안외상의 통계적 고찰과 안외상 점수를 통한 평가
A Statistical Observation of Ocular Injuries and Visual Predictive Value of Ocular Trauma Score
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목적: 안외상 환자의 임상양상을 살펴보아 이를 예방에 이용하고 안외상 점수가 최종 시력 및 예후에 갖는 예측성을 알아보아 이를치료에 이용하고자 하였다. 대상과 방법: 2009년 5월부터 2009년 12월까지 본원 응급실과 외래로 내원한 안외상 환자 1257명 1341안을 대상으로 후향적으로 조사하여 성별, 연령, 외상 원인, 진단명, 수술명, 손상부위, 초기 시력과 최종 시력, 합병증을 확인하였다. 초기 시력, 안구파열, 안구 관통상, 안내염, 망막박리, 구심성동공장애 유무를 통해 안외상 점수를 평가하고, 최종 시력과의 연관성을 알아보았다. 결과: 남자가 79.0%로 많았으며 연령 분포는 남자는 40대, 여자는 20대가 가장 많았다. 진단은 남자는 각막미란, 여자는 안와골절이가장 많았으며 남녀 모두에서 각막미란과 안와골절, 안와좌상, 전방출혈 등이 많은 비율을 차지하였다. 안외상 점수가 44점 이하인경우는 6안(0.7%), 91점부터 100점 사이는 737안(79.9%)으로 최종 시력과 연관성을 보였다. 고찰: 안외상의 최근 경향을 알 수 있었으며 안외상 점수가 최종 시력 예측에 도움이 되고, 이를 예방과 치료에 활용할 수 있을 것으로생각한다.
Abstract
Purpose: To investigate the clinical characteristics of ocular injuries for the prevention and predictability of visual prognosis and the treatment of ocular injuries using the ocular trauma score. Methods: A retrospective survey was performed in 1341 eyes of 1257 patients, who visited Korea University Medical Center from May 2009 to December 2009. The sex, age, causes, diagnosis, primary ocular surgery, injury site, initial and final visual acuities and complications were statistically reviewed. The ocular trauma score was calculated by assigning certain numerical raw points to the following six variables: initial visual acuity, globe rupture, endophthalmitis, perforating injury, retinal detachment, and a relative afferent pupillary defect. The correlation of the ocular traumascore with the final visual acuity was investigated. Results: The incidence of ocular injuries was higher in males (79.0%) than in females and was more common in people in their 40s and 20s respectively. Among the patient the diagnoses, corneal erosion was most common in males, orbital wall fracture was most common in females, and corneal erosion, orbital wall fracture, orbital contusion, and hyphema were most common overall. An ocular trauma score was less than 44 in 6 eyes (0.7%), 9 eyes (1.0%) between a score of 45 and 65, 48 eyes (5.2%) between a score of 66 and 80, 122 eyes (13.2%) between a score of 81 and 90, and 737 eyes (79.9%)between a score of 91 and 100. Conclusions: The present study determined that the ocular trauma score showed a good visual predictive value and could be used in prevention and treatment of ocular injuries.
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