Epidemiology of Ocular Trauma and Predictive Modeling of Visual Outcomes: A 12-Year Retrospective Study at a Tertiary Hospital in China.

Abstract

Background: Ocular trauma is a visually and economically devastating cause of visual loss. This study investigated the prevalence and clinical characteristics of ocular trauma in central and northern China, and assessed prognostic factors.

Methods: Cases of ocular trauma that underwent surgical treatment in a tertiary hospital in China between January 1, 2012, and December 31, 2023, were reviewed. All patient data were collected, including demographic information, type of injury, cause of injury, overall condition, number of surgeries, structural damage, surgical complications, and initial and final visual acuity (VA). We constructed three models to explore the prognostic factors of final VA: linear regression, regression tree, and random forest.

Results: Over 12 years, 1019 patients (1019 eyes) with ocular trauma underwent surgery, of which 836 were open globe injuries. Patients were predominantly male (80.8%), with an average age of 31.1 years. The most at-risk age group was 41-50 years old. Farmers (33.3%) and students (20.9%) were the most common occupations. The most frequent complication was vitreous hemorrhage (95.7%). Most patients required three surgeries (42.2%). During vitrectomy, proliferative vitreoretinopathy and elevated intraocular pressure were observed in 735 patients (72.1%). The final VA ranged from 0 to 3.00 logMAR with a mean of 1.10±0.43 logMAR. Among the three models, the random forest performed the best. Ocular structural damage and surgical complications, along with the number of surgeries, were important factors affecting the visual prognosis.

Conclusion: Individuals at high risk should be given extra care, as traumatic and surgical complications are the main prognostic factors.