한국인 개방성 안구손상 환자에 적용한 수정안외상점수의 유용성
The Availability of Modified Ocular Trauma Score in Korean Patients with Open Globe Injury
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 한국인에서 개방성 안구 손상 환자의 임상 양상을 분석하여 안외상점수 계산 방법을 수정하고, 최종 시력의 예측에 수정 안외상점수의 유용성을 알아보고자 하였다. 대상과 방법: 저자들은 2000년 1월부터 2010년 9월까지 개방성 안구 손상으로 내원한 242명 242안을 대상으로 하여 안외상점수를계산할 때 사용되는 인자 중 안내염과 관통상 여부를 제외하고 손상 위치, 유리체 출혈, 수정체 손상 및 눈꺼풀 열상을 추가하여 국내실정에 맞도록 수정하였다. 수정된 안외상점수의 유용성을 확인하기 위하여 2010년 9월부터 2011년 12월까지 개방성 안구 손상으로내원한 29명 29안을 대상으로 의무 기록을 후향적으로 검토하여 수정된 안외상점수를 적용하였을 때 최종 시력이 0.02 미만인 경우에대한 양성예측도와 음성예측도를 계산하여 원래의 안외상점수 방법과 비교하였다. 결과: 안외상점수는 최종시력이 0.02 미만에 대한 양성예측도는 75.3%, 음성예측도는 90.8%가 되도록 수정되었다. 이는 원래의 안외상점수 방법의 양성예측도 70.1%, 음성예측도 89.8%보다 높았으나 통계적 차이는 보이지 않았다(p=0.5956, p=0.9370). 새로운 환자를 대상으로 적용하여 확인하였을 때 수정 안외상점수는 양성예측도 75.0%, 음성예측도 90.5%로 유용하였다. 결론: 수정된 안외상점수는 원래의 안외상점수 체계와 양성예측도 및 음성예측도가 유사하였으며, 국내 실정에 맞도록 인자가 조정되었으므로 향후 유용하게 사용될 수 있을 것으로 생각한다.
Abstract
Purpose: To modify the ocular trauma score (OTS) model by analyzing the clinical characteristics of Korean patients with open globe injury and to determine the availability of the modified OTS in predicting the final visual acuity. Methods: Among the prognostic factors in the original OTS, endophthalmitis and perforating injury were excluded, and wound location, vitreous hemorrhage, lens damage, and lid laceration were added to the modified OTS based on the data of 242 patients with open globe injury from January 2000 to September 2010. To determine the availability of the modified OTS, 29 patients from September 2010 to December 2011, not included in the previous data, were retrospectively reviewed,and the positive and negative predictive values for assessment of final visual acuity less than 0.02 were calculated by the original and modified OTS. Results: The modified OTS was applied to the previous data, and the positive predictive value was 75.3% and negative predictive value was 90.8%. By using the original OTS, the positive predictive value was 70.1% and negative predictive value was 89.8%. The values of the modified OTS was higher than those of the original OTS, but it was not statistically significant (p = 0.5956, p = 0.9370). When the modified OTS was applied to the new 29 patients, the positive and negative predictive values were 75.0% and 90.5%, respectively. Conclusions: The prognostic factors of the original OTS were modified based on the previous data and the positive and negative predictive values of final visual acuity by modified OTS were similar to those by the original OTS. The modified OTS would be useful in analyzing the patients with open globe injuries and could be used as a prognostic model for Korean patients.
참고문헌 (39)
- Juhng JH, "A statistical observation of the ocular Injuries (I)", J Korean Ophthalmol Soc, 13, pp.157~161 (1972)
- Lee SW, "A statistical observation on the eye injuries in the out-patients", J Korean Ophthalmol Soc, 9, pp.15~19 (1968)
- Kang BN, "A statistical observation of the ocular injuries", J Korean Ophthalmol Soc, 21, pp.497~503 (1980)
- Cho HW, "A clinical study of ocular injuries", J Korean Ophthalmol Soc, 23, pp.1021~1027 (1982)
- Choi SH, "A clinical study of ocular injuries", J Korean Ophthalmol Soc, 28, pp.623~633 (1987)
- Hwang YJ, "A clinical studies of ocular injuries", J Korean Ophthalmol Soc, 20, pp.175~181 (1979)
- 한용수, "안외상의 통계적 고찰", 대한안과학회지, 46(1), pp.18~18 (2005), 대한안과학회
- Lee YO, "A clinical study of the ocular injuries", J Korean Ophthalmo Soc, 28, pp.395~401 (1987)
- Chung SM, "A clinical study of penetrating ocular injuries", J Korean Ophthalmol Soc, 38, pp.491~498 (1997)
- Rhee HC, "Industrial Ocular Injury in St.Mary’s industrial accident hospital", J Korean Ophthalmol Soc, 30, pp.995~1001 (1989)
- Kim JY, "Clinical evaluation of penetration ocular injuries", J Korean Ophthalmol Soc, 33, pp.919~924 (1992)
- Kim HJ, "A clinical observation of perforating ocular injuries", J Korean Ophthalmol Soc, 30, pp.123~130 (1989)
- Kim SS, "A clinical study of industrial ocular injuries", J Korean Ophthalmol Soc, 29, pp.393~403 (1988)
- Esmaeli B, "Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study", Ophthalmology, 102, pp.393~400 (1995)
- Sternberg P Jr, "Multivariate analysis of prognostic factors in penetrating ocular injuries", Am J Ophthalmol, 98, pp.467~472 (1984)
- De Juan E Jr, "Penetrating ocular injuries. Types of injuries and visual results", Ophthalmology, 90, pp.1318~1322 (1983)
- Rahman I, "Open globe injuries: factors predictive of poor outcome", Eye (Lond), 20, pp.1336~1341 (2006)
- Dalma-Weiszhausz J, "Vitrectomy for ocular trauma: a question of timing?", Eur J Ophthalmol, 6, pp.460~463 (1996)
- Pieramici DJ, "Open-globe injury. Update on types of injuries and visual results", Ophthalmology, 103, pp.1798~1803 (1996)
- Hutton WL, "Factors influencing final visual results in severely injured eyes", Am J Ophthalmol, 97, pp.715~722 (1984)
- Punnonen E, "Prognosis of perforating eye injuries with intraocular foreign bodies", Acta Ophthalmol (Copenh), 67, pp.483~491 (1989)
- Matthews GP, "Visual outcome and ocular survival in patients with retinal detachments secondary to open- or closedglobe injuries", Ophthalmic Surg Lasers, 29, pp.48~54 (1998)
- Brinton GS, "Surgical results in ocular trauma involving the posterior segment", Am J Ophthalmol, 93, pp.271~278 (1982)
- Martin DF, "Perforating (throughand- through) injuries of the globe. Surgical results with vitrectomy", Arch Ophthalmol, 109, pp.951~956 (1991)
- Barr CC, "Prognostic factors in corneoscleral lacerations", Arch Ophthalmol, 101, pp.919~924 (1983)
- Groessl S, "Assault-related penetrating ocular injury", Am J Ophthalmol, 116, pp.26~33 (1993)
- Unal MH, "Validation of the ocular trauma score for intraocular foreign bodies in deadly weaponrelated open-globe injuries", Ophthalmic Surg Lasers Imaging, 39, pp.121~124 (2008)
- Unver YB, "Ocular trauma score in open-globe injuries", J Trauma, 66, pp.1030~1032 (2009)
- Uysal Y, "Ocular Trauma Score in childhood open-globe injuries", J Trauma, 65, pp.1284~1286 (2008)
- Han SB, "Visual outcome after open globe injury and its predictive factors in Korea", J Trauma, 69, pp.E66~E72 (2010)
- Kuhn F, "Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries", Ophthalmol Clin North Am, 15, pp.139~143 (2002)
- Kuhn F, "The Ocular Trauma Score(OTS)", Ophthalmol Clin North Am, 15, pp.163~165 (2002)
- 이연희, "개방성 안구손상 환자의 시력 예후 인자와 안외상점수의 예측도", 대한안과학회지, 53(6), pp.825~832 (2012), 대한안과학회
- 송민혜, "안외상으로 인한 입원환자의 통계적 고찰", 대한안과학회지, 50(4), pp.580~587 (2009), 대한안과학회
- May DR, "The epidemiology of serious eye injuries from the United States Eye Injury Registry", Graefes Arch Clin Exp Ophthalmol, 238, pp.153~157 (2000)
- 유준호, "안외상의 통계적 고찰과 안외상 점수를 통한 평가", 대한안과학회지, 52(9), pp.1024~1029 (2011), 대한안과학회
- Acar U, "A new ocular trauma score in pediatric penetrating eye injuries", Eye (Lond), 25, pp.370~374 (2011)
- Schmidt GW, "Vision survival after open globe injury predicted by classification and regression tree analysis", Ophthalmology, 115, pp.202~209 (2008)
- Man CY, "Visual outcome after open globe injury : a comparison of two prognostic models – the ocular trauma score and the classification and regression tree", Eye (Lond), 24, pp.84~89 (2010)