Original Article
The Value of Ocular Trauma Score in Predicting Secondary Glaucoma after Blunt Trauma
Hou Xu, Hu Dan, Wang YuSheng, Shi Rong, Dong Hao
Published 2018-09-25
Cite as Chin J Optom Ophthalmol Vis Sci, 2018, 20(9): 513-518. DOI: 10.3760/cma.j.issn.1674-845X.2018.09.001
Abstract
Objective:We analyzed the incidence of secondary glaucoma, the surgery rate, and the efficacy of intraocular (IOP)-lowering medication following blunt ocular trauma. We also correlated these factors with the ocular trauma score (OTS) system suggested by the International Society of Ocular Trauma and evaluated the applicability of the OTS in predicting the likelihood of secondary glaucoma onset and the optimal treatment of it.
Methods:We conducted a retrospective review of 265 patients (267 eyes) with ocular contusion admitted to Xijing Hospital from January 2014 to December 2016. The initial visual acuity (VA), zone of injury, relative afferent papillary defect, and OTS were evaluated to analyze the clinical characteristics and the incidence of secondary glaucoma. Data were analyzed using chi-square tests, linear correlation analysis, t-tests, and analysis of variance.
Results:Overall, the final VA was better than the initial VA ( χ2=65.99, P<0.001). The incidence of secondary glaucoma was 13.1% (35 eyes), and higher OTSs were associated with lower occurrences (χ2= 8.593, P=0.035). All glaucoma patients had eye injury in zones Ⅰ and Ⅱ, and 12 eyes were involved in zone Ⅲ. Glaucoma patients with worse OTSs had higher surgery rates (r =-0.980, P<0.001). All glaucoma patients with an OTS of 2 received surgery graded over level 3. At 6 months after injury, the IOP of glaucoma patients in each OTS group was significantly lower than at the initial visit (t=6.93, 8.21, 8.24, 6.36, P<0.01), but there were no significant differences in IOP between each group. The number of IOP lowering medications taken at 6 months after injury by patients with a score 2, 3, or 4 trauma was significantly reduced compared with the initial treatment (t=13.50, 4.75, 3.20, P<0.05). However, there was no statistical difference in the number of medications used between groups with score 3, 4, and 5 at the initial treatment or at 6 months.
Conclusions:The OTS is of value in predicting secondary glaucoma after blunt trauma. Poorly scoring victims are more likely to develop secondary glaucoma and need surgical intervention. A larger data sample is needed to determine differences in the number of IOP lowering medication needed for patients with different scores.
Key words:
blunt trauma; post-traumatic glaucoma; ocular trauma score
Contributor Information
Hou Xu
Department of Ophthalmology, Xijing Hospital, Eye Institute of People's Liberation Army, the Fourth Military Medical University, Xi'an 710032, China
Hu Dan
Wang YuSheng
Shi Rong
Dong Hao
