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Title Visual survival after open globe injury: a comparison of two prognostic models for visual outcome in a tertiary ophthalmic centre
Submitted by Ahmed Aziz
Abstract Number 117
Review Result rapid fire presentation
Purpose

The Western Eye Hospital (WEH) is one of the busiest eye trauma centres in the UK. However, the majority of patients presenting with open globe injuries do not receive an indication of visual prognosis at initial assessment. We evaluated the use of the Ocular Trauma Score (OTS) and Classification and regression tree (CART) analysis as prognostic models of visual outcome.

Methods

Retrospective review of 36 consecutive open globe injuries at the WEH from April 2016 to March 2018. OTS and CART predictive models were compared against actual visual outcomes. Classification of open globe injury, average time taken from assessment to primary repair and level of surgeon were collated.

Results

Mean age was 38 (15-86 years), 81% male and 89% of injuries were due to accidents. The majority of injuries were lacerations (53%) with globe rupture in a third of cases. 49% of primary repairs were carried out by non-consultant grades with 74% within 24 hours of the patient’s initial assessment.

When predicting visual survival (LP or better) the OTS had a sensitivity of 93.5%, specificity 100% whilst the CART yielded a sensitivity of 100% and specificity of 75%. When predicting minimal-to-severe visual loss (3/60 or better) OTS had a sensitivity of 90.5%, specificity 78.6% whilst the CART yielded a sensitivity of 100% and specificity of 64.3%.

Conclusion

No difference in visual outcome and scoring sensitivity was found between consultant and non-consultant grades. Both the OTS and CART were shown to have high predictive accuracy. These scoring systems should be incorporated routinely in the initial assessment of open globe injuries to aid counselling of patients.


Additional Authors
Last name Initials City / Hospital Department
Alnahrawy AA London/Western Eye Hospital Oculoplastics
Jain RJ London/Western Eye Hospital Oculoplastics
Lee VL London/Western Eye Hospital Oculoplastics
Shah P London/Western Eye Hospital Oculoplastics