Ocular trauma scores in paediatric open globe injuries

Area of Science:

• Ophthalmology
• Trauma Surgery
• Pediatric Medicine

Background:

• Pediatric open globe injuries present unique challenges in predicting visual outcomes.
• The Ocular Trauma Score (OTS) is a widely used tool, but its applicability in pediatric populations requires assessment.
• The Paediatric Penetrating Ocular Trauma Score (POTS) is a modification for pediatric cases.

Purpose of the Study:

• To evaluate the predictive accuracy and clinical applicability of the Ocular Trauma Score (OTS) for pediatric open globe injuries.
• To compare the predictive value of OTS and POTS for visual outcomes in children.
• To identify key factors influencing visual prognosis in pediatric ocular trauma.

Main Methods:

• Retrospective analysis of 71 pediatric patients (<18 years) with open globe injuries and at least 1-year follow-up.
• Assessment of OTS and POTS variables, including lens and segment injuries, for their predictive power on visual outcome.
• Statistical analysis to determine the significance of various injury parameters on final visual acuity.

Main Results:

• Initial visual acuity, retinal detachment, wound location, lens injury, posterior segment injury, traumatic cataract, hyphaema, and vitreous hemorrhage significantly impacted visual outcome.
• OTS application was challenging due to difficulties in evaluating relative afferent pupillary defect (RAPD) in all pediatric cases.
• Excluding RAPD from OTS calculation maintained its significant prognostic value (p<0.001), and POTS predictions correlated well with final visual acuities (p<0.001).

Conclusions:

• The Ocular Trauma Score (OTS) demonstrates high predictive value for visual outcomes in pediatric open globe injuries.
• The OTS is clinically applicable and prognostic in children, even when relative afferent pupillary defect (RAPD) evaluation is omitted.
• While POTS correlates with outcomes, some of its variables have limited prognostic impact in pediatric ocular trauma.