Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries

• Published in: Injury 2015-09, Vol.46 (9), p.1828-1833
• Main Authors: Zhu, Lili, Wu, Zhencheng, Dong, Feng, Feng, Jia, Lou, Dinghua, Du, Chixin, Ren, Peifang
• Format: Article
• Language: English
• Subjects: Adolescent; Cataract - diagnosis; Cataract - epidemiology; Cataract - physiopathology; Child; Child Health Services; Child, Preschool; China - epidemiology; Directive Counseling; Eye Injuries, Penetrating - diagnosis; Eye Injuries, Penetrating - epidemiology; Eye Injuries, Penetrating - physiopathology; Female; Humans; Infant; Infant, Newborn; Male; Ocular trauma score; Orthopedics; Paediatric penetrating ocular trauma score; Penetrating eye injury; Predictive Value of Tests; Prognosis; Recovery of Function; Reproducibility of Results; Retinal Detachment - diagnosis; Retinal Detachment - epidemiology; Retrospective Studies; Time Factors; Trauma Severity Indices; Traumatic cataract; Visual Acuity
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2015.04.024

Abstract Purpose To compare the ocular trauma score (OTS) and the paediatric penetrating ocular trauma score (POTS) as prognostic model for visual outcome in paediatric traumatic cataract cases after penetrating eye injuries. Methods All children younger than 16 years with unilateral traumatic cataract following penetrating trauma between 2007 and 2012 were retrospectively reviewed. Univariate chi-square analysis was conducted to identify the variables associated with profound visual loss. The area under the receiver-operating characteristic curves (AUROC) was used to assess the predictive ability of the two models. Results The study group comprised 65 boys and 37 girls. The variables associated with profound visual loss were: a relative afferent papillary defect (RAPD) ( P < 0.001), poor initial vision ( P = 0.01), vitreous haemorrhage ( P < 0.001), retinal detachment ( P < 0.001), posterior penetrating site ( P < 0.001), hyphema ( P < 0.001), no intraocular len implantation ( P < 0.001) and endophthalmitis ( P = 0.001). OTS could not be calculated in 21 patients (20.6%) without clinical data on initial visual acuity and RAPD. For the patients with complete clinical data, POTS was similar to OTS in predicting poor vision (AUROC 0.904 vs 0.924) and in predicting good vision (AUROC 0.766 vs 0.736). For all the samples, POTS was a robust predictor of poor vision (AUROC 0.910) and had a moderate ability to predict good vision (AUROC 0.764). Conclusion OTS has high ability to predict visual outcome for paediatric traumatic cataract following penetrating ocular trauma. POTS is also a reliable prognostic model for very young child without initial vision or RAPD, but is only for penetrating eye injuries.