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Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open
Dusica Pahor1,2, Tomaz Gracner1
1Department of Ophthalmology, University Clinical Centre Maribor, Slovenia.
Insights
The Ocular Trauma Score (OTS) demonstrated higher prognostic accuracy for visual outcomes in pediatric open globe injuries compared to the Pediatric Ocular Trauma Score (POTS). The OTS is recommended for counseling pediatric cases due to its ease of use and reliability.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Pediatric Medicine
Background:
- Open globe injuries in children require accurate prognostic models for visual outcome prediction.
- Existing models like the Ocular Trauma Score (OTS) and Pediatric Ocular Trauma Score (POTS) aim to guide treatment and counseling.
- Comparing these scores is crucial for optimizing care in pediatric ocular trauma.
Purpose of the Study:
- To compare the prognostic capabilities of the Ocular Trauma Score (OTS) and the Pediatric Ocular Trauma Score (POTS).
- To evaluate visual outcomes following open globe injuries in pediatric patients using both scoring systems.
- To determine the most effective prognostic model for children with open globe injuries.
Main Methods:
- A retrospective analysis of 36 pediatric patients (<18 years) with open globe injuries was performed.
- Ocular Trauma Score (OTS) and Pediatric Ocular Trauma Score (POTS) were calculated for each case.
- Visual outcomes were assessed and compared between the two scoring systems across different injury categories.
Main Results:
- Significant differences in case distribution were observed between OTS and POTS, with POTS assigning more cases to lower-risk categories.
- The Pediatric Ocular Trauma Score (POTS) showed a better predicted visual prognosis in the lower categories (1-3) compared to the Ocular Trauma Score (OTS).
- Despite POTS showing better prognosis in lower categories, the Ocular Trauma Score (OTS) demonstrated higher prognostic accuracy overall and is easier to use.
Conclusions:
- The study did not confirm a significant benefit of the Pediatric Ocular Trauma Score (POTS) over the Ocular Trauma Score (OTS).
- The Ocular Trauma Score (OTS) is recommended for its ease of use and higher prognostic accuracy in counseling pediatric patients with open globe injuries.
- Further use of the OTS model is advised for improved management and counseling in pediatric ocular trauma cases.
Aim:
To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years.
Patients And Methods:
A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated.
Results:
Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 - 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models.
Conclusion:
Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.
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