The Ocular Trauma Score Underestimates Visual Recovery for the Most Severe Open-Globe Injuries.

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Open-globe injury (OGI) is a severe ocular trauma.
• The Ocular Trauma Score (OTS) is used to predict visual outcomes.
• Pars plana vitrectomy (PPV) is a surgical intervention for OGI.

Purpose of the Study:

• Compare actual visual outcomes in OGI patients with predictions from the Ocular Trauma Score (OTS).
• Evaluate the impact of pars plana vitrectomy (PPV) on visual outcomes after OGI.

Main Methods:

• Retrospective cohort study of 133 OGI patients treated between 2017-2020.
• Compared best-corrected visual acuity (VA) at follow-up with OTS predictions.
• Analyzed outcomes based on timing of PPV: primary, secondary, or no PPV.

Main Results:

• Eyes in OTS category 1 had better visual acuity than predicted (46% LP-HM vs. 15% predicted).
• Predictors of worse VA included older age and worse presenting VA.
• Secondary PPV did not significantly differ in final VA from primary PPV or no PPV groups, despite worse initial presentation.

Conclusions:

• The Ocular Trauma Score (OTS) may underestimate visual outcomes for the most severe OGI (category 1).
• Secondary PPV can lead to significant visual improvement in severe OGI cases.
• Consultation with a vitreoretinal surgeon is recommended for all severe OGI patients, particularly those in OTS category 1.