Clinical characteristics and outcomes of fall-related open globe injuries in Japan

Graefes Arch Clin Exp Ophthalmol. 2018 Jul;256(7):1347-1352. doi: 10.1007/s00417-018-3959-z. Epub 2018 Mar 15.

Abstract

Purpose: To investigate the clinical characteristics and visual outcomes in patients with fall-related open globe injuries and to evaluate differences between fall-related and non-fall-related open globe injuries in Japan.

Methods: A retrospective review of patients with open globe injury who presented to Japan-Clinical Research of Study (J-CREST) hospitals between 2005 and 2015 was enrolled. Clinical information including age, sex, initial visual acuity, final visual acuity, type of injury, status of the crystalline lens, zone of injury, wound length, presence of retinal detachment, proliferative vitreoretinopathy, expulsive hemorrhage, and endophthalmitis was recorded.

Results: A total of 374 eyes were enrolled, of which 120 (32.1%) suffered from fall-related injury with average age of 73.7 ± 15.9 years (range, 11-101 years). A majority of patients were female (55.8%). Of 120 patients with fall-related injury, 109 (90.8%) presented with rupture and 11 (9.2%) with laceration. A multiple regression analysis revealed that final visual acuity was significantly associated with initial visual acuity (r = 0.99, P < 0.001). Compared to non-fall-related open globe injuries, fall-related open globe injuries were associated with elderly age, female sex, poorer initial and final visual acuity, rupture, absence of the lens, larger wound size, retinal detachment, expulsive hemorrhage, and absence of endophthalmitis (P < 0.01).

Conclusions: Fall-related open globe injuries were more frequent in elderly female and accompanied by larger wound lengths and severer ocular complications. Visual outcomes in patients with fall-related open globe injuries were related to initial visual acuity.

Keywords: Fall; Initial visual acuity; Open globe injury; Rupture.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Eye Injuries, Penetrating / diagnosis
  • Eye Injuries, Penetrating / epidemiology
  • Eye Injuries, Penetrating / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods*
  • Rupture
  • Sex Distribution
  • Trauma Severity Indices
  • Visual Acuity*
  • Young Adult