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Clinical, radiographic, and intraoperative risk factors for retinal detachment after open globe injury

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Abstract

Purpose

Retinal detachment (RD) is a vision-threatening complication of open globe injuries (OGI). This study sought to assess clinical, radiographic, and intraoperative risk factors for RD after OGI. A secondary goal was to test the retinal detachment after open globe injury (RD-OGI) score.

Methods

Records of patients undergoing OGI repair at a single trauma center over 3 years were reviewed using a retrospective case series design. Eyes that were enucleated or lost to follow up within 30 days of OGI without evidence of RD were excluded. Potential risk factors for RD development were assessed by logistic regression or chi-square tests were appropriate and were entered into a multivariate logistic regression if significant on univariate analysis. Risk of RD for each eye was categorized by its RD-OGI score.

Results

Seventy-three eyes (72 patients) were included. In univariate analysis, afferent pupillary defect, worse visual acuity, posterior injury, vitreous hemorrhage, and posterior segment volume loss (PSVL) on CT were strong predictors of RD. In multivariate analysis, only PSVL on CT (adjusted OR 10.8, P = 0.025) maintained a statistically significant association with RD risk. At 1 year, 5% of low-risk eyes, 20% of moderate-risk eyes, and 67% of high-risk eyes developed RD. These rates were not significantly different from the RD-OGI derivation or validation cohorts (P = 0.90 and P = 0.67, respectively).

Conclusion

PSVL on CT increases the risk of RD after OGI. The RD-OGI Score was a good prognostic tool for assessing RD risk after OGI in this population.

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Data availability

De-identified patient data were contained in a single spreadsheet, which is available from any author upon reasonable request.

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Funding

The authors declare no outside sources of funding for this research.

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Authors and Affiliations

  1. University of Louisville School of Medicine (Graduated Student), 301 E. Muhammad Ali Blvd, Louisville, KY, 40202, USA

    Travis Bales, Tyler Ogden & Harpal S. Sandhu

  2. Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, 40202, USA

    Harpal S. Sandhu

Authors
  1. Travis Bales
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  2. Tyler Ogden
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  3. Harpal S. Sandhu
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Contributions

All authors contributed to the study conception and design. Material preparation and initial data collection were performed by Travis Bales. Analysis was performed by Harpal S. Sandhu, MD. The first draft of the manuscript was written by Travis Bales with substantial contribution and revision by Harpal S. Sandhu, MD. Additional data collection and subsequent manuscript revision was performed by Tyler Ogden. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Harpal S. Sandhu.

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Conflict of interest

The authors declare that there is no conflict of interest.

Research ethics and patient consent

In this retrospective study, care was taken to protect the identities of human subjects. Patient names were substituted with a numerical code. De-identified patient data were contained in a single spreadsheet. The study was approved by the University of Louisville Institutional Review Board (Study ID# 19.0068) and conducted in accordance with the Declaration of Helsinki and the Health Insurance Portability and Accountability Act (HIPAA). An informed consent waiver was approved by the IRB in accordance with United States Code of Federal Regulations [45 CFR 46.116 (d)].

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Bales, T., Ogden, T. & Sandhu, H.S. Clinical, radiographic, and intraoperative risk factors for retinal detachment after open globe injury. Int Ophthalmol 41, 815–823 (2021). https://doi.org/10.1007/s10792-020-01635-7

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  • DOI: https://doi.org/10.1007/s10792-020-01635-7

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