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Anterior Segment Organ Culture Platform for Tracking Open Globe Injuries and Therapeutic Performance
Published on: August 25, 2021
Characteristics and outcomes of pediatric open globe injury
Janejit Choovuthayakorn1, Prapatsorn Patikulsila, Direk Patikulsila
1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Chiang Mai, 50200, Thailand, janjitc@yahoo.com.
Insights
Pediatric open globe injuries, often caused by wooden objects, frequently affect the cornea. Retinal detachment significantly worsens visual outcomes, even after surgery.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Ocular Injury Epidemiology
Background:
- Open globe injuries represent a significant cause of vision loss in children.
- Understanding injury mechanisms and outcomes is crucial for improving pediatric eye care.
Purpose of the Study:
- To detail the epidemiology, injury mechanisms, and visual outcomes of pediatric open globe injuries.
- To identify factors influencing visual recovery in this population.
Main Methods:
- Retrospective review of medical records for pediatric patients (≤16 years) diagnosed with open globe injury from 2006-2010.
- Analysis of injury type, cause, surgical interventions, and final visual acuity.
Main Results:
- 49 pediatric patients (83.7% male, mean age 9.3 years) were identified.
- Ocular penetration (63.3%), primarily corneal, was the most common injury type, often caused by wooden objects.
- Final visual acuity of ≥6/60 was achieved in 40.8% of patients; only 36% undergoing pars plana vitrectomy achieved this acuity.
- Retinal detachment was a significant negative predictor of visual outcome (OR 0.05, p<0.001).
Conclusions:
- Corneal penetration is a frequent finding in pediatric ocular trauma.
- Pediatric patients with open globe injuries and retinal detachment face a higher risk of poor visual outcomes.
- Effective vision preservation remains a challenge, even with timely surgical intervention, particularly in cases requiring pars plana vitrectomy.
Abstract:
To describe the epidemiology, mechanism of injury, and final visual and anatomical outcomes of pediatric patients with open globe injury. The medical records of patients aged ≤ 16 years diagnosed with open globe injury between January 2006 and December 2010 were retrospectively reviewed. Forty-nine pediatric patients were diagnosed with open globe injury during the study period. Forty-one of the 49 patients (83.7 %) were male. The mean age of the patients was 9.3 ± 4.6 years, with 49 % of the injuries occurring in patients between the ages of 11 and 16 years. Ocular penetration was the most common type of injury (63.3 %), occurring most frequently in the cornea (63.3 %). Wooden objects were the most common cause of injury. Following surgical intervention, 40.8 % of the patients obtained a final visual acuity (VA) of ≥ 6/60. Pars plana vitrectomy was performed in 51 % of cases, with only 36 % of these patients having a final VA of ≥ 6/60. The presence of retinal detachment was the only statistically significant factor (odds ratio 0.05, p < 0.001) that affected VA improvement of more than one line. Corneal penetration was frequently observed in pediatric patients with ocular trauma. Pediatric patients with a retinal detachment were significantly more likely to have a poor final visual outcome than open globe patients whose retina remained attached. Despite prompt surgical intervention, useful vision was preserved in less than half of the patients requiring pars plana vitrectomy.
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