TY  - JOUR
PY  - 2019//
TI  - Visual and ocular morbidity in severe open globe injuries presenting to a regional eye centre in New Zealand
JO  - Clinical and experimental ophthalmology
A1  - Court, Jennifer H.
A1  - Lu, Lucy M.
A1  - Wang, Nancy
A1  - McGhee, Charles Nj
SP  - 469
EP  - 477
VL  - 47
IS  - 4
N2  - IMPORTANCE: Open globe injuries (OGI) are a leading cause of monocular blindness world-wide with considerable cost to the individual and society. <br><br>BACKGROUND: To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand. <br><br>DESIGN: Retrospective study. PARTICIPANTS: A total of 385 eyes of 381 patients over a ten year period. <br><br>METHODS: Eligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes. MAIN OUTCOME MEASURES: Complications of injury, visual acuity at 3 months and final follow-up, and final status of the eye. <br><br>RESULTS: The estimated annual incidence of OGI was 2.8 per 100,000. Working-age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over-represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%), and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥ 6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test p<0.001). <br><br>CONCLUSIONS AND RELEVANCE: The incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at-risk groups to target with education and prevention strategies.<br><br>This article is protected by copyright. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1442-6404
UR  - http://dx.doi.org/10.1111/ceo.13439
ID  - ref1
ER  -