Presenting clinical characteristics of open globe injuries in ocular trauma: baseline analysis of cases in the ASCOT national clinical trial.

Autor: Cro S; Imperial Clinical Trials Unit, Imperial College London, London, UK. s.cro@imperial.ac.uk., Partington G; Imperial Clinical Trials Unit, Imperial College London, London, UK., Cornelius VR; Imperial Clinical Trials Unit, Imperial College London, London, UK., Banerjee PJ; Frimley Health NHS Foundation Trust, London, UK., Zvobgo TM; Moorfields Eye Hospital NHS Foundation Trust, London, UK., Casswell EJ; Moorfields Eye Hospital NHS Foundation Trust, London, UK., Shahid S; Moorfields Eye Hospital NHS Foundation Trust, London, UK., Bunce C; Moorfields Eye Hospital NHS Foundation Trust, London, UK.; The Royal Marsden NHS Foundation Trust, London, UK., Robertson E; Moorfields Eye Hospital NHS Foundation Trust, London, UK., Murphy C; King's Clinical Trials Unit at Kings Health Partners, King's College London, London, UK., Kelly J; King's Clinical Trials Unit at Kings Health Partners, King's College London, London, UK., Charteris DG; Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2023 Jun; Vol. 37 (8), pp. 1732-1740. Date of Electronic Publication: 2022 Sep 14.
DOI: 10.1038/s41433-022-02206-z
Abstrakt: Background/objectives: The Adjunctive Steroid Combination in Ocular Trauma (ASCOT) trial is a unique pragmatic, multi-centre, patient and assessor masked, randomised controlled trial. We evaluate the clinical characteristics and pathology of this large trial cohort of patients with open globe injuries undergoing vitreoretinal surgery, including the associations between patient characteristics and their baseline vision.
Subjects/methods: We (i) summarise demographics, injury history and ocular history of the 280 participants recruited into the ASCOT trial using descriptive statistics; (ii) analyse the national and seasonal variation across England and Scotland in these participant characteristics; and (iii) explore the associations between participant demographic, trauma history, ocular history and presenting baseline visual acuity (measured using the Early Treatment Diabetic Retinopathy Study, ETDRS) using multivariable regression analyses.
Results: The majority of participants with open globe penetrating injuries were of white ethnicity (233, 84%), male (246, 88%), with a median age of 43 years (IQR 30-55 years). There was considerable variability in presenting visual acuity with 75% unable to read any letters on the ETDRS chart, whilst the median ETDRS letter score was 58 (IQR 24-80) for those who could read ≥1 letter. The most common causes of injury were workplace related (31%) or interpersonal violence (24%). Previous eye surgery, visual axis corneal scar, lens status, hyphaemia and vitreous haemorrhaging were found to be associated with presenting vision as measured by the ETDRS chart.
Conclusion: The ASCOT trial provides valuable insights into the spectrum of pathology of patients with open globe eye injuries undergoing vitreoretinal surgery. The identified causes of injury and clinical presentation of the cases will help in training and resource planning to deal with these often challenging surgical cases.
Trial Registration: EudraCT No. 014-002193-37. HTA Project 12/35/64.
(© 2022. The Author(s).)
Databáze: MEDLINE
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