CHARACTERISTICS AND PROGNOSTIC INDICATORS OF FINAL VISUAL ACUITY IN PEDIATRIC OPEN GLOBE INJURY

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Tuan Quoc Le

Abstract

BACKGROUND: Pediatric open globe injury is a common disease which not only brings about severe visual impairment in children but also results in huge economic burden for the society.

PURPOSE:  To evaluate the characteristics as well as prognostic factors associated with unfavorable postoperative visual acuity in pediatric open globe injury.

METHODS: This was a prospective non – comparative case series recruiting 93 children aged from 3 to 15, and were admitted to The Pediatric Department of Ho Chi Minh City Eye Hospital with open globe injuries from November of 2013 to April of 2014. Duration of follow up was 6 months since the last operation. All the epidemiological and clinical characteristics as well as treatment outcomes were assessed. The association between prognostic indicators and unfavorable final visual acuity (< 20/200) was determined via multivariable logistic regression analysis.

RESULTS: The mean age of the research population was 9.04 ± 3.05. Injuries occurred more commonly in boys than in girls (the male to female ratio was 2.20). There were 63.44% of patients injured at home. 80.44% of children got open globe injuries while playing. Sharp object made up the largest percentage of all causes (65.59%). Corneal laceration, accounted for 68.82%, was the commonest type of trauma. 71.95% of children had initial visual acuity less than 20/200. 82 children were followed up until 6 months postoperatively and 75.61% of them had final best-corrected visual acuity ≥ 20/200. Complications’ incidence was quite low (< 10%). Prognostic factors associated with poor final visual acuity were: centrally corneal-related injury, wound length ≥ 6mm, vitreous hemorrhage, endophthalmitis and retinal detachment.

CONCLUSION: Our study results can be beneficial for health educational programs of open globe injuries prevention in children. Unfavourable prognostic indicators are likely to help pediatric ophthalmologists predict their patients’ final visual acuity.

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