Insight into likelihood of retinal detachment following open globe injury

Ocular trauma causing open globe injury, or a breach in the wall of the eye, remains an important cause of vision loss, with more than 200,000 open globe injuries occurring worldwide each year. In many cases, retinal detachment follows the traumatic injury, causing significant vision loss or blindness.

Researchers from the Massachusetts Eye and Ear, Harvard Vanguard Medical Associates and Harvard Medical School Department of Ophthalmology report on the first study in 35 years that reviews the circumstances around retinal detachment after open globe injuries (OGI) and describes a new tool that may help ophthalmologists predict which patients are at higher risk after open globe trauma so they can potentially prevent retinal detachment from happening or identify – and repair – it more quickly, thus saving vision. The paper is posted online in the journal Ophthalmology and slated for the January print edition of that publication.

Researchers performed a retrospective review of 1,036 consecutive OGIs evaluated by the Eye Trauma Service of the Massachusetts Eye and Ear from Feb. 1, 1999, to Nov. 30, 2011. A total of 143 charts were unavailable for review or incomplete and so were excluded from analysis, yielding a total cohort of 893 eyes. Open globe injuries were treated urgently at presentation. After open globe primary repair, patients were admitted for 48 hours of intravenous antibiotics.

Demographic and clinical data from these 893 charts were entered into a database. Variables included were age, sex, date, time and place of injury, mechanism of injury, initial clinical findings, date and time of open globe repair, ocular trauma score, zone of , date of retinal detachment diagnosis, date of retinal detachment surgery, and last date of follow-up (censoring date).

Patients who developed retinal detachment were older (mean age, 46 vs. 38 years; P < 0.0001), had a poorer median visual acuity (light perception vs. 20/400; P < 0.001), were less likely to have a visual acuity of ≥20/200 (1.6% vs. 43%; P < 0.001), were more likely to have an afferent pupillary defect (34% vs. 8%; P < 0.001), and were more likely to have vitreous hemorrhage (85% vs. 32%; P < 0.001) compared with patients who did not develop RD. In both groups, most patients were male (78% vs. 80%; P = 0.65).

"We took this information, along with other variables, and created the Retinal Detachment after Open Globe Injury (RD-OGI) score," said Dean Eliott, M.D., senior author, associate director of the Mass. Eye and Ear Retina Service and Stelios Evangelos Gragoudas Associate Professor of Ophthalmology, Harvard Medical School. "After prospective validation with independent cohorts, the RD-OGI score may be useful to help the ophthalmologist predict which patients are at higher risk for after open globe trauma."

More information: www.aaojournal.org/article/S01… (13)00582-4/abstract

Related Stories

Anti-HIV drugs reduce the cause of some forms of vision loss

May 23, 2008

A potential new therapeutic use for anti-HIV drugs known as protease inhibitors has been suggested by a team of researchers from Harvard Medical School, Boston, and Inserm U848, France, as a result of their work in a mouse ...

Ranibizumab may prevent retinal detachment side effect

Apr 09, 2013

Proliferative vitreoretinopathy (PVR), or the formation of scar tissue in the eye, is a serious, sight-threatening complication in people recovering from surgical repair of retinal detachment. PVR is difficult to predict, ...

New view of origins of eye diseases

Apr 03, 2013

Using new technology and new approaches, researchers at Lund University in Sweden hope to be able to explain why people suffer vision loss in eye diseases such as retinal detachment and glaucoma.

Recommended for you

iPads detect early signs of glaucoma in Nepal eye screening

Oct 20, 2014

Using a tablet screening app could prove to be an effective method to aid in the effort to reduce the incidence of avoidable blindness in populations at high-risk for glaucoma with limited access to health care, according ...

Could reading glasses soon be a thing of the past?

Oct 19, 2014

A thin ring inserted into the eye could soon offer a reading glasses-free remedy for presbyopia, the blurriness in near vision experienced by many people over the age of 40, according to a study released today at AAO 2014, ...

User comments