroidal detachment. Ten eyes (38.4%) had hand motion or worse vision at final follow-up. four eyes (15.4%) which had injuries involving all 3 zones resulted in enucleation or evisceration. With respect to BCVA, the initial BCVA was 2.7±0.3 and the final BCVA was 2.0±0.7, indicating that the patients' BCVA was significantly improved by surgery ( t =4.3, P <0.001). CONCLUSIONS Electric bicycle-related OGIs may have severe consequences. Modern surgical techniques can increase the rate of globe salvage although final vision remains poor. Therefore, increased awareness, proposed policies and suggestions should focus on regulating the use of electric bicycles and reinforcing laws and regulations to improve safety and prevent injuries.
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Yoshimura A, Ishikawa H, Uchida K, Takesue Y, Mori J, Kinoshita T, Morikawa S, Okamoto F, Sawada T, Ohji M, Kanda T, Takeuchi M, Miki A, Kusuhara S, Ueda T, Ogata N, Sugimoto M, Kondo M, Yoshida S, Ogata T, Kimura K, Mitamura Y, Jujo T, Takagi H, Terasaki H, Sakamoto T, Sugisawa T, Komuku-Yamamoto Y, Gomi F. Risk Factors for Legal Blindness in 237 Japanese Patients with Exogenous Endophthalmitis: A Multicenter Cohort Study from J-CREST. Ocul Immunol Inflamm 2023:1-9. [PMID: 36701518 DOI: 10.1080/09273948.2023.2165111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE We investigated potential risk factors for visual prognosis in Japanese patients with exogenous endophthalmitis. METHODS In this retrospective observational multicenter cohort study, risk factors for legal blindness at 12 weeks after treatment initiation were evaluated based on patient characteristics, initial BCVA, causative events, pathogens, ocular symptoms, duration from symptom onset to initial treatment, and selected treatments. RESULTS Overall, 23.1% of eyes developed legal blindness. The six risk factors for legal blindness were presence of eye pain, pathogen identification, poor BCVA at the initial visit, longer duration from symptom onset to initial treatment, type of causative event, and type of causative pathogen. Regarding the type of causative pathogen, coagulase-negative staphylococci was associated with a better visual impairment outcome. CONCLUSION Exogenous endophthalmitis remains a severe ocular infection; however, it can be managed with rapid treatment, as well as other advances in medical knowledge and technology.
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Affiliation(s)
- Ayano Yoshimura
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroto Ishikawa
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
- Department of Ophthalmology, Mirai Eye & Skin Clinic, Osaka, Japan
| | - Kazutaka Uchida
- Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshio Takesue
- Department of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya, Japan
| | - Junya Mori
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Takamasa Kinoshita
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Shohei Morikawa
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Fumiki Okamoto
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoko Sawada
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan
| | - Masahito Ohji
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan
| | - Takayuki Kanda
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan
| | - Masaru Takeuchi
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan
| | - Akiko Miki
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sentaro Kusuhara
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsuo Ueda
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Nahoko Ogata
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Masahiko Sugimoto
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Mineo Kondo
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Shigeo Yoshida
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan
| | - Tadahiko Ogata
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Kazuhiro Kimura
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yoshinori Mitamura
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Tokushima University Graduate School, Tokushima, Japan
| | - Tatsuya Jujo
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hitoshi Takagi
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroto Terasaki
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takaaki Sugisawa
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuki Komuku-Yamamoto
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Fumi Gomi
- J-CREST (Japan Clinical Retina Study group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
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Porapaktham T, Choovuthayakorn J, Nanegrungsunk O, Phinyo P, Tanasombatkul K, Watanachai N, Kunavisarut P, Chaikitmongkol V, Patikulsila D. Open Globe Injury in a Tertiary Hospital of Northern Thailand: No Vision Survival and Ocular Trauma Score. Clin Ophthalmol 2023; 17:365-373. [PMID: 36721667 PMCID: PMC9884457 DOI: 10.2147/opth.s401643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Purpose To determine characteristics and factors associated with no vision survival (included no light perception, enucleation, and evisceration) following open globe injury (OGI) and to correlate the proportion of final vision to predictive values of ocular trauma score (OTS). Patients and Methods The medical records of consecutive patients diagnosed as OGI between January 2015 and December 2020 were retrospectively reviewed. Data collected included demographics, mechanisms and modes of injuries, ophthalmic presentations, managements, and visual outcomes at the final visit. Results Three hundred and seventy-one patients with a mean (standard deviation, SD) age of 44.0 (17.4) years were included. Male with workplace injury was the most frequent scenario. High-velocity metallic objects were the predominant causative materials. Following treatments, fifty-six eyes (14.9%) obtained no vision survival. Factors associated with no vision survival following OGI were low presenting vision, globe perforation, larger wound, presence of relative afferent pupillary defect, retinal detachment, and vitreous hemorrhage. Compared to OTS predictive values, eyes in OTS categories 1 and 2 had a lower proportion of no vision survival. Conclusion This study identified the importance of workplace injuries. Overall, there were comparable final visions between OTS and this study. However, a reduced proportion of no vision survival among severely injured eyes signifies the challenges of OGI management.
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Affiliation(s)
- Tuangprot Porapaktham
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Correspondence: Janejit Choovuthayakorn, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand, Tel +66 53 935512, Fax +66 53 936121, Email
| | - Onnisa Nanegrungsunk
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Musculoskeletal Science and Translational Research (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Krittai Tanasombatkul
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nawat Watanachai
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Paradee Kunavisarut
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Voraporn Chaikitmongkol
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Direk Patikulsila
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Henry RK, Bargoud A, Syal S, Tadrosse A, Shaikh IS, Kost RL, Khouri AS. The impact of primary repair timing on longitudinal visual outcomes after open globe injury. Graefes Arch Clin Exp Ophthalmol 2022; 261:1195-1203. [PMID: 36383277 DOI: 10.1007/s00417-022-05904-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/05/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The urgency with which to repair open globe injuries is a debated topic that lacks grounding in longitudinal visual outcomes data. We aim to test the association between primary repair timing and visual recovery potential following OGI. SUBJECTS/METHODS We performed a retrospective cohort study of medical records from a US academic medical center (7/2017 to 11/2021). We included all patients with a principal diagnosis of OGI, a documented date and time of injury, presentation, repair, and ≥ 3 months of complete follow-up data on visual outcomes. We excluded those with prior OGI in the same eye. We also tested the correlation of injury to repair time (ITR) in hours with best corrected visual acuity (BCVA, in logMAR units) at last follow-up in the general cohort and select subpopulations and the impact of repair delay on visual improvement over the follow-up period. RESULTS One hundred twenty-nine patients with OGI were analyzed (91 patients with ≥ 3 months of follow-up). The majority were male (105/129, 81%) with a median age of 45 years. Most OGI involved zone 1 (57%), followed by zone 3 (24%), and zone 2 injuries (19%). Median ocular trauma score (OTS) was 60 (IQR 37-70); mean presenting BCVA was logMAR 1.9 (median 2.3, IQR 1.0-2.7). Median ITR was 22 h (IQR 15-30 h, range 5-199 h). ITR time did not significantly correlate with final BCVA (n = 91, β = - 0.003, 95% CI - 0.009-0.002, P = 0.233), nor did it significantly increase the odds of developing ocular complications or requiring secondary ocular surgeries (OR 0.985, 95% CI 0.967-1.002, P = 0.085). Additionally, the rate of BCVA improvement over subsequent months of follow-up did not significantly differ based on ITR time. Presenting BCVA (R2 = 0.701, P < 0.001) and OTS (R2 = 0.477, P < 0.001) significantly correlated with final BCVA, independent of repair delays. CONCLUSIONS In this cohort of OGI patients, repair timing does not significantly correlate with final BCVA, and delays beyond 24 h do not significantly correlate with worse visual recovery potential. Repair time alone should be emphasized to a lesser extent as a prognosticator of visual potential, in favor of significant predictors such as the ocular trauma score and presenting visual acuity.
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Risk factors for globe removal after open-globe injury in agricultural regions. Sci Rep 2022; 12:17122. [PMID: 36224319 PMCID: PMC9556698 DOI: 10.1038/s41598-022-21666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/29/2022] [Indexed: 01/04/2023] Open
Abstract
This study aimed to identify the prevalence and risk factors for globe removal among patients with open-globe injuries (OGIs) in agricultural regions. A retrospective chart review of patients with OGIs was performed between January 2010 and December 2019. Univariable and multivariable logistic regression models were used to identify the factors associated with globe removal in OGI. This study included 422 patients (422 eyes). The highest prevalence of OGI was observed in the middle age group (> 20 to 40 years). The most common cause of OGIs was agriculture-related injury (54.7%), followed by industry or workplace-related injury (20.4%), and assault (5.0%). Intraocular foreign bodies, endophthalmitis, and panophthalmitis were reported in 57.6%, 28.4%, and 5.7% of cases, respectively. Eight eviscerations and 43 enucleations were performed, accounting for 12.1% of OGIs. The most common indication for globe removal was panophthalmitis. Multivariable analysis revealed that the predictive factors significantly associated with globe removal were assault injuries (adjusted odds ratio (aOR) = 5.53; p = 0.026), presenting logarithm of the minimum angle of resolution visual acuity (aOR = 311.79; p < 0.001), and endophthalmitis and panophthalmitis (aOR = 3.58 and 734.94, respectively; p < 0.001). This knowledge would aid in patient counseling and encourage health promotion.
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Kousiouris P, Klavdianou O, Douglas KAA, Gouliopoulos N, Chatzistefanou K, Kantzanou M, Dimtsas GS, Moschos MM. Role of Socioeconomic Status (SES) in Globe Injuries: A Review. Clin Ophthalmol 2022; 16:25-31. [PMID: 35027817 PMCID: PMC8749045 DOI: 10.2147/opth.s317017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
Globe injury is a serious worldwide public health issue frequently leading to permanent vision impairment. The plethora of different types of globe injuries is classified into categories, including open and closed globe injuries. Globe injury occurs mainly in the workplace and at home, affecting predominantly middle-aged working men. Socioeconomic status (SES) is defined by income level, educational attainment, and employment status. Low socioeconomic status has been associated with a higher incidence of globe injury and can be utilized to identify at-risk populations. For managing open and closed globe injuries, different strategies are applied and the implementation of adequate globe injury prevention measures is needed for reducing the occurrence of globe injury. The following article aims to provide an overview of globe injury characteristics and their correlation with socioeconomic status and to highlight the significance of considering SES as a variable in globe injury prevention.
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Affiliation(s)
- Panagiotis Kousiouris
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Olga Klavdianou
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Konstantinos A A Douglas
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Nikolaos Gouliopoulos
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Klio Chatzistefanou
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Maria Kantzanou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios S Dimtsas
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
| | - Marilita M Moschos
- 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital, Athens, Greece
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11
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Ueda K, Nagai T, Chubachi A, Sotani Y, Nishisho R, Nakamura M. Comparison of Two Cases of Foveal Laceration Caused by a Mower. Case Rep Ophthalmol 2021; 12:848-853. [PMID: 34899257 PMCID: PMC8613586 DOI: 10.1159/000518807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/20/2021] [Indexed: 11/19/2022] Open
Abstract
We report and compare 2 cases of open globe injury with foveal damage incurred while mowing. Case 1 is a healthy 67-year-old man presenting with an intraocular metallic foreign body and eye pain in his right eye after using a mower. The foreign body perforated the cornea's inferior area and damaged the foveal centralis, leading to central scotoma and decreased visual acuity. 27G pars plana vitrectomy was performed, and the final corrected decimal visual acuity was 0.1, but the visual field was preserved, except for the central scotoma. Case 2 is a healthy 50-year-old man presenting open globe injury with an intraocular metallic foreign body while using a mower. The foreign body damaged the fovea and triggered extensive retinal detachment. One month after surgery, proliferative vitreoretinopathy occurred, requiring additional surgery. The final corrected decimal visual acuity dropped to 0.05, resulting in an extensive visual field defect. Both cases of eye trauma were caused by mower injury, but the visual function outcomes differed with the size of the foreign body and the injury severity at the time of onset. Mower eye trauma is preventable, and efforts to educate users on safety measures are needed.
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Affiliation(s)
- Kaori Ueda
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takayuki Nagai
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Aya Chubachi
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuyuki Sotani
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryuto Nishisho
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makoto Nakamura
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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12
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Mohamed-Noriega K, Treviño-Herrera AB, Mohamed-Noriega J, Velasco-Sepúlveda BH, Martínez-Pacheco VA, Guevara-Villarreal DA, Rodríguez-Medellín DL, Sepúlveda-Salinas AG, Villarreal-Méndez G, González-Cortés JH, Elizondo-Omaña RE, Guzmán-López S, Mohamed-Hamsho J. Relationship of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio With Visual Acuity After Surgical Repair of Open Globe Injury. Front Med (Lausanne) 2021; 8:697585. [PMID: 34881251 PMCID: PMC8645644 DOI: 10.3389/fmed.2021.697585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the relationship and prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with poor final best-corrected visual acuity (BCVA) after surgical repair of open globe injuries (OGI) in adults. Design: Retrospective analysis of data from an ongoing prospective cohort of consecutive patients. Methods: In a tertiary university hospital, 197 eyes of 197 patients were included between 2013 and 2017. NLR and PLR were obtained from pre-operative blood tests to analyze its relationship with poor final BCVA. Results: Severe visual impairment (SVI) was defined as ≤20/200, and was observed in 96 (48.7%) patients after surgical repair of OGI. SVI patients had higher NLR (7.4 ± 6.6 vs. 4.0 ± 3.2, p < 0.001), and PLR (167 ± 92 vs. 139 ± 64; p = 0.021) than non-SVI. NLR ≥ 3.47 and PLR ≥ 112.2 were the best cut-off values for SVI, were univariate risk factors for SVI, and had sensitivity: 69.0, 71.4, and specificity: 63.6, 44.8, respectively. In multivariate analysis, only OTS, athalamia, and hyphema remained as risk factors. NLR had significant correlation with ocular trauma score (OTS) (r = −0.389, p < 0.001) and final BCVA (r = 0.345, p < 0.001). Limitations: Simultaneous trauma in other parts of the body that could influence the laboratory findings. Conclusion: Patients with SVI after a repaired OGI had increased pre-operative NLR and PLR levels. High NLR and PLR are risk factors for SVI in univariate analysis. It is confirmed that low OTS is a risk factor for SVI. High NLR and PLR could be used as a prognostic tool to identify patients at higher risk for SVI after repair of OGI.
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Affiliation(s)
- Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Alan B Treviño-Herrera
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jibran Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Braulio H Velasco-Sepúlveda
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Víctor A Martínez-Pacheco
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Dante A Guevara-Villarreal
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Delia L Rodríguez-Medellín
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Anna G Sepúlveda-Salinas
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Gerardo Villarreal-Méndez
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jesús H González-Cortés
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Rodrigo E Elizondo-Omaña
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Santos Guzmán-López
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jesús Mohamed-Hamsho
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
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13
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Watanachai N, Choovuthayakorn J, Chokesuwattanaskul S, Photcharapongsakul C, Wongsirimeteekul P, Phinyo P, Chaikitmongkol V, Kunavisarut P, Supreeyathitikul P, Patikulsila D. Risk factors and outcomes of post-traumatic endophthalmitis: a retrospective single-center study. J Ophthalmic Inflamm Infect 2021; 11:22. [PMID: 34337691 PMCID: PMC8326234 DOI: 10.1186/s12348-021-00254-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background To describe the epidemiology, characteristics, risk factors, and outcomes of post-traumatic endophthalmitis. Main body Medical records of consecutive open globe injury patients admitted and primarily treated between January 2006 and December 2016 were retrospectively reviewed. Patients were defined as having or not having associated endophthalmitis. Data of demographics, injury characteristics, clinical presentations, and visual outcomes were collected. The potential risks and significant factors for visual outcomes of post-traumatic endophthalmitis were determined. There were 591 patients included in this study. Among these, 118 patients were clinically diagnosed as having accompanied endophthalmitis. Higher proportions of intraocular foreign body (IOFB) (55.1% vs. 27.3%) and injury related to high-velocity objects (55.9% vs. 32.6%) were noted in patients with endophthalmitis compared to patients without endophthalmitis. Anterior wound location (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1 to 3.7; P = 0.020), presence of IOFB (OR, 1.9; 95% CI 1.2 to 3.0; P = 0.005), and delayed presentation of > 24 h (OR, 3.9; 95% CI 2.3 to 6.4; P < 0.001) were significant risk factors for associated endophthalmitis. Final visual acuity (VA) of the overall population improved significantly from 2.4 (0.6) logMAR to 1.4 (0.1) logMAR, P < 0.001, however, patients in the endophthalmitis group achieved a worse final VA than the non-endophthalmitis group (66.1% vs. 43.5%, P < 0.001). Conclusion High proportions of post-traumatic endophthalmitis patients had subsequent poor visual outcomes. Therefore, safety and protective measurements, especially when performing activities related to high-velocity objects, and the institution of prophylactic antibiotics in high-risk groups should be promptly considered to reduce the incidence.
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Affiliation(s)
- Nawat Watanachai
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand.
| | - Susama Chokesuwattanaskul
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Chaipot Photcharapongsakul
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Praelada Wongsirimeteekul
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Phichayut Phinyo
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Voraporn Chaikitmongkol
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Paradee Kunavisarut
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Pongsant Supreeyathitikul
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Direk Patikulsila
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
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14
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Scanzera AC, Dunbar G, Shah V, Cortina MS, Leiderman YI, Shorter E. Visual Rehabilitation With Contact Lenses Following Open Globe Trauma. Eye Contact Lens 2021; 47:288-291. [PMID: 33181528 PMCID: PMC8272942 DOI: 10.1097/icl.0000000000000756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe visual outcomes with various contact lens modalities in patients with a history of ocular trauma who underwent surgical open globe repair. METHODS Records of all patients with a history of open globe injury and repair at a tertiary care hospital between January 1, 2010, and December 31, 2016, were reviewed. Demographics, type of injury, and visual acuity were assessed before and after contact lens evaluation. RESULTS Of 214 patients who underwent open globe repair, 29 (13.6%) were evaluated with a contact lens. Visual acuity improved in 97% (28 of 29) of patients from 1.47±0.75 to 0.67±0.71 logarithm of the minimal angle of resolution (logMAR) with manifest refraction to 0.28±0.45 logMAR with contact lenses (n=29; P<0.0001). Corneal opacity was the most common clinical indication (20 of 29) for fitting followed by aphakia (13 of 29). A range of contact lens modalities, including corneal rigid gas-permeable (12 of 28), soft (9 of 28), hybrid (3 of 28), scleral gas-permeable (2 of 28), and piggyback (2 of 28) lenses were prescribed. CONCLUSION In this study, patients with a history of trauma and open globe repair with good neurosensory visual potential had improvements in visual acuity with contact lens greater than manifest refraction. Soft and gas-permeable lenses were used to improve visual acuity in patients with a history of open globe repair and corneal scarring, aphakia, iris abnormalities, or other ocular sequelae. Although corneal rigid gas-permeable lenses were prescribed most often, additional consideration should be given to other contact lens modalities, including soft, piggyback, hybrid, and scleral gas-permeable lenses.
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Affiliation(s)
- Angelica C Scanzera
- Department of Ophthalmology and Visual Sciences (A.C.S., G.D., V.S., M.S.C., Y.L., E.S.), Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL; Division of Epidemiology and Biostatistics (A.C.S.), School of Public Health, University of Illinois at Chicago, Chicago, IL; Currently Department of Ophthalmology and Visual Sciences (G.D.), University of Michigan, Ann Arbor, MI; and Dr. Gary Gold & Associates (V.S.), Sunnyvale, CA
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15
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Ishikawa H, Uchida K, Takesue Y, Mori J, Kinoshita T, Morikawa S, Okamoto F, Sawada T, Ohji M, Kanda T, Takeuchi M, Miki A, Kusuhara S, Ueda T, Ogata N, Sugimoto M, Kondo M, Yoshida S, Ogata T, Kimura K, Mitamura Y, Jujo T, Takagi H, Terasaki H, Sakamoto T, Sugisawa T, Komuku Y, Gomi F. Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST. Pathogens 2021; 10:pathogens10040390. [PMID: 33805010 PMCID: PMC8063932 DOI: 10.3390/pathogens10040390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 12/25/2022] Open
Abstract
Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.
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Affiliation(s)
- Hiroto Ishikawa
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 6638501, Japan; (T.S.); (Y.K.); (F.G.)
- Correspondence: ; Tel.: +81-798-45-6462
| | - Kazutaka Uchida
- Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya 6638501, Japan;
| | - Yoshio Takesue
- Department of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya 6638501, Japan;
| | - Junya Mori
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo 0608604, Japan; (J.M.); (T.K.)
| | - Takamasa Kinoshita
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo 0608604, Japan; (J.M.); (T.K.)
| | - Shohei Morikawa
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba 3058576, Japan; (S.M.); (F.O.)
| | - Fumiki Okamoto
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba 3058576, Japan; (S.M.); (F.O.)
| | - Tomoko Sawada
- Department of Ophthalmology, Shiga University of Medical Science, Otsu 5202192, Japan; (T.S.); (M.O.)
| | - Masahito Ohji
- Department of Ophthalmology, Shiga University of Medical Science, Otsu 5202192, Japan; (T.S.); (M.O.)
| | - Takayuki Kanda
- Department of Ophthalmology, National Defense Medical College, Tokorozawa 3598513, Japan; (T.K.); (M.T.)
| | - Masaru Takeuchi
- Department of Ophthalmology, National Defense Medical College, Tokorozawa 3598513, Japan; (T.K.); (M.T.)
| | - Akiko Miki
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 6500017, Japan; (A.M.); (S.K.)
| | - Sentaro Kusuhara
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe 6500017, Japan; (A.M.); (S.K.)
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara 6348522, Japan; (T.U.); (N.O.)
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara 6348522, Japan; (T.U.); (N.O.)
| | - Masahiko Sugimoto
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu 5148507, Japan; (M.S.); (M.K.)
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu 5148507, Japan; (M.S.); (M.K.)
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, Kurume 8300011, Japan;
| | - Tadahiko Ogata
- Department of Ophthalmology, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (T.O.); (K.K.)
| | - Kazuhiro Kimura
- Department of Ophthalmology, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (T.O.); (K.K.)
| | - Yoshinori Mitamura
- Department of Ophthalmology, Tokushima University Graduate School, Tokushima 7708503, Japan;
| | - Tatsuya Jujo
- Department of Ophthalmology, St. Marianna University School of Medicine, Kawasaki 2168511, Japan; (T.J.); (H.T.)
| | - Hitoshi Takagi
- Department of Ophthalmology, St. Marianna University School of Medicine, Kawasaki 2168511, Japan; (T.J.); (H.T.)
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 8908520, Japan; (H.T.); (T.S.)
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 8908520, Japan; (H.T.); (T.S.)
| | - Takaaki Sugisawa
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 6638501, Japan; (T.S.); (Y.K.); (F.G.)
| | - Yuki Komuku
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 6638501, Japan; (T.S.); (Y.K.); (F.G.)
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya 6638501, Japan; (T.S.); (Y.K.); (F.G.)
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16
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Open Globe Injuries Related to Traffic Accidents: A Retrospective Study. J Ophthalmol 2021; 2021:6629589. [PMID: 33614167 PMCID: PMC7878097 DOI: 10.1155/2021/6629589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/28/2020] [Accepted: 01/25/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose To evaluate epidemiology, clinical characteristics and outcomes of patients sustained traffic-related open globe injury (OGI). Methods The medical records of all OGI patients who were admitted in a tertiary referral center from January 2006 to December 2016 were retrospectively evaluated. Then, the records of injuries related to traffic accidents were identified and reviewed in detail. Results Among the overall causes of OGI, traffic-related accidents comprised 92/978 (9%) of cases. Nearly half of the injuries (51%) occurred in the 20–39-year-old group and 59% involved automobile transportation. Globe rupture occurred in 48 (47%) eyes. Following treatments, LogMAR visual acuity (VA) significantly improved from a median (interquartile range) of 2.3 (1.9–2.3) to 1.7 (0.3–3.0), at the final appointment. Presence of relative afferent pupillary defect and presence of retinal detachment were predictors for poor final visual outcomes. Conclusions Traffic-related OGI had a high prevalence in the young. The risky transportation modes were motorcycles in teenagers and automobiles in young adults. Despite treatment, there was a considerable proportion of impaired final VA. This information could help establish effective safety education and encourage regular adherence to road safety behaviors in the high-risk groups.
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17
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Siddiqui N, Chen EM, Parikh R, Douglas VP, Douglas KA, Feng PW, Armstrong GW. Epidemiology of United States Inpatient Open Globe Injuries from 2009-2015. Ophthalmic Epidemiol 2021; 28:469-478. [PMID: 33522349 DOI: 10.1080/09286586.2021.1875008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To study the epidemiology of inpatient open globe injuries (OGI) in the United States (US). METHODS This was a retrospective cohort study of patients with a primary diagnosis of OGI in the National Inpatient Sample (NIS) from 2009 to 2015. Sociodemographic characteristics, including age, gender, race, ethnicity, insurance, and income were stratified for comparison. Annual prevalence rates were calculated using 2010 US Census data. Statistical analysis included Chi-square tests, ANCOVA, and Tukey tests. RESULTS A total of 6,821 US inpatient hospital discharge records met inclusion/exclusion criteria. The estimated national prevalence of OGI during the 5-year period from 2009 to 2015 was 34,061 (95% confidence interval [CI] 31,445-36,677). The overall annual prevalence rate was 1.58 per 100,000 per year (CI 1.56-1.59). Overall, average annual prevalence rates were highest among patients 85 years or older (7.72, CI 6.95-8.49), on Medicare (3.92, CI 3.84-4.00), males (2.28, CI 2.25-2.30), African Americans (2.38, CI 2.32-2.44), and Native Americans (1.80, CI 1.62-2.00). OGI rates were lowest among Whites (1.21, CI 1.19-1.22), females (0.89, CI 0.87-0.91), those with private insurance (0.84, CI 0.82-0.86), and Asians (0.69, CI 0.64-0.74). Being in the lowest income quartile was a risk factor for OGI (p < .05). CONCLUSIONS Inpatient OGIs disproportionately affected those over 85, young males, elderly females, patients of African-American descent, on Medicare, and in the lowest income quartile. Additionally, children and young children had lower rates of OGI compared to adolescents. Further studies should delineate causes for socioeconomic differences in OGI rates to guide future public health measures.
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Affiliation(s)
- Neha Siddiqui
- University of Illinois Hospital and Clinics, Chicago, Illinois, USA; Carle Illinois College of Medicine, Champaign, Illinois, USA
| | - Evan M Chen
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA
| | - Ravi Parikh
- NYU Langone Health Department of Ophthalmology, New York University School of Medicine, New York, NY, USA.,Manhattan Retina and Eye Consultants, New York, NY, USA
| | - Vivian Paraskevi Douglas
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Konstantinos Aa Douglas
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Paula W Feng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA
| | - Grayson W Armstrong
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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18
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Globe rupture: a single-center retrospective study of demographic patterns and outcomes. Sci Rep 2020; 10:19139. [PMID: 33154518 PMCID: PMC7645784 DOI: 10.1038/s41598-020-76121-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/23/2020] [Indexed: 12/03/2022] Open
Abstract
Globe rupture is one of the severe mechanisms of eye injury. This study aimed to describe an epidemiologic patterns and visual outcomes of the open globe injury from globe rupture at a tertiary referral centre. Medical records of 167 patients (173 eyes) were retrospectively reviewed. Overall, males were predominant (82%). Road traffic- (26.3%) and work- (23.4%) were the major contributors. However, falling was the main mechanism in the elderly aged over 60 years. At presentation, 91.4% of eyes had initial visual acuity (VA) of worse than 20/200. The mean (SD) VA in logarithm of the minimum angle of resolution (LogMAR) unit at final [1.8 (1.1)] was significantly improved from presenting VA [2.4 (0.6)] (p ˂ 0.001). Predictors for final VA of worse than 20/400 included poor initial VA, presence of relative afferent pupillary defect, and endophthalmitis. In conclusion, this study observed the peak incidence of globe rupture in young teen to early adult patients, with unique characteristics in each age group. Even with significant visual improvement following the treatments, profound visual loss was still a common consequence. Thus, the role of effective prevention along with a multidisciplinary team together with timely and prompt ophthalmic management should be emphasised.
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19
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Supreeyathitikul P, Chokesuwattanaskul S, Choovuthayakorn J, Patikulsila D, Watanachai N, Kunavisarut P, Chaikitmongkol V. Epidemiology and Outcomes Following Open Globe Injury in Agricultural Region, an 11-Year Experience. Ophthalmic Epidemiol 2020; 27:246-251. [PMID: 31994961 DOI: 10.1080/09286586.2020.1716381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine the characteristics and epidemiology of open globe injury (OGI) in a third referral centre over 11 years. METHODS The study was a retrospective observational study. The medical records of 978 OGI cases (a total of 998 eyes), admitted to Chiang Mai University Hospital, Thailand from January 2006 to December 2016, were reviewed. RESULTS The mean age (SD) of patients was 39.1 (17.5) years. Patients were predominantly male (867, 88.7%). The age with the highest incidence of injury ranged from 41 to 60 years, in both genders. Most injuries happened at the workplace (64.8%), with flying objects from electric grass trimmers (23.9%) being the major injury-related mechanism. Penetration injuries were found in 479 eyes (48.0%). In elderly group (aged >60 years), a higher proportion of a globe rupture injuries were observed (13.3%). In general, intraocular foreign body group presented with better initial visual acuity (VA) compared to other injury types (p< 0.001). In all types of injury, final VA was significantly improved after treatment. However, rupture and perforation globe injuries had significantly worse final VA outcomes, compared to penetration and intraocular foreign body injuries (p< 0.001). With multivariable regression analysis, poor initial VA (p< 0.001), type of injury (p= 0.028), positive relative afferent pupillary defect (RAPD) (p< 0.001), and endophthalmitis (p< 0.001) were associated with poor visual outcomes. CONCLUSIONS Work-related eye injury is a major cause of OGI. Poor initial VA, endophthalmitis, presence of RAPD, and rupture were the predictors for poor final visual outcomes.
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Affiliation(s)
| | | | - Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand
| | - Direk Patikulsila
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand
| | - Nawat Watanachai
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand
| | - Paradee Kunavisarut
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand
| | - Voraporn Chaikitmongkol
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University , Chiang Mai, Thailand
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