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A Meta-Analysis and Meta-Regression of Pediatric Open Globe Injuries in Türkiye
Kursat Atalay1, Havva Kaldirim Erdogan1, Fatma Gezer Savur1
1Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, İstanbul, Türkiye.
Insights
Pediatric open globe injuries (OGI) are a significant health concern. This meta-analysis reveals boys, home accidents, and sharp objects are common causes, impacting visual acuity, especially in younger children.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Open globe injuries (OGI) represent a critical cause of vision loss in children.
- Understanding the epidemiology and risk factors for pediatric OGI is essential for developing targeted prevention strategies.
- Previous research has highlighted the impact of OGI, but a comprehensive meta-analysis specific to Türkiye is lacking.
Purpose of the Study:
- To conduct a meta-analysis of pediatric open globe injuries (OGI) reported in Türkiye over a five-year period up to June 2023.
- To identify demographic, etiological, and injury-specific factors associated with OGI in children.
- To evaluate the visual outcomes in pediatric OGI cases.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA and MOOSE guidelines.
- Inclusion of studies on individuals under 18 years without age or follow-up restrictions.
- Random-effects model employed for meta-analysis, with heterogeneity assessed using I2 and Q-test.
Main Results:
- The average age of injured children was 7.4 years, with boys accounting for 66.8% of injuries.
- Home injuries (46.9%) were most prevalent, often caused by sharp-pointed objects (71.9%).
- Trauma Zone 1 had the highest incidence (63.8%). Boys showed a positive effect size for no light perception visual acuity, while Trauma Zones 1 and 2 had negative effect sizes for visual acuity <0.1.
Conclusions:
- Pediatric open globe injuries are a significant public health issue in Türkiye.
- Standardized research and data collection are crucial for a better understanding and management of these injuries.
- Findings underscore the need for targeted prevention efforts focusing on common causes and high-risk groups.
Objectives:
To do a meta-analysis of pediatric open globe injuries (OGI) presented from Türkiye for the 5 years up to June 2023.
Methods:
We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement and the Meta-analysis of Observational Studies in Epidemiology criteria. We included studies that analyzed individuals younger than 18 years without age and follow-up period restrictions. We performed random-effects model estimates for the meta-analysis of the relevant studies. We evaluated the heterogeneity with the inconsistency index I2 and the Q-test.
Results:
The average age of child injuries was 7.4 (95% confidence interval [CI]: 6.9-8.5) years. While the injury rate in boys was 66.8% (95% CI: 61.8-71.4), it was observed as 33.2% (95% CI: 28.6-38.2) in girls. Home injuries were the highest with 46.9% (95% CI: 22.4-73.1). Sharp-pointed object traumas were the most common, accounting for 71.9% (95% CI: 58.3-82.4). When the trauma zone distribution was examined, it was determined as zone 1 with the highest rate of 63.8% (95% CI: 60.1-67.3). Zone 2 and zone 3 have been observed with decreasing frequency (25.4% and 105%, respectively). The overall effect size of boys was positive in the group whose final best-corrected visual acuity (BCVA) was no light perception (β: 1.1657; p=0.0039). For patients with a final BCVA <0.1, Trauma Zone 1 (β: -0.0054; p=0.0410) and Zone 2 (β: -0.0034; p=0.0211) were found to have a negative overall effect size.
Conclusion:
OGI is one of the important health problems. We think that standardized research will contribute to the enlightenment of this issue.
