VALUE OF OCULAR TRAUMA SCORE IN PREDICTING THE INCIDENCE OF RETINAL DETACHMENT AFTER CLOSED GLOBAL INJURY

Abstract

Background: One of the more serious complications of closed globe injuries is retinal detachment (RD), which frequently results in the loss of permanent vision if not treated promptly. The Ocular Trauma Score (OTS) was developed as an instrument that can be used to forecast visual outcomes in cases of ocular trauma. Its predictive efficacy on RD in particular, following closed globe injuries, however, is under-studyed. Objectives: To determine the predictive ability of the Ocular Trauma Score (OTS) in estimating the incidence of retinal detachment in closed globe injuries, as well as the relevance of the latter in clinical decision making and improved management. Place and duration of study: From June 2024 to November 2024 Ophthalmology Department, Combined Military Hospital Quetta. Methodology: This Prospective observational cohort study involved 100 patients who sustained injuries to the closed globe at a tertiary referral centre in a retrospective study. Demographic data of the patients, details of injury, OTS scores, and initial visual acuity were gathered. Incidents of retinal detachment were taken, and statistical analysis was done through the chi-square test to test the relation between the categories of OTS scores and the occurrence of RD. The average age of patients was 40 years, and the standard deviation was 15 years. Results: Among the 100 patients, the incidence of retinal detachment was 15%. Patients with an OTS score of 4 or 5 had an RD incidence of 18%, compared to only 4% in those with higher OTS scores (1–3). Statistical analysis revealed a significant correlation between lower OTS scores and higher RD risk (p = 0.03). Additionally, poor initial visual acuity (light perception or no light perception) was significantly associated with RD (p = 0.02). Factors such as vitreous hemorrhage, blunt trauma, and posterior segment involvement also increased RD risk. Conclusion: Ocular Trauma Score is a good indicator of the retinal detachment after closed globe injuries. The more serious injuries and poor visual acuity upon presentation are reflected by lower OTS scores, which are associated with a higher incidence of RD. This knowledge may help clinicians recognise patients who are at a higher risk of retinal detachment and help intervene early.