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Citation
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Bowe T, Serina A, Armstrong M, Welcher J, Adebona O, Gore C, Staffa SJ, Zurakowski D, Shah AS. Am. J. Ophthalmol. 2021; ePub(ePub): ePub. |
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Abstract
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PURPOSE: To evaluate the timing of ocular hypertension (OHT) after pediatric closed-globe injury (CGI) and traumatic hyphema. We hypothesize that OHT will occur at different times based on injury characteristics.
DESIGN: Retrospective, cohort study.
METHODS: SETTING: : Single-center, tertiary-care, pediatric hospital. PARTICIPANTS: Subjects included patients ≤18 years of age at the time of injury who suffered CGI and traumatic hyphema between 2002 and 2019. OBSERVATION PROCEDURE(S): Intraocular pressure and injury demographics were abstracted for every visit after injury. OHT was defined as >21 mmHg at presentation or after a reading of ≤21 mmHg at a prior visit. MAIN OUTCOME MEASURES: The primary outcome measure was the timing of OHT categorized into 4 periods: presentation, acute (day 1-7), sub-acute (day 8-28), or late (day >28). Secondary outcome measures were identification of risks factors for OHT by multivariable logistic regression.
RESULTS: OHT occurred in 119 (39%) of the 305 subject eyes. OHT occurred in 35 patients at presentation, 69 times acutely, 35 times sub-acutely, and 36 times late. Pupil damage predicted acute-period OHT (p=0.004). OHT at presentation predicted sub-acute period OHT (p=0.004). Iridodialysis and cataract predicted late-period OHT (p=0.007 and p<0.001, respectively).
CONCLUSIONS: OHT after CGI and traumatic hyphema in pediatric patients is common. Injury demographics predict this complication. Integration of these risk factors with current literature allows proposal of a risk-stratification tool to guide efficient surveillance for OHT.
Language: en |