Ulus Travma Acil Cerrahi Derg. 2023; 29(11): 1280-1287 | DOI: 10.14744/tjtes.2023.72470

The relationship between computed tomography findings and ocular trauma and pediatric ocular trauma scores in pediatric globe injuries: Does imaging have prognostic and diagnostic value?

Dilara Pirhan¹, Sevgi Subasi¹, Büþra Kurt Musaoðlu¹, Burcu Alparslan², Levent Karabaþ^1
1Department of Ophthalmology, Kocaeli University, School of Medicine, Kocaeli, Türkiye
²Department of Radiology, Kocaeli University, School of Medicine, Kocaeli, Türkiye

BACKGROUND: The aim of this study is to assess the relationship between computed tomography (CT) findings in open globe injuries (OGIs) in pediatric patients and the pediatric ocular trauma score (POTS) and OTS in pediatric ocular trauma.
METHODS: In 34 pediatric patients with OGI, CT findings were categorized into nine main categories: Scleral irregularity, lens dislocation, abnormal vitreous density, choroid-retinal layer thickening, preseptal thickness increase, intraocular foreign body and air, vitreous hemorrhage, retinal detachment, and perforation. The relationship between different types and numbers of CT findings and the POTS and OTS was evaluated.
RESULTS: The mean age of trauma was 6.6±3.1. Of the patients, 9 (26.5%) were female and 25 (73.5%) were male. The most com-mon CT findings are scleral irregularity and increased preseptal thickness (47.1%). In univariate analysis, a P<0.05 was found between 16 patients with 1 or less CT findings (median POTS value 80 [71.25–90.0]) and 11 patients with 2 or 3 CT findings (median POTS value 60 [15–70]). A P<0.05 was found between 16 patients with 1 or less CT findings (median POTS value 80 [71.25–90.0]) and 7 patients with 4 or more CT findings (median POTS value 45 [25–80]). A P > 0.05 was found between 11 patients with 2 or 3 CT findings (median POTS value 60 [15–70]) and 7 patients with 4 or more CT findings (median POTS value 45 [25–80]). No significant difference was found between the number of CT findings and OTS stages. While POTS was significant (P<0.05) in patients with ab-normal vitreous density (median 45 [30–69.6]), OTS value was not significant (P>0.05). There was no significant difference between POTS and OTS in other CT findings.
CONCLUSION: The number of CT findings may assist in predicting POTS and, consequently, estimating visual prognosis in pediatric patients with OGI. In emergency situations where, sufficient clinical data are unavailable, the objective findings from CT may help in assessing the severity of ocular trauma and potentially predicting long-term visual outcomes.

Keywords: Computed tomography, ocular trauma; pediatric ophthalmology; visual acuity.

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Pediatrik glob yaralanmalarýnda bilgisayarlý tomografi bulgularý ile oküler travma ve pediatrik oküler travma skorlarý arasýndaki iliþki: görüntülemenin prognostik ve tanýsal deðeri var mý?

Dilara Pirhan¹, Sevgi Subasi¹, Büþra Kurt Musaoðlu¹, Burcu Alparslan², Levent Karabaþ^1
1Kocaeli Üniversitesi, Týp Fakültesi, Göz Hastalýklarý Ana Bilim Dalý, Kocaeli, Türkiye
²Kocaeli Üniversitesi, Týp Fakültesi, Radyoloji Ana Bilim Dalý, Kocaeli, Türkiye

AMAÇ: Bu çalýþmanýn amacý, pediatrik hastalarda açýk glob yaralanmalarýnda bilgisayarlý tomografi (BT) bulgularý ile pediatrik oküler travma skoru (POTS) ve oküler travma skoru (OTS) arasýndaki iliþkiyi deðerlendirmektir.
GEREÇ VE YÖNTEM: Açýk glob yaralanmasý (AGY) olan 34 pediatrik hastada BT bulgularý 9 ana kategoriye ayrýldý: Skleral irregularite, lens dislokasyonu, anormal vitreus dansitesi, koryoretinal tabaka kalýnlaþmasý, preseptal kalýnlýk artýþý, intraoküler yabancý cisim ve hava, vitreus hemorajisi, retina dekolmaný ve perforasyon. Farklý tip ve sayýdaki BT bulgularý ile POTS ve OTS arasýndaki iliþki deðerlendirildi.
BULGULAR: Ortalama travma yaþý 6.6±3.1 idi. Hastalarýn 9’u kadýn (%26.5) 25’i (%73.5) erkekti. En yaygýn BT bulgularý skleral irregülarite ve pre-septal kalýnlýk artýþýdýr (%47.1). Çok deðiþkenli analizde 1 veya daha az BT bulgusu olan 16 hasta (median POTS deðeri 80 (71.25-90.0)) ile 2 ya da 3 BT bulgusu olan 11 hasta (median POTS deðeri 60 (15-70)) arasýnda p deðeri <0.05 bulundu. 1 veya daha az BT bulgusu olan 16 hasta (median POTS deðeri 80 (71.25-90.0)) ile 4 veya daha fazla BT bulgusu olan 7 hasta (median POTS deðeri 45 (25-80)) arasýnda p deðeri <0.05 bulundu. 2 ya da 3 BT bulgusu olan 11 hasta (median POTS deðeri 60 (15-70)) ile 4 veya daha fazla BT bulgusu olan 7 hasta (median POTS deðeri 45 (25-80)) arasýnda p deðeri>0.05 bulundu. BT bulgu sayýsý ile OTS evreleri arasýnda anlamlý farklýlýk bulunamadý. Anormal vitreus dansitesi var olan hastalarda (median 45 (30-69.6)) POTS anlamlý iken (p<0.05) OTS deðeri anlamlý bulunmadý (p>0.05). Diðer BT bulgularýnda ise POTS ve OTS arasýnda anlamlý fark bulunmadý.
SONUÇ: BT bulgularýnýn sayýsý, AGY olan pediatrik hastalarda POTS skorunu öngörmede ve dolayýsýyla görsel prognozu tahmin etmeye yardýmcý olabilir. Yeterli klinik verilerin bulunmadýðý acil durumlarda, BT'nin objektif bulgularý oküler travmanýn ciddiyetini ve muhtemelen uzun vadeli görsel sonucunu tahmin etmeye yardýmcý olacaktýr.

Anahtar Kelimeler: Bilgisayarlý tomografi, görme keskinliði; oküler travma; pediatrik oftalmoloji.

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