Geographical Differences in Ophthalmic Trauma Outcomes and Risk Factors: The International Globe and Adnexal Trauma Epidemiological Eye Study (IGATES)

Abstract

Objectives: characterize the international variation in ophthalmic trauma and validate prognostic markers for low-, middle- and high income countries. Subjects/Methods:.Observational Multicentre cohort study using International Globe and Adnexal Trauma Epidemiological Eye Study (IGATES) to collect data on acute presentations with ophthalmic injury including open/closed globe injury, and/or Adnexal/orbital involvement, and/or Intraocular/ Intraorbital foreign body from April 2014 to August 2023. 5350 patients (5557 eyes) from 31 centers in 12 countries. Main outcome measures included demographics, mechanism and setting of injury, and presenting and final visual outcomes. Results: Male to female ratio of 3.6:1 and mean age 30.7 years-old (range 0.1 to 103 years-old, standard deviation 18.5). Age, gender, presenting and final best corrected visual acuity were strongly associated with country (p<0.005). Poor final visual outcomes were strongly associated with Ocular Trauma Score (p<0.005) and type of injury (p<0.005). Median BCVA LogMAR of open globe injuries (1 LogMAR) compared to closed globe injuries (0.2 LogMAR). Duration between injury and presentation and improvement in BCVA LogMAR were strongly associated with countries income classification with high-income countries (HIC) showing reduced duration to presentation (HIC 5 hours, LIC 28 hours) and increased improvement (-0.40 HIC, -0.19 LIC) when compared to low income countries (LIC’s). Conclusion: Country of injury, ocular trauma score and age were associated with presenting and final visual outcomes. IGATES provides an opportunity to collect global data on ophthalmic trauma to facilitate management and prevention strategies aimed towards improving outcomes.