Prognostic indicators of visual acuity after open globe injury and retinal detachment repair

Henry Lin, Gareth M.C. Lema, Pradeepa Yoganathan

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: To identify prognostic indicators of postoperative visual acuity and retinal detachment (RD) in open globe injuries. Methods: Retrospective review of 50 adult open globe injuries between September 2011 and March 2014. Hierarchical multivariable regression was used to evaluate relationships among injury characteristics, postoperative visual acuity, and RD after age adjustment. Results: Mean participant age was 46.2 years, and mean follow-up was 1.2 years. Blunt trauma accounted for 58% of injuries (29/50), and the wound extended posteriorly into sclera in 64% of cases (32/50). The retinal detachment occurred in 40% of patients (20/50), 95% of whom had developed vitreous hemorrhage (19/20). Multivariable regression revealed that preoperative visual acuity (P = 0.0010), posterior wound extension (P = 0.022), and RD (P = 0.0038) independently predicted postoperative visual acuity. No other injury characteristic was related to postoperative visual acuity after adjustment for preoperative visual acuity. Vitreous hemorrhage predicted RD (P< 0.001), and further consideration of preoperative visual acuity and other variables did not improve model fit. Moreover, among patients who underwent RD repair (n = 13), earlier vitrectomy after vitreous hemorrhage diagnosis (#12 days) was associated with fewer macula-off RDs (P = 0.018) and better postoperative visual acuity (P = 0.0055). Conclusion: Preoperative visual acuity, posterior wound extension, and RD significantly influenced postoperative visual acuity after open globe injury. Vitreous hemorrhage predicted RD, and prompt intervention after detection may improve visual outcomes.

Original languageEnglish
Pages (from-to)750-757
Number of pages8
JournalRetina
Volume36
Issue number4
DOIs
StatePublished - 2016
Externally publishedYes

Keywords

  • Ocular Trauma Score
  • open globe injury
  • retinal detachment
  • vitreous hemorrhage

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