Lima GV, Serrano LME

Language: Spanish
References: 16
Page: 130-136
PDF size: 63.08 Kb.

ABSTRACT

Background. Visual deficiency (VD) is an indirect clinical sign of open-globe trauma, but its value for detecting the latter is unknown. The probability of having open-globe trauma whenever VD existed was identified, as well as the cut-point that could be more useful for detection at primary care. Methods. Patients with open-globe trauma (groups 1) paired by agent (blunt or sharp) to patients with closed-globe trauma of similar age were evaluated. The rate of VD (mild: grade › 1, moderate: grade › 2, severe: grade › 3 and absolute: › 4, system for classifying mechanical injuries of the eye) was compared between groups, overall and by agent (χ²). The probability of having open-globe trauma (odds ratio, OR), and sensibility and specificity in each VD category were determined; the category with the highest value was identified by receiver operator characteristics (ROC) curves. Results. 100 patients per group were evaluated (age 2-84, mean 26.6), 118 had mild (59%), 93 moderate (46.5%), 81 severe (40.5%) and 17 absolute VD (8.5%); all the categories of VD were more frequent in group 1. The rate of open-globe trauma was significantly higher in patients with VD (p ‹ 0.001, OR ≥ 14), the most useful value in the ROC curves was that of severe deficiency (grade › 3) in trauma with a blunt agent. Conclusions. Although VD is more frequent in patients with open-globe trauma, its usefulness for diagnosis is greater in trauma caused by a blunt agent; the most useful cut-point (grade › 3) should be evaluated in open-population, in order to identify its predictive values.

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